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Health and Illness Concepts II Nursing: N2310 > Maternity/Infant Health (Exam One) > Flashcards

Maternity/Infant Health (Exam One) Flashcards

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1
Q

What laboratory panel is standard in labor and delivery?

A

Complete Blood Count (CBC)

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2
Q

What specific laboratory values are assessed in labor and delivery?

A
  • Hemoglobin

- Hematocrit

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3
Q

What is the leading cause of maternal morbidity and mortality?

A

Postpartum hemorrhage

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4
Q

Why does postpartum hemorrhage often go unnoticed?

A

Patients believe it is a normal finding following delivery

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5
Q

How has postpartum hemorrhage traditionally been classified?

A
  • Early

- Late

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6
Q

Nurses and physicians tend to ______ guess the amount of postpartum blood loss.

A

Under-guess

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7
Q

Is postpartum bleeding a subjective or objective finding?

A

Subjective

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8
Q

Dark red blood is usually indicative of what?

A

Deep cervical lacerations

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9
Q

When does early postpartum hemorrhage occur?

A

Within 24 hours of the birth

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10
Q

When does late postpartum hemorrhage occur?

A

More than 24 hours but less than 6 weeks after the birth

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11
Q

Postpartum hemorrhage is defined by how much blood loss following a vaginal birth?

A

500 mL

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12
Q

Postpartum hemorrhage is defined by how much blood loss following a cesarean birth?

A

1000 mL

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13
Q

Why would hydramnios or a macrosomic fetus cause a boggy uterus?

A

Makes the uterus bigger

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14
Q

What is the leading cause of postpartum hemorrhage within the first hour following birth?

A

Uterine atony

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15
Q

What is the priority nursing intervention for a patient experiencing hemorrhage due to uterine atony?

A

Perform fundal massage

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16
Q

What is the first sign of uterine atony?

A

Profuse bleeding

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17
Q

How is the risk of hemorrhage reduced?

A
  • Contraction of uterus

- Firming of uterus

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18
Q

What length of time is allotted to deliver the placenta following birth?

A

30 minutes

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19
Q

If the placenta has not been delivered within 30 minutes following the birth, what is this considered?

A

Retained placenta

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20
Q

List the risk factors associated with manual removal and separation of the placenta.

A
  • Infection
  • Bleeding
  • Retained placental fragments
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21
Q

What type of surgical intervention is utilized to remove retained placental fragments that are unable to be manually removed?

A

Dilation and curettage (D&C)

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22
Q

List the three different levels of adherent retained placenta.

A
  • Accreta
  • Increta
  • Percreta
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23
Q

What is placenta accreta?

A

Slight penetration of the myometrium

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24
Q

What is placenta increta?

A

Deep penetration of the myometrium

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25
Q

What is placenta percreta?

A
  • Deep penetration of the myometrium

- May invade nearby organs

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26
Q

List the risk factors associated with adherent retained placenta.

A
  • Bleeding
  • Infection
  • Hysterectomy
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27
Q

Describe placenta abruptio.

A

Premature separation of the placenta

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28
Q

_________ _________ is NOT considered an abnormal placental adherence pattern.

A

Placenta abruptio

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29
Q

A patient with a firm uterus is experiencing bright red bleeding from the vagina. The nurse knows the most likely cause for the bleeding is what?

A

Lacerations of genital tract

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30
Q

List the most common causes of lacerations of the lower genital tract.

A
  • Operative births
  • Precipitate births
  • Abnormal presentation of fetus
  • Congenital abnormalities of maternal soft tissue
  • Previous scarring from infection
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31
Q

Describe the bleeding characteristics associated with lacerations of the genital tract.

A
  • Slowly

- Continuous

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32
Q

What is the most common type of hematoma?

A

Vulvar hematoma

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33
Q

Describe a vulvar hematoma.

A

Visible and painful

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34
Q

What type of patient is most at risk for developing a vaginal hematoma?

A
  • Primiparous women

- Use of forceps

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35
Q

Patients who have had a episiotomy are at an increased risk for what?

A

Vaginal hematomas

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36
Q

What type of hematoma is the least common and most life threatening?

A

Retroparateneal

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37
Q

List nursing interventions for a patient with a hematoma.

A
  • Apply ice
  • Pain medication
  • Cushion (donut) to sit on
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38
Q

What is the purpose of marking a hematoma?

A

Manage size and growth

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39
Q

What condition is potentially life threatening, a medical emergency, and requires immediate attention?

A

Inversion of the uterus

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40
Q

Inversion of the uterus occurs in ___ in _______ births.

A

1 in 2,500 births

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41
Q

What type of medication is given to a patient with an inversion of the uterus? Why?

A
  • Tocolytics

- Relaxes the uterus

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42
Q

Describe incomplete inversion of the uterus.

A
  • Smooth muscle can be palpated through the cervix

- Uterus has not come through the cervix

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43
Q

Describe complete inversion of the uterus.

A
  • The uterus is inside-out

- Uterus is coming out through the cervix

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44
Q

Describe prolapsed inversion of the uterus.

A

Large mass of uterus is protruding outside of the vagina

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45
Q

What is the most common reason for late postpartum hemorrhage?

A

Subinvolution of the uterus

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46
Q

List the signs and symptoms of subinvolution of the uterus.

A
  • Uterus does not shrink
  • Increased bleeding
  • Prolonged lochial discharged
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47
Q

List medications used to manage postpartum hemorrhage.

A
  • Oxytocin
  • Methergine
  • Hemabate
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48
Q

What medication increases the risk of postpartum hemorrhage?

A

Magnesium sulfate

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49
Q

Why does magnesium sulfate increase the risk for postpartum hemorrhage?

A
  • Acts as smooth muscle relaxant
  • Causes uterine relaxation
  • Causes uterine atony
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50
Q

What type of surgical intervention is utilized for late postpartum hemorrhage if it is unable to be corrected otherwise?

A

Dilation and curettage (D&C)

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51
Q

A _________ ________ is a nonsurgical intervention that is inserted into the uterus to apply internal pressure in order to manage postpartum hemorrhage.

A

Bakri balloon

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52
Q

If a Bakri balloon is inserted, the nurse knows not to perform what?

A

Fundal massage

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53
Q

Inversion of the uterus will most likely lead to __________ _______.

A

Hemorrhagic (hypovolemic) shock

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54
Q

List the signs and symptoms of hemorrhagic (hypovolemic) shock.

A
  • Hypotension
  • Tachycardia
  • Urine output less than or equal to 30 mL per hour
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55
Q

What is the primary nursing intervention for a patient experiencing hemorrhagic (hypovolemic) shock?

A

Fluid replacement

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56
Q

An autoimmune disorder in which anti-platelet antibodies decrease the lifespan of platelets is known as what?

A

Idiopathic thrombocytopenic purpura (ITP)

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57
Q

Describe von Willebrand disease (vWD).

A

Defect in blood clotting protein

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58
Q

What is considered the primary treatment of choice for von Willebrand disease (vWD) as it can be administered orally, nasally, and IV?

A

Desmopressin

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59
Q

___________ __________ results from formation of blood clots inside of a blood vessel, caused by inflammation or partial obstruction of the vessel.

A

Venous thromboembolism (VTE)

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60
Q

Where does deep venous thrombosis (DVT) most commonly occur?

A

Lower extremities

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61
Q

Involvement varies, but deep venous thrombosis (DVT) can extend from the ______ to the _________ _________.

A

From the foot tot he iliofemoral region

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62
Q

What medical manifestation is considered a complication of deep venous thrombosis and occurs when part of a blood clot dislodges?

A

Pulmonary embolism

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63
Q

Pain and tenderness in the extremities, accompanied by warmth, redness, and harness is indicative of what condition?

A

Thrombophlebitis

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64
Q

What is considered the first sign or symptom of postpartum infection?

A

Increased temperature for two successive days, beginning 24 hours after birth

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65
Q

What is considered the most important and least expensive measure to prevent postpartum infection?

A
  • Aseptic technique

- Handwashing

66
Q

Infants whose birth weight is below the _____ percentile are considered to have a low birth weight.

A

10th

67
Q

Infants whose birth weight is above the _____ percentile are considered to have a high birth weight.

A

90th

68
Q

An infant whose birth weight falls between the 10th and 90th percentiles on intrauterine growth curves is considered what?

A

Appropriate for gestational age (AGA) infant

69
Q

Describe a preterm infant in relation to gestational age.

A

An infant born before 37 weeks gestation

70
Q

Describe a postterm infant in relation to gestational age.

A

An infant born at or after 42 weeks gestation

71
Q

The majority of high risk infants are those born in less than ____ ________.

A

37 weeks

72
Q

A premature infants growth and developmental milestones are corrected for gestation until they reach what age?

A

2 1/2

73
Q

Because premature infants will not hit normal growth and development milestones, their age is often __________.

A

Corrected

74
Q

Describe corrected age for the premature infant.

A

Add gestational age and postnatal age

75
Q

What anatomical structure on the premature infant is the first to experience catch-up growth?

A

Head

76
Q

Describe the purpose of administering artificial surfactant in a neonate.

A

Improves ability of lungs to exchange oxygen and carbon dioxide

77
Q

Apnea occurs when an infants breathing ceases for what amount of time?

A

Longer than 20 seconds

78
Q

What type of breathing pattern is common in premature infants?

A

Periodic breathing

79
Q

Describe periodic breathing.

A

5 to 10 seconds of respiratory pauses followed by 10 to 15 seconds of rapid respirations

80
Q

List the signs and symptoms of an infant experiencing cold stress.

A
  • Mottled skin
  • Acrocyanosis
  • Cyanosis
  • Irritability
  • Increased respiratory rate
  • Periods of apnea
81
Q

Rapid changes in body temperature may cause what in the neonate?

A

Apnea

82
Q

What is the normal range for PaO2 in the neonate?

A

60 to 80 mm Hg

83
Q

If a neonate is on mechanical ventilation, what are the priority nursing interventions?

A
  • Auscultate breath sounds
  • Ensure patency of endotracheal tube
  • Assess oxygen saturation
  • Notify x-ray to verify placement
84
Q

A neonate on mechanical ventilation is continuing to experience respiratory distress after multiple intervention attempts. As the nurse you know this is indicative of what condition?

A
  • Shock

- Hypovolemia

85
Q

Hyperoxygenation, or a high arterial blood oxygen level, can result in what condition for the neonate?

A

Retinopathy of prematurity (ROP)

86
Q

Describe bronchopulmonary dysplasia.

A

Caused by use of positive pressure ventilation against immature lung tissue

87
Q

Is patent ductus arteriosus (PDA) associated with hyper-oxygenation or hypo-oxygenation?

A

Hypo-oxygenation

88
Q

Why are endotracheal tubes usually accompanied by a nasogastric or oral tube in a neonate?

A
  • Mechanical ventilation causes distention

- Tubes are used to decompress the stomach if filled with air

89
Q

A premature infant is scheduled to receive a gavage feeding. The nurse should encourage the parents of the infant to do what during this feeding?

A

Hold the infant

90
Q

List nursing interventions to prevent bloating, reflux, and vomiting in a neonate receiving gavage feedings.

A
  • Administered slowly over 20 to 30 minutes
  • Small amounts
  • Warm temperature
91
Q

What should the nurse document after each gavage feeding administration?

A

Response to the feeding

92
Q

Describe necrotizing enterocolitis.

A

Inflammatory disease of gastrointestinal mucousa

93
Q

List the signs and symptoms of necrotizing enterocolitis.

A
  • Abdominal distention
  • Temperature instability
  • Grossly, bloody stools
94
Q

List the risk factors for developing necrotizing enterocolitis.

A
  • Polycythemia
  • Anemia
  • Congenital heart disease
95
Q

Describe the purpose of kangaroo care.

A
  • Infant directly interacts with parents

- Enhances infant temperature regulation

96
Q

How should a nurse interact with the parents of an infant who is being cared for in the NICU?

A
  • Educate parents
  • Frequent communication
  • Explain procedures/equipment
  • Encourage questions
97
Q

T/F: Preterm infants have greater surface area in proportion to their weight.

A

True

98
Q

Small for gestational age (SGA) and intrauterine growth restriction (IUGR) infants are at an increased risk for which complications?

A
  • Perinatal asphyxia
  • Hypoglycemia
  • Hyperglycemia
  • Polycythemia
  • Heat loss
99
Q

List the conditions that late preterm infants are at an increased risk for.

A
  • Respiratory distress
  • Thermoregulation
  • Hypoglycemia
  • Hyperbilirubinemia
  • Infection
100
Q

List complications commonly associated with a post mature infant.

A
  • Meconium aspiration
  • Hypoglycemia
  • Dry, cracked skin
  • Persistent pulmonary hypertension
101
Q

Describe asymmetric intrauterine growth restriction (IUGR).

A
  • Weight is less than 10th percentile

- Head circumference is greater than 10th percentile

102
Q

T/F: Infants with asymmetric intrauterine growth restriction (IUGR) have the potential for normal growth and development.

A

True

103
Q

A newborn acquires petechiae during childbirth. The nurse will determine this finding benign if what?

A

Disappears within 48 hours and does not come back

104
Q

Because bruising of the newborn sustained during childbirth may be mistaken as cyanosis or respiratory distress, it is critical for the nurse to do what?

A
  • Document the bruising

- Report the bruising to co-workers

105
Q

A retinal hemorrhage may cause what?

A
  • Vision issues

- Complete vision loss

106
Q

Describe caput succedaneum.

A
  • Crosses suture line
  • Presents as pitting edema
  • Resolves within 48 to 72 hours
107
Q

Describe cephalhematoma.

A

-Occurs over parietal bone
-Does not cross suture line
-Initially firm and softens over time
-Resolves in 2 to 3 weeks
-

108
Q

How are cephalhematoma’s diagnosed in a full-term infant?

A

Laboratory testing

109
Q

What type of hemorrhage due to childbirth causes more long-term damage to the neonate and is hard to recognize?

A

Subgaleal hemorrhage

110
Q

T/F: Unless a blood vessel is involved, linear skull fractures heal without special treatment.

A

True

111
Q

What bone of the newborn is most often fractured during childbirth?

A

Clavicle

112
Q

What type of therapy or treatment is implemented for a newborn suffering from a clavicle fracture?

A
  • No special treatment necessary

- Swaddle the newborn

113
Q

Birth trauma that results the in paralysis of the arm caused by nerve injury to C5 or C6 is known as what?

A

Erb-Duchenne palsy

114
Q

Which type of palsy is classified as an upper plexus injury?

A

Erb-Duchenne palsy

115
Q

What type of nerve injury results in respiratory distress of the newborn due to the inability of the diaphragm to expand properly?

A

Phrenic nerve injury

116
Q

Describe Klumpke’s palsy.

A
  • Rare injury of shoulder

- Affects movement of affected lower arm and hand

117
Q

Which type of palsy is classified as a lower plexus injury?

A

Klumpke’s palsy

118
Q

A subarachnoid hemorrhage occurs in preterm infants as a result of what?

A

Hypoxia

119
Q

A subarachnoid hemorrhage occurs in term infants as a result of what?

A

Trauma

120
Q

List the signs and symptoms of a subdural hemorrhage.

A
  • Apnea
  • Unequal pupils
  • Tense fontanel seizures
  • Coma
121
Q

Describe distinguishable features of infants of diabetic mothers.

A
  • Macrosomia
  • Squinty eyes
  • Big, round cheeks
122
Q

What conditions are infants of diabetic mothers at a higher risk for developing?

A
  • Respiratory distress syndrome
  • Perinatal hypoxia
  • Birth trauma
123
Q

Hypoglycemia is indicated in the term infant of a diabetic mother if their blood glucose level is less than what?

A

40 mg/dL

124
Q

List the signs and symptoms of hypoglycemia in a term infant.

A
  • Jitteriness
  • Apnea
  • Tachypnea
  • Cyanosis
125
Q

A diabetic mother gives birth to a macrocosmic infant. What is the priority nursing intervention?

A
  • Frequent blood glucose level monitoring

- Observe for s/sx of hypoglycemia

126
Q

The newborn infant is susceptible to infection because of what?

A

Immature immune system

127
Q

List the causes of sepsis in a newborn.

A
  • Lacerations (trauma)
  • Meconium aspiration
  • Prolonged rupture of membranes
  • Transplacental infections
128
Q

What sign(s) or symptom(s) is indicative of sepsis in an infant, both before and after birth?

A
  • Tachypnea

- Tachycardia

129
Q

What is the purpose of erythromycin (antibiotic) instillation into the eyes of the newborn shortly after birth?

A
  • Prophylactic treatment
  • Prevents gonorrheal infection
  • Prevents ophthalmia neonatorum
130
Q

What transplacental infection is caused by contact with cat-litter boxes, or undercooked or contaminated meats?

A

Toxoplasmosis

131
Q

A newborn infant has a rash on their palms and around their anus. This is indicative of what infection?

A

Syphilis

132
Q

How is HIV transmitted to a newborn from the mother postnatally?

A
  • Breastfeeding

- Breast milk

133
Q

Which neonatal infection is the leading cause of neonatal morbidity and mortality in the United States?

A

Group B streptococci (GBS)

134
Q

The incidence of group B streptococci is decreasing in the neonate because of what?

A

Effective drug treatment

135
Q 
Tachycardia in utero may be present if the mother uses which substances? (SATA)
A. Tobacco 
B. Meth
C. Cocaine 
D. Heroine 
E. Alcohol 
F. Marijuana 
G. Ecstasy
A

A, B, C, F, G

136
Q

Describe the characteristics of an infant with fetal alcohol syndrome.

A
  • Small for gestational age
  • Thin eyes
  • Thin upper lip
  • Microcephaly
  • Lowset ears
137
Q

__________ is the number one cause of cognitive impairment and dysfunction in the neonate.

A

Alcohol

138
Q 
There is an increase for placental abruption if the mother abuses which substances? (SATA) 
A. Meth 
B. Heroine 
C. Alcohol 
D. Tobacco 
E. Cocaine
A

A, E

139
Q

What scoring system is used for an infant experiencing withdrawals?

A

Neonatal abstinence syndrome (NAS) scoring

140
Q

What medication is commonly prescribed for infants experiencing withdrawal from substances?

A

Morphine

141
Q

What nursing intervention should be implemented for an infant experiencing withdrawal from substances?

A
  • Swaddling the infant
  • Holding the infant
  • Frequent, increased feedings
142
Q

According to the American College of Obstetricians and Gynecologists, pregnant women should not exceed _______ of caffeine per day.

A

200 mg

143
Q

A person who is Rh negative means he/she _______ have the Rh antigen.

A

Does not

144
Q

Rhogam is given during what week of pregnancy as a standard precaution.

A

29 weeks

145
Q

The mother will receive another Rhogam injection within 72 hours after birth if the infant has what Rh factor?

A

Rh positive (Rh+)

146
Q

Describe the maternal and paternal characteristics of an infant who is most likely to express Rh incompatibility.

A
  • Rh negative mother
  • Rh positive father
  • Father is dominant (homozygous) for Rh factor
147
Q

Only Rh-_______ offspring of an Rh-_________ mother are at risk for Rh incompatibility.

A

Only Rh-positive offspring of an Rh-negative mother are at risk for Rh incompatibility.

148
Q

What is the most common cause of pathological hyperbilirubinemia?

A

Hemolytic disorders

149
Q

When is a direct Coombs’ test performed? Who/what is the direct Coombs’ test performed on?

A

On the cord blood after birth

150
Q

When is an indirect Coombs’ test performed? Who/what is the indirect Coombs’ test performed on?

A

On the mother before birth

151
Q

What medication has the most effect on preventing neural tube defects?

A

Folic acid

152
Q

The CDC urges all women of reproductive age to consume ______ of folic acid each day.

A

400 mcg

153
Q

List foods high in folic acid.

A
  • Broccoli
  • Bananas
  • Lentils
  • Avocado
  • Asparagus
154
Q

What is the priority nursing intervention for a patient with myelomeningocele?

A
  • Protect the sac

- Infection prevention

155
Q

List the signs and symptoms of acute distress related to parental grieving?

A
  • Crying
  • Denial
  • Shock
  • Hyperventilation
  • Want someone with them
156
Q

What should the nurse not expect to see in a family that is grieving?

A
  • Numbness

- Lack of response

157
Q

Describe the reorganizational phase of grief.

A
  • Able to function at home/work
  • Experience a return of self-esteem and confidence
  • Able to cope with new challenges
  • Placed loss in perspective
158
Q

Describe complicated grief.

A
  • Intense

- Lasts longer than the expected amount of time

159
Q

Why is the term recovery not appropriate to describe the grief related to perinatal loss?

A

Grief can continue for life

160
Q

Within a family, who is most likely to experience survivors guilt related to perinatal loss?

A

Grandparents

161
Q

A mother is anticipated to give birth to a stillborn infant. What should the nurse ask the mother prior to delivery?

A

Would you like to see or hold your baby after giving birth?

162
Q

What must the nurse be cognizant of in regard to autopsies and perinatal loss?

A
  • Personal views
  • Cultural views
  • Religious views

Health and Illness Concepts II Nursing: N2310 (10 decks)

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