OB Final Study Guide 2011
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| Family center care includes mom and | husband and kids, whole family
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| Nurse does not give 6am seizure meds at 10am pt ambulates and falls. The nurse is sued for? | malpractice
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| describe evidenced based practice | questions why something is effective and is there a better approach
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| why was family centered maternity care developed | in response to parents requests that infants be with them
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| WIC provides | supplemental food supplies to low income women who are pregnant or nursing
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| a nursing process that is controlled and directed toward finding solution or options is called | critical thinking
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| write a correct NI for giving pt 100ml every 2 hrs | Provided 100 ml of fluid of choice every 2hrs while awake
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| process of determining outcomes and intervention of care is which stage of the nursing process | planning
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| what kind of delivery is a nurse midwife qualified to perform | vaginal
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| give examples of a independent nursing function | teaching (prenatal care)
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| what is a therapeutic nursing response to “I am afraid to have a cesarean” | “what concerns you most about a cesarean”
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| how can a nurse best assist a family to cope with stress | helping to identify family strengths
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| what type of family does a 3 year old with 2 adoptive moms belong to | same sex parents
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| what do families that deal well with stress believe about stress | that some stress is normal
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| NI: an appropriate goal for a patient with a different ethnic background | adapt ethnic practices to health needs
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| 5 functions of nursing process and family | affective, economic, healthcare, reproductive, socialization
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| non traditional families included | multigenerational, same sex
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| fertilization most likely takes place in the | fallopian tubes
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| what supplement may prevent neural tube defects | folic acid
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| what is one of the things you should do for your patient, as their advocate | ensure access to available resources
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| what kind of disorders are men more commonly affected by | X linked disorders
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| female chromosome | XX
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| Trisomy 21 Syndrome's common name | Down's Syndrome
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| what is one female secondary sexual characteristic (and usually the first to develop) | breast development
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| if a womens menstruation occurs every 28 days, what day will she most likely ovulate | at 14 days
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| what shape can you use to describe a non pregnant uterus with | pear
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| if menstruation began on October 5 and normally a 28 day cycle ovulation will occur when | Oct 19
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| breastfeeding pt with warm, red, painful breast, temp, & flu like symptoms NI? | notify HCP
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| what are the phases of a normal ovarian cycle | Ovulatory, follicular, luteal
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| the part of the uterus that renews monthly in the absence of pregnancy | endometrium
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| twins that are from 2 different ova and may be different sexes are what kind of twins | dizygotic twins
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| what is the configuration of the umbilical cord vessels | 2 arteries and 1 vein
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| what does cephalocaudal growth pattern mean | the brain develops first
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| what is the purpose of the foramen ovale | to shunt blood from the right atrium to the left atrium
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| what is the function of the ductus arteriosus | carry blood from pulmonary arteries to the descending aorta
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| a pregnant women at 20 weeks gestation fundal measures 20cm even w/umbilicus, is this normal growth | yes
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| 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
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| “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
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| vascular volume increases during pregnancy 30 – 50%, why? | to provide adequate perfusion to the placenta
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| why do mom's visit HCP every 4 weeks in first trimester | to monitor condition of mom and fetus
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| what is a good therapeutic response to a mom who fears something happening to her baby | tell me about your concerns
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| step in maternal role attachment that relates to mom giving up certain aspects of her previous life | grief work
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| what is an example of a man trying on fathering behaviors | coaching little league ball
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| why might an Asian woman refuse to meet your eyes while you are teaching her | cultural beliefs
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| a women who has female genitalia mutilation is at risk for | obstructed labor, laceration, hemorrhage, infection
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| can you delegate elevating a breast lumpectomy patient's arm to promote lymph node drainage to CNA | yes
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| what is the grava of a women with first pregnancy, term, living, 2nd, preterm, living 3rd miscarriage, 4th current pregnancy | G 4 P1112
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| do you give a drug for the sole purpose of fetal therapy | No
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| Non reassuring pattern of the fetal HR is noted and mother is left side lying change her position the right. |
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| 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.
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| 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.
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| Best time to teach non pharmacological pain control methods | is the latent phase.
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| Method of pain management that would be safest for a Gravida 3 Para 2002 admitted at 8 cm is | breathing and relaxation techniques.
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| Nerve block used in labor that provides anesthesia to the lower vagina and perineum is | a pudendal.
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| NI after epidural narcotic | Monitor respirations hourly
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| the least favorable maternal position is | supine
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| the first type of breathing technique is | slow paced
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| Labor pain in the back- have support person | apply firm pressure to the lower back.
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| Excessive anxiety in labor heightens the woman’s sensitivity to pain by | increasing muscle tension.
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| 24 year old G2 P1001 who is in active labor at 39 weeks prenatal data most important is | positive result for Group B strep.
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| A patient with leaking of fluid at 34 weeks requires | immediate notification of HCP.
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| 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.
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| Factors for treatment modality are | personal and family history, financial resources, and maternal age.
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| 4P's of labor | Powers, Passage, Passenger, and Psyche
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| Fetal factors that regulate HR | autonomic nervous system, Baroreceptors, chemoreceptors, and adrenal glands
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| Amnitomy care | monitor fetus for non reassuring signs
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| oxytocin set up | secondary infusion and controlled by infusion pump
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| cervix prep for induction | prostaglandin
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| why use a urinary catheter during a focepts birth | because full bladder reduces room in pelvis
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| medium episiotomy, NI | apply cold packs promptly
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| NI targeted toward prevent hemorrhage after C section | access fundas regularly for firmness
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| fundus levels at umbilicus, firm, midline, 24 hrs after cesarean | document normal finding
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| 3hrs post partum, difficulty urinating, finally urinates 100mL, the next NI should be to? | reassess fundal height
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| what can aid in episiotomy healing | warm sits bath
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| prevent breast engorgement | wear well fitted bra
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| s/s new mom should report | reappearance of red locia
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| father reluctant to spoil newborn, does not pick up baby when he cries. NI? | explain baby cries to communicate
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| parent care for newborn | give positive feed back
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| what do surfactants do in the lungs? | keeps aveoli open between breaths
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| why does the foramen ovale close | because pressure in Left atrium is higher than right
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| brown fat is to? | maintenance of temperature
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| prevent jaundice | regular and adequate breastfeeding
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| why infection signs are subtle in newborn? | because leukocyte and inflammatory signs are immature
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| infant shoulder discotia, asses for? | clavicle fracture
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| what newborn reflex helps with breastfeeding | rooting
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| where is the best site to do a glucose determination on an infant | lateral heel
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| newborn axillary temp 35.9 (96.6), NI? | place in a radiant warmer
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| steps to returning an infant to mom | mom read printed band and verify match to baby
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| site for hep B injections | vatus lateralis
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| why do you need to support a baby's head? | muscles to weak to support
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| what is a normal circumcision assessment | development of yellow crust
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| What can a mom cause by breastfeeding for only 5 minutes on each breast | cause frequent hunger ???
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| 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
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| 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
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| how best to asses diet | ask about previous day
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| alcohol use and pregnancy | avoid entirely throughout pregnancy
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| when presenting a child with an anomaly, what should you do to? | emphasize normal aspects of the baby
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| Amniotomy shows green fluid with a mild odor | monitor the fetus closely for non-reassuring signs.
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| Oxytocin | is a secondary infusion controlled by a pump
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| For cervical prepreation for delivery use? | can use prostaglandin gel
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| Why is a urinary catheter needed for a forceps delivery? | A full bladder reduces the available room.
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| During the recovery phase of a median episiotomy the nurse should | apply cold packs to peri-area promptly.
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| Best method to prevent post partum hemorrhage | assess uterine firmness regularly
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| 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.
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| Woman 3 hours post partum has difficulty urinating- | ASSESS height of fundus.
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| Woman is 24 hours post partum with episiotomy | how do you help with the healing? Warm sitz baths.
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| Prevention of breast engorgement? | Wear a well fitting bra/binder constantly.
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| New mom should report | reappearing of red lochia after it has changed to serous.
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| 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.
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| Best nursing encouragement for new parents | Positive Feedback
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| Primary purpose fo surfactant- | keep alveoli partially open between breaths
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| The foramen ovale closes because the- | ressure of the left atrium is greater than the right.
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| Brown fat is used for | to maintain temperature.
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| To prevent jaundice | frequent breast or bottle feedings.
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| Infection in the newborn has subtle signs, why? | Leukocytes and inflammatory responses are immature.
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| 9 lb 11 oz baby delivered vaginally with shoulder dystocia, what to assess for? | Clavicle fractures.
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| What is the newborn reflex that teaches mom how to feed? | Rooting.
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| The best location for blood glucose testing on infant | lateral surface of the heel.
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| Infant axillary temp is 35.9 (96.6), what to do? | Place in warmer.
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| Correct site for Hep b injection- | vastus lateralis
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| Must support newborns head, why? | Baby’s muscles are to weak
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| Normal circumcision assessment | development of yellow crust
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| 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.
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| Mom has a baby at 29 wks, what to do about breastfeeding? | She can pump to maintain lactation until nursing is possible.
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| Mom is concerned about taking medications since she is breastfeeding. What to teach? | Teach her to take meds just after breastfeeding.
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| Important dietary assessment question to ask pregnant adolescent | What did you eat yesterday?
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| Alcohol during pregnancy | NO NO NO NO NO NO NO NO NO NO NO NO!
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| When presenting an infant with an anomaly to parents, what should you do? | Emphasize normal aspects first.
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| Mom of stillborn baby is angry with the doctor | THIS is a normal grieving response.
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| Main goal when dealing with battered women- | emphasize that they have the right not to be hurt.
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| What is the difference between an inevitable and a threatened abortion? | Ruptured membranes
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| Mom is receiving methotrexate, what dietary teaching is needed? | Avoid taking a vitamin with folic acid.
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| Intrapartal care for sever preeclampsia | promote placental blood flow and prevent maternal injury.
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| What causes clonus? | An irritable CNS
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| Name of the test for gestational diabetes- | glucose challenge test.
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| Best evaluation for client administration of insulin- | client is able to accurately withdraw, mix and inject.
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| What warning sign to watch for in pregnant woman with LUPUS? | Increased BP
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| Teaching for pregnant woman with chickenpox | report cough and dyspnea immediately.
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| HIV med for pregnancy | Zidovudine
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| TB med for pregnancy- | Isoniazid, rifampin
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| Nursing assessment for infection | cloudy amniotic fluid
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| Monitoring for admin of mag sulfate | hourly vs, heart and lung sounds
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| Drop in FHR possible | prolapsed cord.
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| Male or female condoms protect against | STD’s.
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| Coitus interruptus, breast feeding, and natural family planning | are not the most reliable. IUD is the most reliable.
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| Thrombophlebitis, liver tumor, and possible pregnancy should not receive | oral contraceptives.
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| Family planning, NI | educate couples on the various methods of contraception.
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| Informed consent concerning contraceptive is important because | it may have potentially dangerous side effects.
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| cervical cap contraindicated in | Toxic shock syndrome
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| Diet of pregnant woman should be composed of what kind of carbs | complex carbs.
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| Increase absorption of iron by taking with | with orange juice
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| Folates | green leafy vegetables
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| Pica | ingestion of nonfood substances
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| Legumes | calcium
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| Determine the cultural influence on a client’s diet by identifying | the food preferences and methods of food prep. common to that culture
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| Week 28 and weigh gain of 17 lbs. | is normal
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| Primary reason for evaluating (AFP) level | is to determine neural tube deficits
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| Nurse’s role in diagnostic testing | is to provide information about the tests.
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| Nursing intervention necessary before a second-trimester transabdominal ultrasound | is to instruct the client to drink 1 to 2 quarts of water.
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| Purpose of amniocentesis for the client hospitalized at 34 weeks with pregnancy induced hypertension | is determination of fetal lung maturity.
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| As the uterus contracts during labor, maternal-fetal exchange of oxygen and waste products | diminishes as the spiral arteries are compressed.
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| Pregnant woman can usually tolerate the normal blood loss associated with childbirth because | they have increased blood volume.
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| Essential part of nursing care for the laboring woman is helping the woman | to manage the pain.
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| Gravida 3 para 2 whose longest previous labor was 4 hours should go to the hospital | the soonest after labor begins.
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| 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).
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| A woman who is in second-stage labor is almost ready to give birth if | the vulva bulges and encircles the fetal head.
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| 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.
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| Contraindication for application of internal monitoring devices is | unruptured membranes.
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| Finding of beat-to-beat variability can be determined by | electronic fetal monitoring.
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| Most appropriate method of intrapartum fetal monitoring when a woman has a history of hypertension during pregnancy is | continuous electronic fetal monitoring.
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| If you cannot get accurate assessment of the actual intrauterine pressure, what should you use | use a intrauterine pressure catheter
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| If fetal HR baseline increases 1 to 20 beats/min. after vibro-acoustic stimulation the fetus is showing | a reassuring response.
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| Non reassuring pattern of the fetal HR is noted and mother is left side lying change her position the right. |
🗑
|
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| 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
🗑
|
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| the least favorable maternal position is | supine
🗑
|
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| the first type of breathing technique is | slow paced
🗑
|
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| Labor pain in the back- have support person | apply firm pressure to the lower back.
🗑
|
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| Excessive anxiety in labor heightens the woman’s sensitivity to pain by | increasing muscle tension.
🗑
|
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| 24 year old G2 P1001 who is in active labor at 39 weeks prenatal data most important is | positive result for Group B strep.
🗑
|
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| 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.
🗑
|
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| Factors for treatment modality are | personal and family history, financial resources, and maternal age.
🗑
|
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| 4P's of labor | Powers, Passage, Passenger, and Psyche
🗑
|
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| Fetal factors that regulate HR | autonomic nervous system, Baroreceptors, chemoreceptors, and adrenal glands
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|
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