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Maternal Newborn 2 Flashcards

1
Q

Crib slats should be no more than how far apart to prevent entrapment/fractures/suffocation?

A

2.25 inches

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2
Q

Space between mattress and the sides of the crib?

A

Less than two finger widths (.8 inches)

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3
Q

How often to check smoke detectors to ensure proper functioning?

How often to replace batteries?

A

Once a month

Twice per year

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4
Q

Set water heater to what degree?

Set bath water to?

A

120.2 F or less

100 F

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5
Q

16 weeks pregnant with diabetes and BMI of 31 (overweight) what to include in teaching about diet ??

A

If BMI greater than 30- limit total caloric intake to 25 kcal/day or less

Do not skip a meal (eat on a schedule) to prevent hypoglycemia and ketoacidosis

Carbs 55% , Protein 20%, Fat 25%

Eat large bedtime snack with at least 25g of complex carbs

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6
Q

How often one should formula feed newborn?

A

3-4 hours

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7
Q

How much will new born drink of formula during first 24-48 hrs?

A

15-30mL

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8
Q

Why not to feed newborn water between feedings

A

Formula Contains enough water to meet newborns fluid needs

Feeding water between feedings can lead to improper calorie intake

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9
Q

How often to burp newborn during feeding ?

A

A few times during the feeding

to reduce spitting up after feeding

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10
Q

How to listen to fetal heart tones at 12 weeks (3 months)

A

Ultrasound stethoscope

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11
Q

When should the nurse obtain a blood sample for the MSAFP (maternal serum alpha - fetoprotein) screen?

A

Between 15 and 20 weeks of gestation

The AFP blood test determines how much AFP is in the mother’s blood.

High levels of AFP may suggest the developing baby has a neural tube defect such as spina bifida or anencephaly

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12
Q

When should the nurse collect a vaginal and anal specimen for GBS? Guillain-Barré syndrome (Streptococcus group B) (rare disorder in which a person’s own immune system damages their nerve cells, causing muscle weakness and sometimes paralysis)

A

35 -37 weeks

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13
Q

When to measure Fundal height for gestational age?

A

Between 18 and 30 weeks

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14
Q

What actions should the nurse take for a client who is 18 hours postpartum and his 4th° perineal laceration? Client says the pain is a 4

A

Witch hazel pads

(cleanse and condition your skin gently and thoroughly. helps tighten pores and tone skin without drying, leaving skin feeling clean, soft and refreshed)

Give ice packs

Cool water sitz bath

Practice relaxation techniques

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15
Q

Client teaching before taking medroxyprogesterone acetate injection for contraception ?

A

Client may gain weight on this med

Client may also have decrease in bone density (take calcium supplement)

This medication is safe with lactation, however client should wait six weeks after delivery to start medication if breast-feeding

Client will receive injection every 11 to 13 weeks (3 months) as a form of contraception

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16
Q

What finding to report to dr at 38 weeks ?

A

Glycosuria - (excess sugar in urine - complication of gestational diabetes)

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17
Q

Expected finding of pregnancy?

A

Leg cramps- poor circulation

Insomnia- physical discomforts

Leukorrhea - Due to an increased amount of cervical mucus from hormonal changes

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18
Q

Best source of folate ? How much a day?

A

1 cup cooked spinach

600 mcg

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19
Q

What to do for a client receiving betamethasone for preterm labor)

A

Inject IM in vastus lateralis

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20
Q

Side effect of terbutaline? (treatment of asthma)

A

Dizziness

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21
Q

Which electrolyte level to monitor for when giving magnesium sulfate?

A

Magnesium

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22
Q

What is a contraindication (when not to use) for the use of oral contraceptives?

A

Frequent headaches with visual changes

(It can indicate a cardiovascular conditions such as hypertension) It can lead to increase risk of stroke, heart attack, thromboembolism

Some Antibiotics and antiviral meds (for oral contraceptives- reduce effectiveness)

Serious disorders such as gallbladder disease and liver cirrhosis

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23
Q

UTI prevention teaching for 25 week gestation ?

A

Empty bladder before going to bed at night
(a full bladder Provides environment that can grow bacteria)

Wipe from front to back

Where all cotton undergarments to avoid trapping heat and moisture

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24
Q

Education about prevention of newborn abduction?

A

An alarm will sound of someone removes the newborn safety device

The client should only transport newborn between the nursery and room in a bassinet

Never leave a newborn unattended even while showering

Only facility personnel with badges indicating that the individual work specifically in the maternal newborn unit should transport newborns

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25
What is a non-stress test?
Used to determine FHR, baby’s movement, contractions (changes of heart rhythm when moving and contractions )
26
Client teaching about non-stress test at 33 weeks?
Press the button when you feel the baby move Eat and drink as usual prior to the test The stress monitors for accelerations in the fetal heart rate with fetal movement
27
contraction stress test teaching?
measure the baby's heart rate during uterine contractions During contractions, the flow of blood and oxygen to the placenta temporarily slows down. measure the baby's heart rate during uterine contractions Might require a IV infusion for the administration of Oxytocin Might require the client to perform nipple stimulation to initiate contractions
28
Postpartum discharge teaching instructions
Do not use powder on newborn due to aspiration Use a firm mattress in the newborns crib to reduce SIDs Do not put pillows or comforters in crib Place in Supine position
29
Car seat safety with a newborn
Place in car seat rear facing in the middle of the backseat until two years old or until weight and height restrictions are ok Position the retainer clip at the level of the babies armpits Play shoulder harness straps in the slats at or below the level of the newborn shoulders The guardian should position the newborn in the car seat at 45° angle to prevent the newborns head from falling forward which can lead to airway obstruction
30
What to do for constipation and pregnancy?
Drink 2L water/ day Do not take mineral oil - depletes vit A,D, E, K Avoid enemas because it can trigger labor or cause injury to client or fetus Do not take docusate sodium because it can cause dependence and electrolyte imbalance
31
What to report with a pt taking oxytocin | Stimulates uterine contractions
If urine output is less than 120 mL q 4 hours - can indicate urine retention which can lead to hyponatremia and water intoxication Nausea, vomiting, headache, hypotension More than five contractions in 10 minutes or single contractions lasting longer than two minutes
32
Formula preparation teaching?
Spitting up can indicate over feeding or gastroesophageal reflex Over diluted formula can result in an adequate growth and too much formula can stress the newborns renal system Client may use tapwater after running from faucet for two minutes. The client should then boil it for 1 to 2 minutes and cool it for no longer than 30 minutes. Sterile bottled water is also safe Client should discard any formula that remains in a bottle if you’re feeding
33
What report in the active phase of the first stage of labor?
Report fetal heart rate below 110 or above 160 Report Uterine contractions lasting shorter than 40 seconds or more than 90 seconds Report Green fluid from the vagina which indicates that the fetus has passed meconium stool. Early decelerations are expected in this phase of labor
34
Postpartum complications after 18 hours of birth?
The funds should be located at the level of the umbilicus for the first 24 hours after birth. After that it should decrease 1 cm each day. A temperature of 100.4°F is an expected finding in the first 24 hours after birth due to dehydration Lochia that is bright red or contains large blood clots (may indicate excessive bleeding) Login with small blood clots is an expected finding in the first 24 hours
35
How to administer phytonadione? (Vit k)
IM Until the newborn can produce its own
36
To report to the provider for a client who is receiving magnesium sulfate?
Absent deep tendon reflexes Which can lead to respiratory or cardiac arrest Report a urinary output of less than 25 to 30 mL per hour
37
One hour oral glucose tolerance test client who is pregnant teachings?
Avoid caffeine in the morning because it can increase glucose levels
38
Three hour glucose tolerance test teachings?
Be sure to ingest A proper amount of carbohydrates for at least three days before the test, except for the overnight 12 hrs fast immediately before the test urine sample at the start of the test
39
What to know about hgb?
During the postpartum. The clients Hgb little can decline moderately for 3 to 4 days
40
What to know what WBC during postpartum?
During the first 10 to 12 days after birth the clients WBC can increase it to 25,000 and still be in the expected reference range, anything over can indicate an infection
41
How long is normal time for newborns First void to occur?
24 hours
42
How should the newborns umbilical cord look?
Two arteries and one vein | If only 1 Artery nb could have renal anomaly
43
Time frame to report jandauce
First 24 hours of life
44
Actions to take to decrease the clients risk of developing thrombophlebitis?
Instructed to ambulate several times a day to increase circulation Report any pain or tenderness in the legs Do not give an NSAIDS Apply warm compresses to the Legs to prevent clot formation
45
Breastfeeding teaching for 12 hour newborn ?
Awake newborn to feed every 4 hours for first 24-48 hours after birth Do not remove colostrum from nipples After 6 months- feed iron rich foods Use breast pump after feeding only if newborn is not able I feed at the breast.
46
Intrauterine device teachings?
Report late, abnormal spotting, or bleeding to the provider Report pain during intercourse Report to the provider if you can not feel the strings because it can be an indication of dislodgment Report exposure to infection or unusual vaginal discharge
47
How often to bathe newborn? Hair? Bath water temp?
Q 2-3 days to protect skin Wash hair 1-2x weekly Keep water temperature at 100°F
48
How to take nb blood glucose
``` Wash hands and put on gloves Warm infants heel Cleanse site with alcohol and dry Apply pressure using gauze Cuddle and comfort infant ```
49
Report to provider 48 hours after delivery?
Reddened area on the calf Dysuria (painful and difficult urination) Cracked nipples – can lead to mastitis (inflammation in breast gland/utter)
50
What to do FIRST for Client receives Iv fentanyl 10 minutes ago for pain and has slurred speech and altered mental status?
Take O2 saturation Apply tocotranducer to abdomen (Monitor clients contractions) Administer naloxone Ask the patient to rate the pain from a scale of 0 to 10 because of reverse effects of pain medication
51
Risk factors for developing being pre-eclampsia at 26 weeks of gestation
Rheumatoid arthritis – systemic lupus (Connective tissue diseases increases clients risk) BMI greater than 30 Multifetal gestation (more than one fetus) Infection Chronic hypertension (headache) Abnormal Uric acid level
52
What to recommend to someone with hyperemesis gravidarum (severe prolonged vomiting)
Monitor intake and output to determine clients hydration status Eat foods and drink fluids separately Eat cold or room temp foods Low fat and high protein diet Collect specimens for your analysis, CBC, electrolytes, liver enzymes, Bilirubin levels
53
If the funders is 2 cm above the umbilicus at two hours postpartum and is boggy what is the likely cause of this?
Bladder distention (pushing on uterus)
54
This is a slow, oozing trickle of blood, during which the funders can remain firm?
Cervical laceration
55
Is uterine bleeding and expected findings after delivery?
Yes. It often contains large clots resulted from a relaxed distended
56
This can lead to uterine atony (loss of muscle tone) and excessive vagina bleeding?
Retention of placental fragments
57
Interventions for a patient with eclampsia priority following a seizure?
Administer oxygen by facemask at 10 L a minute FIRST The nurse should use an 18 gauge catheter to administer magnesium sulfate Insert a indwelling urinary catheter to monitor the clients Output The nurse should raise the side rails of the bed and pad the rails with blankets or pillows to ensure safety
58
What is a kosher diet?
Avoid eating meat and dairy together
59
Understanding the purpose of carboprost (oxytocin properties) after postpartum ?
Reduce bleeding/hemorrhage after birth
60
When to receive Rh immune globin?
If mother is Rh negative (to treat Rh incompatibility)
61
What to receive to treat anemia ?
Iron supplements
62
Finding to expect with a client who is a primigravida (pregnant for the first time) and has hyperthyroidism?
Diaphoresis (sweating)
63
Expected finding of hypothyroidism?
Cold intolerance Hoarseness Hair loss
64
Report to doctor if happens around 37 weeks as a sign of hypertension or preeclampsia?
Blurred vision
65
Newborn umbilical cord care teaching?
Report any drainage from babies umbilical cord- could be infection Only use warm water to wash cord The cord should fall off within 10 to 14 days Secure the diaper below the cord to prevent infection and promote drying
66
Discharge teaching with a client who has mastitis (inflammation of breast gland or nipple) of the left breast?
Pump breast frequently- to prevent growth of bacteria and increase comfort Continue breast feeding or pump (does not contaminate milk)
67
How to relieve Engorgement (blocked milk ducts) pain in breasts?
Apply cold cabbage leaves
68
When might client experience leukorrhea (White or gray vagina discharge from estrogen increase) in pregnancy?
Throughout the entire pregnancy
69
When should the client expect abdominal enlargement by?
The 14th week of pregnancy
70
When should the client feel fetal movement in pregnancy also known as quickening?
At 16 to 20 weeks
71
Potential complication of giving birth to a newborn who is large for gestational age (LGA)
InCrease of the risk of hemorrhage to do uterine atony (stress on muscles)
72
Expected findings for a client who is postpartum?
Deep tendon reflex is between 1+ and 2+ Leukocytosis for 4-7 days Elevated temperature during the first 24 hours after birth
73
Magnesium sulfate IV for preeclampsia- What is indication of magnesium sulfate toxicity that you should report to the provider?
Respiratory depression Decreased urine output
74
Proteinuria is an indication of what during pregnancy?
Preeclampsia
75
What are expected findings for someone who has Endometritis (inflammation of inner pinning of uterus) and is 48 hours post partum following a C-section
*Elevated HR Elevated respiration’s Fever Chills Nausea Anorexia Fatigue Pelvic pain Lochia with foul odor
76
Normal WBC range Erythrocyte sedimentation rate
12k-25k rate of 20mm/hr
77
Common adverse effect of metronidazole? (Do not need to tell dr)
Metallic taste in mouth
78
What medication can reduce effectiveness of contraceptives?
Penicillins and tetracycline
79
If breastfeeding and prescribed metronidazole, what to educate patient?
Do not breast feed for 8-10 days -pump and dump while taking medication and for 24-48 hours after last dose.

proctored ATI (6 decks)

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