Maternal/Newborn

Question 1

What are some of the ways to decrease nausea and constipation during pregnancy?

Answer 1

For nausea: Eat small meals frequently, alcohol, caffeine, fried/fatty foods
For Constipation: Increase fluids and fiber, and exercise

Question 2

What antibiotic is used for GBS in pregnancy?

Answer 2

Penicillin G or Ampicillin

Question 2

What are some ways to decrease discomfort during menstruation for patients with fibrocystic breast condition?

Answer 2

Reduce salt intake, wear a supportive bra, apply cold/heat, avoid caffeine

Question 3

In intrapartum nursing care, what are the conditions that would warrant cessation of oxytocin?

Answer 3

Variable decelerations in FHR
Uterine Tachysystole-
Contraction frequency lasting for more than 5 to 10 minutes
Single contraction lasting longer than 2 minutes
Contractions of normal duration occurring within one minute of each other
Contraction intensity of more than 55mmHg detected by IUPC
Uterine resting tone of greater than 15mmHg between contractions
No relaxation of the uterus between contractions

Question 4

What are the adverse effects of an epidural?

Answer 4

Maternal hypotension
Fetal bradycardia
Fever
Itching
Inability to feel the urge to void
Urinary retention
Loss of the bearing down reflex

Question 5

What medication is given to patients with Hyperemesis gravidarum?

Answer 5

Give pyridoxine (vitamin B6) and other vitamin supplements as tolerated.
Pyridoxine alone or in combination with doxylamine
Use antiemetic medications (metoclopramide) cautiously for uncontrollable nausea and vomiting.

Question 6

What are the causes of variable decelerations in FHR?

Answer 6

Umbilical cord compression
Short cord
Prolapsed cord
Knot in the cord
Nuchal cord (around fetal neck)

Question 7

If a patient is going to be getting a pap smear, what should the nurse tell the patient not to do 24 hours before the exam?

Answer 7

Refrain from using vaginal medications, douching or sexual intercourse within 24 hours prior to examination which can alter test results

Question 8

What is Caput Succedaneum?

Answer 8

Caput succedaneum (localized swelling of the soft tissues of the scalp caused by pressure on the head during labor) is an expected finding that can be palpated as a soft edematous mass and can cross over the suture line. Caput succedaneum usually resolves in 3 to 4 days and does not require treatment.

Question 9

What does HELLP syndrome stand for?

Answer 9

H: Hemolysis resulting in anemia and jaundice
EL: Elevated liver enzymes resulting in elevated alanine aminotransferase (ALT) or aspartate transaminase (AST), epigastric pain, and nausea and vomiting
LP: Low platelets (less than 100,000/mm3), resulting in thrombocytopenia, abnormal bleeding and clotting time, bleeding gums, petechiae, and possibly disseminated intravascular coagulation.

Question 10

What is an early deceleration?

Answer 10

Slowing of FHR at the start of contraction with return of FHR to baseline at end of contraction

Question 11

What causes early decelerations?

Answer 11

Compression of the fetal head resulting from:
Uterine contractions​​​​​​​
Vaginal exam
Fundal pressure
Placement of internal monitoring

Question 12

What is a late deceleration?

Answer 12

Slowing of FHR after contraction has started with return of FHR to baseline well after contraction has ended

Question 13

What things cause late decelerations?

Answer 13

Uteroplacental insufficiency causing inadequate fetal oxygenation
Maternal hypotension, placenta previa, abruptio placentae, uterine tachysystole with oxytocin
Preeclampsia
Late- or post-term pregnancy
Maternal diabetes mellitus

Question 14

What are the assessments for placenta previa?

Answer 14

Assess for bleeding, leakage, or contractions.
Assess fundal height.
Refrain from performing vaginal exams (can exacerbate bleeding). QS​​​​​​​
Administer IV fluids, blood products, and medications as prescribed. Corticosteroids, such as betamethasone, promote fetal lung maturation if early delivery is anticipated (cesarean birth).
Have oxygen equipment available in case of fetal distress.

Question 15

What is placenta previa?

Answer 15

Placenta previa occurs when the placenta abnormally implants in the lower segment of the uterus near or over the cervical os instead of attaching to the fundus. The abnormal implantation results in bleeding during the third trimester of pregnancy as the cervix begins to dilate and efface.

Question 16

What are the guidelines for diaphragm use?

Answer 16

-Be properly fitted with a diaphragm by a provider.
-Replace every 2 years and refit for a 20% weight fluctuation, after abdominal or pelvic surgery, and after every pregnancy.
-The diaphragm can be inserted up to 6 hr before intercourse and must stay in place 6 hr after intercourse but for no more than 24 hr.
-Spermicide must be reapplied with each act of coitus.
-Empty the bladder prior to insertion of the diaphragm, to decrease pressure on the urethra.
-The diaphragm should be washed with mild soap and warm water after each use.

Question 17

What are the guidelines for infant phototherapy?

Answer 17

Maintain an eye mask over the newborn’s eyes for protection of corneas and retinas.
Keep the newborn undressed. For a male newborn, a surgical mask should be placed (like a bikini) over the genitalia to prevent possible testicular damage from heat and light waves. Be sure to remove the metal strip from the mask to prevent burning.
Avoid applying lotions or ointments to the skin because they absorb heat and can cause burns.
Remove the newborn from phototherapy every 4 hr, and unmask the newborn’s eyes, checking for inflammation or injury.
Reposition the newborn every 2 hr to expose all of the body surfaces to the phototherapy lights and prevent pressure sores.
Check the lamp energy with a photometer per facility protocol.