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OB Final 2011

OB Final Study Guide 2011

QuestionAnswer
Family center care includes mom and husband and kids, whole family
Nurse does not give 6am seizure meds at 10am pt ambulates and falls. The nurse is sued for? malpractice
describe evidenced based practice questions why something is effective and is there a better approach
why was family centered maternity care developed in response to parents requests that infants be with them
WIC provides supplemental food supplies to low income women who are pregnant or nursing
a nursing process that is controlled and directed toward finding solution or options is called critical thinking
write a correct NI for giving pt 100ml every 2 hrs Provided 100 ml of fluid of choice every 2hrs while awake
process of determining outcomes and intervention of care is which stage of the nursing process planning
what kind of delivery is a nurse midwife qualified to perform vaginal
give examples of a independent nursing function teaching (prenatal care)
what is a therapeutic nursing response to “I am afraid to have a cesarean” “what concerns you most about a cesarean”
how can a nurse best assist a family to cope with stress helping to identify family strengths
what type of family does a 3 year old with 2 adoptive moms belong to same sex parents
what do families that deal well with stress believe about stress that some stress is normal
NI: an appropriate goal for a patient with a different ethnic background adapt ethnic practices to health needs
5 functions of nursing process and family affective, economic, healthcare, reproductive, socialization
non traditional families included multigenerational, same sex
fertilization most likely takes place in the fallopian tubes
what supplement may prevent neural tube defects folic acid
what is one of the things you should do for your patient, as their advocate ensure access to available resources
what kind of disorders are men more commonly affected by X linked disorders
female chromosome XX
Trisomy 21 Syndrome's common name Down's Syndrome
what is one female secondary sexual characteristic (and usually the first to develop) breast development
if a womens menstruation occurs every 28 days, what day will she most likely ovulate at 14 days
what shape can you use to describe a non pregnant uterus with pear
if menstruation began on October 5 and normally a 28 day cycle ovulation will occur when Oct 19
breastfeeding pt with warm, red, painful breast, temp, & flu like symptoms NI? notify HCP
what are the phases of a normal ovarian cycle Ovulatory, follicular, luteal
the part of the uterus that renews monthly in the absence of pregnancy endometrium
twins that are from 2 different ova and may be different sexes are what kind of twins dizygotic twins
what is the configuration of the umbilical cord vessels 2 arteries and 1 vein
what does cephalocaudal growth pattern mean the brain develops first
what is the purpose of the foramen ovale to shunt blood from the right atrium to the left atrium
what is the function of the ductus arteriosus carry blood from pulmonary arteries to the descending aorta
a pregnant women at 20 weeks gestation fundal measures 20cm even w/umbilicus, is this normal growth yes
what is the appropriate NI for pt in 3 trimester complaining of feeling dizzy and agitated while taking vitals have patient turn to her left side and recheck BP in 5 minutes
“I'll eat 2 large meals a day with frequent protein snacks” Does this patient understand teaching about ways to avoid morning Nausea? No, needs additional teaching
vascular volume increases during pregnancy 30 – 50%, why? to provide adequate perfusion to the placenta
why do mom's visit HCP every 4 weeks in first trimester to monitor condition of mom and fetus
what is a good therapeutic response to a mom who fears something happening to her baby tell me about your concerns
step in maternal role attachment that relates to mom giving up certain aspects of her previous life grief work
what is an example of a man trying on fathering behaviors coaching little league ball
why might an Asian woman refuse to meet your eyes while you are teaching her cultural beliefs
a women who has female genitalia mutilation is at risk for obstructed labor, laceration, hemorrhage, infection
can you delegate elevating a breast lumpectomy patient's arm to promote lymph node drainage to CNA yes
what is the grava of a women with first pregnancy, term, living, 2nd, preterm, living 3rd miscarriage, 4th current pregnancy G 4 P1112
do you give a drug for the sole purpose of fetal therapy No
Non reassuring pattern of the fetal HR is noted and mother is left side lying change her position the right.
Nurse’s should teach the woman and her support person (about delivery procedures; initially) about the monitoring equipment and discuss any questions they have related to electronic monitoring.
Contractions are 4 to 5 min. apart, and last for 30 sec. in active labor nurse’s should ask assessment questions when? when the contraction is over.
Best time to teach non pharmacological pain control methods is the latent phase.
Method of pain management that would be safest for a Gravida 3 Para 2002 admitted at 8 cm is breathing and relaxation techniques.
Nerve block used in labor that provides anesthesia to the lower vagina and perineum is a pudendal.
NI after epidural narcotic Monitor respirations hourly
the least favorable maternal position is supine
the first type of breathing technique is slow paced
Labor pain in the back- have support person apply firm pressure to the lower back.
Excessive anxiety in labor heightens the woman’s sensitivity to pain by increasing muscle tension.
24 year old G2 P1001 who is in active labor at 39 weeks prenatal data most important is positive result for Group B strep.
A patient with leaking of fluid at 34 weeks requires immediate notification of HCP.
A 22 year old G3 P2002 at 38 weeks and contractions every 3 min., who is requesting to use the bathroom to have a bowel movement should be assessed first.
Factors for treatment modality are personal and family history, financial resources, and maternal age.
4P's of labor Powers, Passage, Passenger, and Psyche
Fetal factors that regulate HR autonomic nervous system, Baroreceptors, chemoreceptors, and adrenal glands
Amnitomy care monitor fetus for non reassuring signs
oxytocin set up secondary infusion and controlled by infusion pump
cervix prep for induction prostaglandin
why use a urinary catheter during a focepts birth because full bladder reduces room in pelvis
medium episiotomy, NI apply cold packs promptly
NI targeted toward prevent hemorrhage after C section access fundas regularly for firmness
fundus levels at umbilicus, firm, midline, 24 hrs after cesarean document normal finding
3hrs post partum, difficulty urinating, finally urinates 100mL, the next NI should be to? reassess fundal height
what can aid in episiotomy healing warm sits bath
prevent breast engorgement wear well fitted bra
s/s new mom should report reappearance of red locia
father reluctant to spoil newborn, does not pick up baby when he cries. NI? explain baby cries to communicate
parent care for newborn give positive feed back
what do surfactants do in the lungs? keeps aveoli open between breaths
why does the foramen ovale close because pressure in Left atrium is higher than right
brown fat is to? maintenance of temperature
prevent jaundice regular and adequate breastfeeding
why infection signs are subtle in newborn? because leukocyte and inflammatory signs are immature
infant shoulder discotia, asses for? clavicle fracture
what newborn reflex helps with breastfeeding rooting
where is the best site to do a glucose determination on an infant lateral heel
newborn axillary temp 35.9 (96.6), NI? place in a radiant warmer
steps to returning an infant to mom mom read printed band and verify match to baby
site for hep B injections vatus lateralis
why do you need to support a baby's head? muscles to weak to support
what is a normal circumcision assessment development of yellow crust
What can a mom cause by breastfeeding for only 5 minutes on each breast cause frequent hunger ???
what should a mom do who cannot breastfeed her baby right away but, wants to once baby is able? use breast pump to maintain lactation
When should a mom be given an anlgesic so that the baby gets less of the medication? less will reach baby if taken right after breastfeeding
how best to asses diet ask about previous day
alcohol use and pregnancy avoid entirely throughout pregnancy
when presenting a child with an anomaly, what should you do to? emphasize normal aspects of the baby
Amniotomy shows green fluid with a mild odor monitor the fetus closely for non-reassuring signs.
Oxytocin is a secondary infusion controlled by a pump
For cervical prepreation for delivery use? can use prostaglandin gel
Why is a urinary catheter needed for a forceps delivery? A full bladder reduces the available room.
During the recovery phase of a median episiotomy the nurse should apply cold packs to peri-area promptly.
Best method to prevent post partum hemorrhage assess uterine firmness regularly
Checking the fundus for a mom who delivered 24 hours ago- the fundus is at midline and at level of umbilicus and firm- What to document? DOCUMENT that it is normal.
Woman 3 hours post partum has difficulty urinating- ASSESS height of fundus.
Woman is 24 hours post partum with episiotomy how do you help with the healing? Warm sitz baths.
Prevention of breast engorgement? Wear a well fitting bra/binder constantly.
New mom should report reappearing of red lochia after it has changed to serous.
A new father is reluctant to pick up newborn because he does not want to spoil it. Teach that newborns cry to communicate their needs.
Best nursing encouragement for new parents Positive Feedback
Primary purpose fo surfactant- keep alveoli partially open between breaths
The foramen ovale closes because the- ressure of the left atrium is greater than the right.
Brown fat is used for to maintain temperature.
To prevent jaundice frequent breast or bottle feedings.
Infection in the newborn has subtle signs, why? Leukocytes and inflammatory responses are immature.
9 lb 11 oz baby delivered vaginally with shoulder dystocia, what to assess for? Clavicle fractures.
What is the newborn reflex that teaches mom how to feed? Rooting.
The best location for blood glucose testing on infant lateral surface of the heel.
Infant axillary temp is 35.9 (96.6), what to do? Place in warmer.
Correct site for Hep b injection- vastus lateralis
Must support newborns head, why? Baby’s muscles are to weak
Normal circumcision assessment development of yellow crust
Mom wants to nurse only five minutes on each side to avoid nipple soreness, what can you teach her? Teach her that limiting time can cause frequent infant hunger due to not getting rich milk.
Mom has a baby at 29 wks, what to do about breastfeeding? She can pump to maintain lactation until nursing is possible.
Mom is concerned about taking medications since she is breastfeeding. What to teach? Teach her to take meds just after breastfeeding.
Important dietary assessment question to ask pregnant adolescent What did you eat yesterday?
Alcohol during pregnancy NO NO NO NO NO NO NO NO NO NO NO NO!
When presenting an infant with an anomaly to parents, what should you do? Emphasize normal aspects first.
Mom of stillborn baby is angry with the doctor THIS is a normal grieving response.
Main goal when dealing with battered women- emphasize that they have the right not to be hurt.
What is the difference between an inevitable and a threatened abortion? Ruptured membranes
Mom is receiving methotrexate, what dietary teaching is needed? Avoid taking a vitamin with folic acid.
Intrapartal care for sever preeclampsia promote placental blood flow and prevent maternal injury.
What causes clonus? An irritable CNS
Name of the test for gestational diabetes- glucose challenge test.
Best evaluation for client administration of insulin- client is able to accurately withdraw, mix and inject.
What warning sign to watch for in pregnant woman with LUPUS? Increased BP
Teaching for pregnant woman with chickenpox report cough and dyspnea immediately.
HIV med for pregnancy Zidovudine
TB med for pregnancy- Isoniazid, rifampin
Nursing assessment for infection cloudy amniotic fluid
Monitoring for admin of mag sulfate hourly vs, heart and lung sounds
Drop in FHR possible prolapsed cord.
Male or female condoms protect against STD’s.
Coitus interruptus, breast feeding, and natural family planning are not the most reliable. IUD is the most reliable.
Thrombophlebitis, liver tumor, and possible pregnancy should not receive oral contraceptives.
Family planning, NI educate couples on the various methods of contraception.
Informed consent concerning contraceptive is important because it may have potentially dangerous side effects.
cervical cap contraindicated in Toxic shock syndrome
Diet of pregnant woman should be composed of what kind of carbs complex carbs.
Increase absorption of iron by taking with with orange juice
Folates green leafy vegetables
Pica ingestion of nonfood substances
Legumes calcium
Determine the cultural influence on a client’s diet by identifying the food preferences and methods of food prep. common to that culture
Week 28 and weigh gain of 17 lbs. is normal
Primary reason for evaluating (AFP) level is to determine neural tube deficits
Nurse’s role in diagnostic testing is to provide information about the tests.
Nursing intervention necessary before a second-trimester transabdominal ultrasound is to instruct the client to drink 1 to 2 quarts of water.
Purpose of amniocentesis for the client hospitalized at 34 weeks with pregnancy induced hypertension is determination of fetal lung maturity.
As the uterus contracts during labor, maternal-fetal exchange of oxygen and waste products diminishes as the spiral arteries are compressed.
Pregnant woman can usually tolerate the normal blood loss associated with childbirth because they have increased blood volume.
Essential part of nursing care for the laboring woman is helping the woman to manage the pain.
Gravida 3 para 2 whose longest previous labor was 4 hours should go to the hospital the soonest after labor begins.
A woman who is Gravida 3 Para 2002 enters the intrapartum unit. Most important nursing assessment is fetal HR, maternal VS, and nearness to birth (SVE, contractions, bleeding).
A woman who is in second-stage labor is almost ready to give birth if the vulva bulges and encircles the fetal head.
A woman who is touching her infant with the fingertips and talking to him softly in high-pitched tones, the nurse should document this evidence of normal early maternal infant attachment behavior.
Contraindication for application of internal monitoring devices is unruptured membranes.
Finding of beat-to-beat variability can be determined by electronic fetal monitoring.
Most appropriate method of intrapartum fetal monitoring when a woman has a history of hypertension during pregnancy is continuous electronic fetal monitoring.
If you cannot get accurate assessment of the actual intrauterine pressure, what should you use use a intrauterine pressure catheter
If fetal HR baseline increases 1 to 20 beats/min. after vibro-acoustic stimulation the fetus is showing a reassuring response.
Non reassuring pattern of the fetal HR is noted and mother is left side lying change her position the right.
Nurse’s should teach the woman and her support person about the monitoring equipment and discuss any questions they have related to electronic monitoring.
Contractions are 4 to 5 min. apart, and last for 30 sec. in active labor nurse’s should ask assessment questions when the contraction is over.
Best time to teach non pharmacological pain control methods is the latent phase.
Method of pain management that would be safest for a Gravida 3 Para 2002 admitted at 8 cm is breathing and relaxation techniques.
Nerve block used in labor that provides anesthesia to the lower vagina and perineum is a pudendal.
NI after epidural narcotic Monitor resp. hourly
the least favorable maternal position is supine
the first type of breathing technique is slow paced
Labor pain in the back- have support person apply firm pressure to the lower back.
Excessive anxiety in labor heightens the woman’s sensitivity to pain by increasing muscle tension.
24 year old G2 P1001 who is in active labor at 39 weeks prenatal data most important is positive result for Group B strep.
A patient with leaking of fluid at 34 weeks requires immediate notification of HCP.
A 22 year old G3 P2002 at 38 weeks and contractions every 3 min., who is requesting to use the bathroom to have a bowel movement should be assessed first.
Factors for treatment modality are personal and family history, financial resources, and maternal age.
4P's of labor Powers, Passage, Passenger, and Psyche
Fetal factors that regulate HR autonomic nervous system, Baroreceptors, chemoreceptors, and adrenal glands
Created by: freenpackn