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Nur 113 exam 2 > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

What are some non pharmacological interventions for preTerm labor

A

Bedrest
Monitor FHR
Ensure hydration

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2
Q

What are some Pharmacological Interventions for PreTerm Labor?

A

Administer Fluids
Administer medications
Terbutaline, magnesium sulfate , nifedipine

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3
Q

What medications are administered for Preterm Labor?
*hint TMN**

A

Terbutaline
Magnesium Sulfate
Nifedipine

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4
Q

What are some maternal side effects to monitor with Terbutaline?

A

HTN Crisis
Tachycardia
Chest pain
Hypokalemia, Hypoglycemia
Pulmonary edema
Cardiac arrhythmias
Intolerable BP (>90/60)

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5
Q

What are some Fetal side effects to monitor with Terbutaline?

A

TACHYCARDIA
Potassium levels
Notify hcp of adverse effects

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6
Q

What is Naegele’s Rule ?

A

Take a women’s LMP
Subtract 3 months
Add 7 days to days
Add 1 year

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7
Q

What are some S&S to a Placental Abruption?

A

Sudden onse painful vaginal bleeding **
Uterine tenderness
Late decelerations with FHR
Hypovelmic shock (increase
BP, pale , decreased LOC, Urinary retention)
Contractions with hypertonicity

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8
Q

What are some interventions for placental Abruption?

A

Notify MD
Place patient on side
Place on 02 and foley
Prepare for c section

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9
Q

When and how is it appropriate to treat Group b strep?

A

After birth with antibiotics

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10
Q

What is the nursing priority during epidural analgesic?

A

Monitor for HYPOTENSION

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11
Q

What is the initial treatment for Gestational diabetes?

A

Management of diet first!!
Exercise

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12
Q

What are other options to treat gestational diabetes?

A

Insulin if needed
Glyburide

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13
Q

Contractions occurring regularly becoming stronger, longer and closer together.. True or false labor signs ?

A

True Labor Signs

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14
Q

Contractions occurring more intense with walking are considered true or false labor ?

A

True Labor signs

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15
Q

A patient comes into her doctor office and is 30 weeks of gestation she’s complaining of lower back pain radiating to her abdomen the nurse should consider these signs as true or false labor signs?

A

True

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16
Q

A patient reports having bloody show during her doctors visit she is 28 weeks of gestation is this considered true or false labor signs ?

A

True

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17
Q

Cervix softening with effacement ,urinary frequency are signs of false or true labor signs ?

A

True

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18
Q

A patients comes in for an office visit complaining of contractions occuring irregularly and stoping when she walks or changes position, the nurse should consider these are signs of what kind of labor?

A

False

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19
Q

A 28 week gestation client comes for her office visit complains of pain in her abdomen right above her umbilicus and can feel it in her back this is considered what kind of labor sign

A

False

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20
Q

A soft cervix with no effacement and no bloody show can relate to what sign of labor ?

A

False

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21
Q

Magnesium Sulfate is infused at what rate ?

A

125 ML/hr

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22
Q

What are some pre-conceptual education for women?

A

Take folic acid before pregnancy
Take prenatal vitamins before pregnancy
Exercise
Avoid smoking , alcohol, drugs OTC medications if not stated otherwise by HCP

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23
Q

What is the most reliable indicator of fetal growth?

A

Measurement Fundal Height
Uterine size

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24
Q

At 12-16 weeks the fundus should be located ?

A

Top of the pubic bone

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25
Q

At 21-36 weeks the fundus should be located?

A

At the top of the uterus

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26
Q

At 20 weeks the fundus should be located where

A

At the naval

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27
Q

Can the fundus at 21-22 weeks still be located at the naval?

A

Yes (normal)

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28
Q

How many stages of labor are there

A

4

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29
Q

What is stage 1 of labor

A

Where dilation occur
Cervix will dilate from (1-10)

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30
Q

The latent stage of labor is where the cervix is dilated?

A

1-3 sm

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31
Q

The active stage of labor is where the cervix is dilated …

A

4-7sm

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32
Q

The transition phase of labor is where the cervix is dilated …

A

8-10 sm

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33
Q

Stage 2 of labor is considered what?

A

Pushing and ends when baby is delivered

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34
Q

What is the 3 stage of labor?

A

Placenta is delivered

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35
Q

Stage 4 of labor is ?

A

Recovery

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36
Q

What should the nurse do if the fundus is boggy and not at midline

A

Massage for 2-3 mins

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37
Q

What some nursing interventions during the 4th stage of labor ?

A

Monitor vitals
Monitor for signs of infections ,RD, N/v, Low BP
Monitor Lochia discharge
Measure soaked peri pads

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38
Q

What should the nurse assess during the stage of recovery if patient is experiencing more than normal blood loss?

A

Assess fundus , massage
Measure soaked peripad
Assess if Pitocin was received during labor

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39
Q

What is the expected weight gain for a healthy BMI patient ?

A

25-30lbs

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40
Q

What is the Expected weight gain in the first trimester ?

A

1-2kg

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41
Q

What is the expected weight gain in the last two trimester ?

A

0.5 kg per week

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42
Q

If a patients BMI is less than 18.5 what is expected of them ?

A

Gain 28-40 lbs

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43
Q

What is a risk for pregnancy if BMI is less than 18.5 ?

A

Preterm Labor

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44
Q

If a patients BMI is over 25 what is expected of them?

A

Weight loss of 15-25 lbs

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45
Q

What are some risk associated with pregnancy if patient BMI is over 25?

A

Risk for C-section
Complicated Prolonged Recovery

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46
Q

What are some nursing interventions for Hypermesis Gravidarum?

A

Prevent dehydration and N/V
Assess vitals, weight and calorie count
Monitor FHR
Encourage small meals with fluid intake inbetween
Encourage sitting up right after meals

47
Q

During the summer pregnant women are more prone to experience what and why?

A

Braxton Hicks
Due to lack of hydration

48
Q

Back pain is a sign of what in pregnant women?

A

Active Labor

49
Q

What are some warning signs for women at 28 week gestation ?

A

Premature labor
Placenta previa or abruption
Decrease fetal movement
ROM
Back pain signaling active labor

50
Q

A 28year old women arrives for her 28 weeks gestation visit exhibiting Shob with exertion ? What can this indicate

A

Active labor
Not NORMAL

51
Q

What are some interventions to do if a patient experiences signs of ROM?

A

Monitor FHR
Assess the membranes
Limit cervix checks
Notify md

52
Q

Why should the nurse limit cervix checks for ROM?

A

Risk of infection

53
Q

Early decelerations are caused by ?

A

Head compression

54
Q

What are the nursing interventions for early decelerations?

A

Continue to monitor
No intervention needed

55
Q

What would early decelerations look like on the monitor ?

A

Mirror image of moms contractions

56
Q

What is the highest priority for a prolapsed cord ?

A

Push the presenting part back up with 2 fingers and prepare for c section

57
Q

How will a prolapsed cord look on a monitor ?
Think VEAL—> CHOP

A

Variable decelerations

58
Q

What is a precipitous birth ?

A

Fast birth within 3 hours or less

59
Q

What is the main intervention for a precipitous birth ?

A

Skin to skin for mother and baby

60
Q

What is chronic villus sampling?

A

Assessment of developing placenta

61
Q

When does Chronic villus sampling occur ?

A

10-13 weeks of gestation

62
Q

How is Chronic villus sampling conducted ?

A

Aspirated through abdominal wall or intravaginally with syringe

63
Q

What is phenegran used for in pregnant mothers?

A

Nausea/ Vomiting
Sedative in labor

64
Q

How would a nurse administer Phenegran?

A

Slow Push

65
Q

How often should fetal kicks be assessed by mother?

A

Daily

66
Q

What is a normal fetal kick count?

A

10 kicks within 2 hours

67
Q

When can an expecting mother feel her baby move ?

A

16-20 weeks of gestation

68
Q

A patient reports feeling 4 movements in a 1 hr session is this considered normal?

A

Yes

69
Q

During what gestation should fetal kicks be surveillanced ?

A

28 weeks

70
Q

When should the mother notify her HCP regarding fetal kicks ?

A

Fewer than 3 movements in 2 hrs
After rest and eating if fetal count continues to remain fewer than expected

71
Q

What is priority nursing action for fetal heart tones?

A

If heart tone is heard at the top of abdomen after 32 weeks
(Breech Baby)

72
Q

A mother comes in at 6 weeks gestation and the nurse is unable to hear the baby heart tones is this considered normal?

A

Yes normal reassure mom

73
Q

What actions should the nurse take if unable to hear fetal heart tones?

A

Reposition mother
Assess mothers radial pulse while reading for babys tone

74
Q

Where should the nurse expect to hear a fetal tone?

A

Moms right or left lower abdomen

75
Q

What is the cause of variable decelerations ?

A

Cord compression

76
Q

What are the nurse interventions for variable decelerations ?

A

D/c oxytocin
Position change
Oxygen (non rebreather)
Push presenting part back up with two fingers
Prepare for C-section
Amino infusion
Breathing technique

77
Q

On the monitor what will variable decelerations look like

A

“V”

78
Q

What is the priority nursing intervention for Pitocin ?

A

STOP INFUSION if signs of complications
Monitor FHR changes (stop if changes occur)

79
Q

What can be expected at a 18 week gestation ultrasound visit?

A

Ensuring appropriate development of fetus and adequate amniotic fluid.

80
Q

During a prenatal health history what should be obtained first ?

A

Obstetrical history
(Complications of prior pregnancies)

81
Q

What other information will be obtained during a prenatal health history visit?

A

Medical history
Social history
Family history
Environmental history
Abuse or at risk of abuse hx

82
Q

Gravidity stand for?

A

’s of pregnancies

83
Q

GTPAL is

A

Gravidity
Term births
Preterm births
Abortions or miscarriages
Living children

84
Q

Twins are counted as one in GTPAL expect for in?

A

Living children

85
Q

What is the nursing assessment during ROM?

A

Nitrazine test
Assess membranes
Monitor vital
Fetal monitoring

86
Q

What are some teachings for adolescent prenatal care ?

A

Nutrition
Support system
Encourage continued prenatal care and appropriate assistance
Encourage adolescent to apply for wic if nutrition is a concern

87
Q

What are some risk for ectopic pregnancy

A

STI
IUDs
Assisted reproductions
Tubal surgery

88
Q

What are expected findings in ectopic pregnancies?

A

Unilateral stabbing pain and tenderness in lower abdomen quadrant
Delayed menses (1-2 weeks)
Scant dark red/vaginal spotting lasting 6-8 weeks after menses
Red vaginal bleeding indicating rupture
Hemorrhage shock

89
Q

What is the nursing care for ectopic pregnancy ?

A

Replace fluids , maintain electrolytes
Provide client with education and physiological support
Administer meds as prescribed
Prepare for sx
Provide referral to event and partner to pregnancy loss support group
Obtain HCG and progesterone levels, liver and renal function studies.

90
Q

What is an increased risk of complication with previous cesarean sections?

A

Higher risk for placenta previa

91
Q

What are some nursing actions for patients in active stage 1 labor?

A

Promote comfort
Warm shower, massage, walk, epidural
Provide quiet environment
Encourage voiding 1-2 hrs
Encourage effective breathing pattern and rest between contractions
Encourage participation in care and keep informed

92
Q

What are some nursing actions for patients in stage 2 labor?

A

Provide ice chips and ointment for dry lips
Provide praise and encouragement to the mother
Monitor for signs of birth ( perineal bulging or vizualation of fetal head)

93
Q

During active labor there is no change with the station of baby, mother is fully effaced and dilated what are the nurses action?

A

Prepare for sx

94
Q

During active labor the mother is fully effaced and 7 sm dilated what is the nurses actions?

A

Instruct not to push, can cause swelling and prolonged labor
Encourage effective breathing techniques

95
Q

What is the progression for nulliparous ?

A

First time moms should progress 1 sm per hr

96
Q

What is variability on fetal monitor ?

A

Variable decelerations
Accelerations
Early decelerations
Late decelerations

97
Q

Variable decelerations is caused by

A

Cord compression

98
Q

Early deceleration is caused by?

A

Head compression

99
Q

Accelerations is caused by ?

A

Normal fetal compression

100
Q

Late decelerations is caused by?

A

Placental insufficiency

101
Q

What are some nursing interventions for Late decelerations ?

A

D/c oxytocin
Position change
Oxygen
Hydration
Elevate legs to correct hypotension

102
Q

How are late decelerations viewed on monitor?

A

Come after moms contractions

103
Q

What are some nursing actions for patients in transition phase of labor ?

A

Encourage rest in between contractions
Provide privacy
Wake mother during contraction so she can begin breathing techniques
Obtain FHR
Offer fluids, ice chips and ointment for lips
Encourage voiding q1-2 hrs

104
Q

What are some pharmacological measures for patients in active labor?

A

DO NOT GIVE PAIN meds if past a 5 or 90%effaced
Opioid analgesics
Bulophranol/ nalbuphine
Epidural/ spinal analgesic
Regional block

105
Q

What is the main risk associated with type 1 diabetes during pregnancy ?

A

Fetal Demise

106
Q

What are S&S of magnesium toxicity ?

A

Decreased respirations
Absent tendon reflexes
Decrease during output (>30ml/hr)
Decreased level of consciousness
Cardiac arrythmias

107
Q

What is the main Intervention for Magnesium toxicity ?

A

STOP infusion
Administer antidote (calcium gluconate/ Calcium Chloride)
Prepare for actions to prevent respiratory or cardiac arrest

108
Q

A mother is RH negative and Gave birth to a RH positive baby what are the nurse actions ?

A

RHOGAM
Can be administered at 28 weeks

109
Q

How is oxygen carried to the fetus

A

Carried through the umbilical arteries

110
Q

What is the first organ system to begin forming in the embryo?

A

Fetal circulation

111
Q

What allows the oxygenated blood to bypass the fetal lungs?

A

Foreman oval

112
Q

When will the Ductus arteroirus normally close ?

A

After newborn period

113
Q

A patient who is 13 weeks of gestation came in to receive a chronic virull sample, she is Rh negative what would the patient receive ? Why?

A

Rhogam
Due to increase risk of RH sensitization

Nur 113 exam 2 (1 decks)

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