HESI Maternity Flashcards
A couple must avoid unprotected intercourse for?
for several days before the anticipated ovulation and for 3 days after ovulation to prevent pregnancy.
Practice determining gravidity and parity. A woman who is 6 weeks pregnant has the following maternal history: • She has a healthy 2-year-old,vdaughter. • She had a miscarriage at 10 weeks. • She had an elective abortion at 6 weeks, 5 years earlier. • With this pregnancy, she is a gravida 4, para 1 (only 1 delivery after 20 weeks’ gestation).
GTPAL is 4-1-0-2-1
Practice calculating EDB. If the first day of a woman’s last normal menstrual period was October 17, what is her EDB, using the Nägele rule?
July 24. Count back 3 months and add 7 days (always give February 28 days).
As pregnancy advances, the uterus presses on abdominal vessels (vena cava and aorta). Teach the woman that?
a left side-lying position relieves supine hypotension and increases perfusion to uterus, placenta, and fetus.
Remember, the normal fetal heart rate is?
110 to 160 bpm.
Name the major discomforts of the first trimester and one suggestion for amelioration of each.
- Nausea and vomiting: crackers before rising
- fatigue: rest periods and naps and 7 to 8 hours of sleep at night.
The hemodilution of pregnancy peaks at _____ weeks and results in a/ an _____ in a woman’s Hct.
28 to 32 weeks; decrease
State three principles relative to the pattern of weight gain in pregnancy.
Total gain should average 25 to 35 lb. Gain should be consistent throughout pregnancy. An average of 1 lb/ week should be gained in the second and third trimesters.
During pregnancy a woman should add _____ calories to her diet and drink _____ of milk per day.
300; 3 cups
Fetal heart rate can be auscultated by Doppler at _____ weeks’ gestation.
10 to 12
Describe the schedule of prenatal visits for a low-risk pregnant woman
Once every 4 weeks until 28 weeks; every 2 weeks from 28 to 36 weeks; then once a week until delivery
When an amniocentesis is done in early pregnancy, the bladder must be?
full to help support the uterus and to help push the uterus up in the abdomen for easy access. When an amniocentesis is done in late pregnancy, the bladder must be empty so it will not be punctured.
______ caused by head compression and fetal descent, usually occur between 4 and 7 cm and in the second stage of labor. Check for labor progress if early decelerations are noted
early decellerations
If cord prolapse is detected, the examiner should?
position the mother to relieve pressure on the cord (i.e., knee-chest position) or push the presenting part off the cord until immediate cesarean delivery can be accomplished.
Late decelerations indicate?
uteroplacental insufficiency and are associated with conditions such as postmaturity, preeclampsia, diabetes mellitus, cardiac disease, and abruptio placentae
When deceleration patterns (late or variable) are associated with decreased or absent variability and tachycardia, the situation is?
ominous (potentially disastrous) and requires immediate intervention and fetal assessment.
a decrease in uteroplacental perfusion results in?
late decelerations; cord compression results in a pattern of variable decelerations (Fig. 6-10C). Nursing interventions should include changing maternal position, discontinuing Pitocin infusion, administering oxygen, and notifying the health care provider.
The most import determinant of fetal maturity for extrauterine survival is?
lung maturity:lung surfactant (L:S) ratio (2: 1 or higher).
What does the biophysical profile (BPP) determine?
Fetal well-being
List three necessary nursing actions prior to an ultrasound examination for a woman in the first trimester of pregnancy.
Have client fill bladder. Do not allow client to void. Position client supine and with uterine wedge.
Name the four periodic changes of the FHR, their causes, and one nursing treatment for each.
- Accelerations are caused by a burst of sympathetic activity; they are reassuring and require no treatment.
- Early decelerations are caused by head compression; they are benign and alert the nurse to monitor for labor progress and fetal descent.
- Variable decelerations are caused by cord compression; change of position should be tried first.
- Late decelerations are caused by UPI and should be treated by placing client on her side and administering oxygen.
Normal maternal temperature during labor
<100.4
__________ results in respiratory alkalosis that is caused by blowing off too much CO2. Symptoms include: • Dizziness • Tingling of fingers • Stiff mouth
Have a woman do?
Hyperventilation: Have woman breathe into her cupped hands or a paper bag in order to rebreathe CO2.
Give the ? after the placenta is delivered because the drug will cause the uterus to contract. If the drug is administered before the placenta is delivered, it may result in a retained placenta, which predisposes the client to hemorrhage and infection.
oxytocin
? is not given to clients with hypertension because of its vasoconstrictive action. Pitocin is given with caution to those with hypertension.
Methergine
Never give Methergine or Hemabate to a?
client while she is in labor or before delivery of the placenta.
? is one of the most common reasons for uterine atony or hemorrhage in the first 24 hours after delivery. If the nurse finds the fundus soft, boggy, and displaced above and to the right of the umbilicus, what action should be taken first?
Full bladder: First, perform fundal massage; then have the client empty her bladder. Recheck fundus every 15 minutes for 1 hour, then every 30 minutes for 2 hours.
If narcotic analgesics (codeine, meperidine) are given?
raise side rails and place call light within reach. Instruct client not to get out of bed or ambulate without assistance. Caution client about drowsiness as a side effect.
Identify two reasons to withhold anesthesia and analgesia until the midactive phase of stage I labor.
If analgesia and anesthesia are given too early, they can retard labor; if given too late, they can cause fetal distress.
List four nursing actions for the second stage of labor.
Make sure cervix is completely dilated before pushing is allowed. Assess FHR with each contraction. Teach woman to hold breath for no longer than 10 seconds. Teach pushing technique.
List three signs of placental separation.
Gush of blood, lengthening of cord, and globular shape of uterus
What is the purpose of eye prophylaxis in the newborn?
To prevent ophthalmia neonatorum, which results from exposure to gonorrhea in the vagina
What is the major cause of maternal death when general anesthesia is administered?
Aspiration of gastric contents
Hypotension commonly occurs after the laboring client receives a regional block. What is one of the first signs the nurse might observe?
Nausea
State three actions the nurse should take when hypotension occurs in a laboring client.
Turn client to left side. Administer O2 by mask at 10 L/ min Increase speed of intravenous infusion (if it does not contain medication).
