Maternity and Newborn Health

Question 1

What are the expected findings of a reactive nonstress test? Is it a reassuring or concerning finding? How long is this test?

Answer 1

A REACTIVE non stress test should present with two or more fetal heart rate accelerations within a 20-minute period. This is a reassuring finding and may last for up to 40 minutes (an additional 20 minutes may be added to a non stress test when it is nonreactive for the first 20 minutes).

Question 2

Fetal monitoring strips
Reassuring vs Non-reassuring

Answer 2

Reassuring:
- FHR within baseline 110-160 bpm
- Moderate variability
- Accelerations

Non-reassuring
- Above or below baseline FHR
- Decreased variability
- Variable decelerations
- Late decelerations

Question 3

What is subinvolution and what are the signs and symptoms of it?

Answer 3

Subinvolution is the failure of the uterus to contract and return to its non pregnant size and location.

Question 4

What are 4 teachings for a breastfeeding mother that developed mastitis?

Answer 4

• Continue to breastfeed your child normally
• Empty each breast at each feeding
• Complete the entire course of the prescribed antibiotic
• Wear a supportive bra without an underwire

Question 5

What is vernix caseosa?

Answer 5

A thick white substance that resembles cream cheese, provides a protective covering for the fetal skin in utero. It is a normal finding upon assessment.

Question 6

What findings on a newborn assessment will require follow-up?

Answer 6

• High pitched cry (May indicate withdrawals, or may be a sign of increased ICP)
• White patches on cheeks and tongues (Candidiasis)
• Respiratory rate 25 breaths/minute (30-60 breaths/minute is the normal range)

Question 7

What are the four defects that define tetralogy of fallot? What are hallmark signs or symptoms?

Answer 7

• Overriding aorta
• Pulmonary stenosis
• Hypertrophy of the right ventricle
• Ventricular septal defect

Hallmark symptoms - Heart murmur and mild to severe cyanosis

Question 8

What is transposition of the great arteries? What are the hallmark signs or symptoms?

Answer 8

In the transposition of the great arteries, the pulmonary artery leaves the left ventricle, and the aorta leaves the right ventricle. These infants are severely cyanotic and require surgery urgently.

Question 9

What is Hypoplastic left heart syndrome? What are hallmark signs or symptoms?

Answer 9

When the left side of the heart is under developed, the nurse would note cyanosis and murmur at birth.

Question 10

What is coarctation of the aorta? What are the hallmark signs or symptoms?

Answer 10

Coarctation of the aorta is a narrowing of the aorta near the ductus arteriosus. Due to this narrowing, there is increased blood flow to the upper extremities and decreased blood flow to the lower extremities.

Question 11

What assessment findings are expected in placental abruption?

Answer 11

Painful vaginal bleeding
Hypotension
Rigid abdomen

Question 12

What does the mnemonic LION stand for when trying to improve fetal oxygenation?

Answer 12

Lie the mother on her left side
Increase IV fluids
Oxygen
Notify the HCP

Question 13

What fetal heart rate pattern will most likely be seen in a patient with a prolapsed umbilical cord?

Answer 13

Variable decelerations