final exam pt 3 Flashcards
what complication is the mother at risk for after the delivery of a macrosomic fetus (>8.8 lb)?
uterine atony
what are 4 classic signs of abruptio placentae?
- sudden vaginal bleeding
- abdominal pain
- uterine tenderness
- contractions
why can we begin doing amniocentesis around 14 wk of gestation?
that is when amniotic fluid becomes available
what type of patients are given Rh immunoglobulin (RhoGAM)?
Rh negative
what is the priority nursing action following an amniotomy?
assess fetal HR
when is a glucocorticoid injection given to mothers?
premature preterm rupture of membranes
what is the focus of care for premature rupture of membranes prior to 32 weeks?
prolonging pregnancy to reduce risk of preterm complications
what FHR pattern is suspected with umbilical cord compression?
variable decelerations
what should the nurse do if the patient is experiencing hyperstimulation of the uterus due to oxytocin administration?
discontinue oxytocin
what order would these events occur in:
- amenorrhea, lightening, Goodells sign and quickening ?
- amenorrhea
- Goodells sign
- quickening
- lightening
what intervention should the nurse take to decrease the likelihood of hypotension caused by epidural anesthesia?
admin IV fluid bolus
what complication is the priority of care for a macrosomic newborn whos mother has diabetes mellitus?
hypoglycemia
what is the cause of newborn hypoglycemia?
hyperinsulinemia
what actions can the nurse take to promote development for the preterm newborn?
- cluster care
- dimming lights
- use both hands to reposition
- prone position (promote flexion)
what action should be taken first for late decelerations?
change position
what indicates a reactive nonstress test?
2 qualifying accelerations (+15 bpm/15 secs) within 20-mins
what is indicates a nonreactive nonstress test?
< 2 accelerations in 20 mins
when is the FHR audible by doppler?
8 - 17 weeks
what gestational parameter is lanugo an expected finding?
20 - 36 weeks
when may quickening begin?
14-16 weeks
what are 3 medications that are indicated for preterm labor?
- indomethacin
- magnesium sulfate
- terbutaline
what is the priority for the newborn after assuring airway patency?
drying the baby’s skin
what action should be taken first after the nurse observes the umbilical cord protruding from the vagina?
insert a gloved hand into the vagina to relieve pressure on the cord
what is the priority assessment when admin magnesium sulfate?
resp rate
how should fetal station of 0 be interpreted?
lowermost portion of the fetus is at level of the ischial spine
what is the priority action for a mother 3 week postpartum who is feeling “down,” no energy and wanting to cry?
ask about SI/HI
wanting to harm newborn?
when should nurse report contractions to the provider?
> 90 sec
what are some physical traits with postmature newborns?
- positive moro reflex
- cracked, peeling skin
- long, hard fingernails
what education should be provided for the newly pregnant mother?
- expected/unexpected manifestations
- postpartum care
- newborn care
- prenatal visit schedule
- when to contact provider
what nursing actions should be taken for those with severe preeclampsia?
- bed rest, quiet, nonstimulating
- continuous fetal monitoring
- daily weight
- assess DTR Q1hr
what is the priority nursing action following amniotomy?
assess FHR pattern
what action should be taken for supine hypotension?
position client with one hip elevated
why would a stat ultrasound be ordered for a patient who has reported heavy, red vaginal bleeding?
to determine the location of the placenta
what is the priority action for the nurse for the newborn who is SGA?
monitor BG levels
what is the priority nursing action for the patient who has saturated a perineal pad within 10 min?
massage the fundus
what action should the nurse take to promote the emotional well being of a client who is having an inevitable abortion?
- offer option to view products of conception
- possible grief responses
- refer support group
what is methylergonovine given to prevent?
pph
why is ultrasound performed prior to an amniocentesis?
identify location of placenta and fetus
what type of abortion is characterized by fetal death, but retained products of conception?
missed miscarriage
what characterized an incomplete miscarriage?
passed some, but not all products
what type of miscarriage is characterized by heavy bleeding, cervical dilation and often, ROM?
inevitable
what type of miscarriage have all products of conception been expelled?
complete
what FHR assessment should the nurse obtain prior to administration of spinal epidural anesthesia?
30 min EFM strip
how can the nurse elicit a moro reflex?
- sharp clap near infant
how should the client be positioned for fetal heart tone assessment?
head supported with pillow
how can cold stress be prevented?
place newborn under radiant heat warmer
what are expected findings of severe preeclampsia?
- headache
- burred vision
- photophobia
- RUQ pain
- +clonus
- proteinuria
