Test Two Word Scramble

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Question	Answer
A laboring client is receiving oxytocin. Which finding requires immediate intervention?	Fetal heart rate decelerations with contractions
A nurse is caring for a client in the transition phase of labor. Which behavior is most characteristic of this phase?	Increased anxiety and irritability
Which intervention is appropriate when caring for a laboring client experiencing hypotension after epidural anesthesia?	Turn to left lateral position
Which is the nurse’s priority action when a laboring mother has meconium-stained amniotic fluid?	Notify the neonatal resuscitation team
Which is a priority nursing diagnosis for a client in active labor with ruptured membranes?	Risk for infection
Which finding is most concerning during labor?	Late decelerations on fetal monitor
A nurse notices variable decelerations on the fetal monitor. What should the nurse do first?	Change the mother's position
The fetal heart rate shows early decelerations. The nurse should:	Continue to monitor
Which is most important to assess immediately after artificial rupture of membranes?	Fetal heart rate
Which client is at greatest risk for uterine rupture?	Client with a prior cesarean section
A woman at 39 weeks is in early labor. The priority nursing action is to:	Assess fetal heart rate and contraction pattern
Which of the following is a presumptive sign of impending labor?	Nesting behavior
A woman asks how to recognize true labor. The nurse should explain:	True labor causes cervical change.
Which indicates the start of the first stage of labor?	Onset of regular contractions
The second stage of labor begins with:	Full cervical dilation (10 cm)
The third stage of labor ends with:	Delivery of the placenta
The fourth stage of labor involves:	Immediate postpartum recovery
A nurse explains that contraction frequency is measured:	From the beginning of one contraction to the beginning of the next
Contraction duration is defined as:	Time from the beginning to the end of one contraction
Contraction intensity is best assessed by:	Palpating the uterus during contraction
Which is a sign of impending labor?	Loss of the mucus plug
Which is a characteristic of the transition phase of labor?	Increased irritability and rectal pressure
During the second stage, which nursing action is essential?	Encourage pushing with contractions
A fetus is in distress. Which maternal condition is likely contributing?	Maternal hypotension
The nurse assesses the fetal heart rate immediately after amniotomy. Why?	To check for cord prolapse
A woman experiences lightening. What does this mean?	The baby has dropped into the pelvis
The bloody show is best described as:	A pink-tinged vaginal discharge from cervical changes
The client is in the fourth stage of labor. The nurse should prioritize:	Monitoring for hemorrhage
Which maternal sign suggests placental separation?	Fundus becomes firm and rises
A client is 4 hours postpartum and complains of severe perineal pain despite medication. What complication does the nurse suspect?	Perineal hematoma
What symptom most clearly indicates postpartum depression rather than “baby blues”?	Persistent thoughts of harming the baby
A mother reports difficulty urinating 8 hours after delivery. The nurse notes a distended bladder and displaced uterus. What is the priority?	Straight catheterization (in and out cath.)
What action should the nurse take first for a woman with signs of postpartum hemorrhage?	Fundal massage
Which woman is at highest risk for postpartum hemorrhage?	Multipara with a history of PPH (Postpartum hemorrhage)
A postpartum client is diagnosed with a uterine infection. Which medication is expected?	Antibiotics
Which factor increases a woman’s risk for postpartum thrombophlebitis?	Cesarean delivery
A woman reports severe right breast pain, redness, and warmth. She is breastfeeding. What is the likely diagnosis?	Mastitis
A postpartum woman with suspected retained placenta should be assessed for:	Persistent bright red bleeding
Which factor is a common cause of postpartum urinary retention?	Epidural anesthesia
Which intervention is most effective in preventing postpartum DVT?	Early ambulation
A woman has a firm fundus, but heavy bleeding persists. What is the most likely cause?	Vaginal laceration
A newborn has a blood glucose level of 35 mg/dL. What is the nurse’s priority action?	Breastfeed immediately
Which newborn is at highest risk for hypoglycemia?	Infant of a diabetic mother
A newborn presents with poor feeding, jitteriness, and a weak cry. What is suspected?	Hypoglycemia
A newborn with meconium-stained fluid at birth is at risk for:	Meconium aspiration syndrome
Which newborn should the nurse assess first?	Grunting respirations
What is the best prevention for hypothermia in a newborn?	Early skin-to-skin contact
A newborn shows signs of respiratory distress. What should the nurse assess first?	Oxygen saturation
What finding is most concerning in a newborn at 2 hours old?	Nasal flaring and intercostal retractions
Which newborn finding requires immediate follow-up?	Grunting with respirations
Which condition places a newborn at highest risk for sepsis?	Prolonged rupture of membranes
What are some side effects of an epidural block?	Maternal hypotension and urinary retention
What is done immediately after membranes are ruptured?	A Nitrazine test (Fern test) and assess FHR
What happens during stage 1, 2, 3, and the 4th stage of labor?	Stage 1: Dilation & Effacement (4-6hrs) Stage 2: Expulsion of fetus (delivery) (30mins-2hrs) Stage 3: Expulsion of Placenta (5-30mins) Stage 4: Recovery (Bonding/skin-to-skin)
What are some abnormal newborn assessments?	Hypothermia, hypoglycemia, and respiratory ditress
Care of a patient who is having variable decelerations	Position changing, give oxygen, correct hypotension, reduce uterine activity, and push & breathing techniques
What are some ways to stimulate contractions?	Oxytocin, methergine, stimulation of the nipples, walking around, and upright sitting
Priority when birth is imminent	Prevent injury to mom & baby
Normal range of fetal heart rate?	110-160bpm
Define variable, early, and absent deceleration?	Early Deceleration is gradual & temporary drops in FHR during contractions. Variable Deceleration is an abrupt decrease of 15bpm. Absent Deceleration is less than 60bpm.
What is late deceleration	It begins after the beginning of the contraction & do not return to normal, meaning reduce blood flow to the placenta & potential fetal acidemia.
Definition of frequency of contractions	It's the elapsed time from the beginning of one contraction until the beginning of the next contraction
What can a variable deceleration indicate?	Umbilical cord is being compressed, too little amniotic fluid, or fetal respiratory acidosis.
Initial care of a newborn at birth	Maintaining thermoregulation, cardiorespiratory function, observing & docu., urination & passage of meconium, identifying mom, partner, & newborn, performing & docu. a brief assessment for major anomalies & encouraging bonding & breastfeeding.
When would you not administer pain meds?	If mom is dilated 8-10cm or within 2hrs before delivery
Position avoided during labor	Supine (flat on back)
Definition of precipitate birth	Completed in less than 3hrs, & no HCP present
Definition of relaxation phase of a contraction	When muscles return to its resting state with decrease tension of muscle returning back to its original length
What color and amount is abnormal amniotic fluid?	Green color (fetus passed meconium, first stool). Cloudy/yellow means infection.
Tx of a third-degree laceration	Cold packs applied to the perineum for the first 12hrs, warmth (heat packs), sitz baths, or administer oral pain meds.
How do you know that true labor has begun?	Contractions gradually develop a regular pattern becoming stronger even when walking, lower back/abdomen discomfort, bloody show, & progressive effacement & dilation of cervix
Care of a patient with mastitis	Heat, massage the breast, or warm shower
Postpartum hemorrhage nursing care	Check vitals, monitor oxygen, assess lochia, massage the fundus, measure I&O, monitor for signs of anemia, & give emotional support
Tx of abnormal deceleration	Perform a scalp pH, fetal stimulation, vibroacoustic stimulation, & fetal pulse oximetry to assess urgency for delivery
What is the Bishop Score used for?	To assess the ripeness of the cervix for induction, the score needs to be greater than 6.
Priority assessment after amniotomy	Assess FHR
Why does breastfeeding cause pain in the uterus?	Because when the breast is being stimulated (baby feeding) the oxytocin kicks in & starts the contractions back up.
What is the location of the uterus after delivery?	The belly button & will descend 1cm/day
Risk factors for Hypoglycemia after birth	Blood glucose less than 45, preterm/posterm, diabetic mom, (LGA) large for gestational age or (SGA), (IUGR) internal uterine growth restriction, asphyxiated, cold stress, or mom had tocolytics during labor
What interventions would a nurse do for a mom with a soft "boggy" uterus?	Massage uterus until firm, allow infant to breastfeed, administer a diluted oxytocin IV infusion, methergine, or prostaglandins, & NPO just in case of surgery
What is Lochia Rubra, Serosa, & Alba?	Lochia R. is composed of mostly blood about 3days post birth. Lochia S. is pinkish in color mixed with blood & mucus. Lochia A. is mucus clear & colorless or white.
Bleeding after delivery what should you do first?	Massage the fundus
Priority for care of a newborn after ABC's	Blood sugar & keep infant warm (96.8-97.7)
Discharge teaching for a breastfeeding mom?	Drink plenty of fluids, wear a wireless bra, make sure mom is switching to both breasts, take a warm shower, massage breast, or contact lactation consultant
Indications for induction of labor	Gestational hypertension, ruptured membranes w/o spontaneous onset of labor, infection within the uterus, med/fetal prob., prolonged preg., incompatibility between mom&baby blood types, placenta insufficiency, & fetal death.
What does the nurse do after the MD inserts the epidural?	Observe for low BP, urinary retention, maintain position, check BP q5mins, FHR, catheterization, & ambulation carefully.
What are signs of hyperventilation?	SOB, dizziness, & tingling of hands& feet
Signs of hypovolemic shock	Increased pulse (tachycardia)
What assessment do you need to do before you massage the fundus?	Check for bladder fullness
What are contraindications for induction of labor?	Placenta previa, umbilical cord prolapses, abnormal fatal presentation, high station in fetus, active herpes, abnormal pelvis, & previous c-section incision
What are complications of NO lochia?	It is not normal needs to be reported, because could mean a blood clot or contained fragments.
Postpartum complications to include in postpartum discharge teaching?	Shock, hemorrhage, thromboembolic disorders, puerperal infections, subinvolution of the uterus, & mood disorders
What is Homan's Sign?	It's a physical examination to identify DVT (pain in the calf or behind the knee when the foot id dorsiflexed & knee extended)
Women w/ varicose veins lead to what after birth?	Prone to blood clots (pulmonary embolism). Watch for tachypnea & dyspnea.
What meds. need to be given to a newborn before discharged?	Erythromycin, Vit. K, & Herpes B vaccine dose 1
C-section birth indications	Abnormal labor, inability of the fetus to pass through moms pelvis, maternal conditions (DM), active herpes virus, previous surgery on the uterus, fetal compromise, & placenta previa or abruptio placentae.

Created by: chawal