Mother Baby Flashcards
How do you straighten the auditory canal of a patient under 3 yo?
To straighten the auditory canal, the pinna should be pulled downward and back, instead of upward and back.
What is the recommended weight gain for pregnant women with a BMI between 20-25?
The recommended weight gain for women with an average BMI is 11.5 to 16 kg, or roughly 25 to 35 lb. This amount is sufficient to ensure that the fetus is adequately nourished.
What are complications related to vacuum-assist birth?
Perineal, vaginal, or cervical laceration
A newborn’s car seat should be at what angle?
45 degrees
The baby’s car seat should be rear facing until what age?
Until 2 years old or until reaching the age and weight the car seat manufacturer recommends
At what height should the retainer clip of a car seat be placed?
At the level of the baby’s armpits
What position should the nurse place the mother during an umbilical prolapse?
Knee-chest position
What is an indication for an emergency cesarean birth on a fetal monitoring strip?
late or variable decelerations
What is the expected reference temperature for a newborn?
36.5° C to 37.5° C
(97.7° F to 99.5° F)
How should a client prevent discomfort with engorgement?
The client should place ice packs on the breasts to reduce swelling and relieve the pain caused by engorgement.
The client should wear a tight-fitting, supportive bra or breast binder to decrease the discomfort caused by engorgement.
Why do newborns receive vitamin K?
Newborns are deficient in vitamin K and should receive it following birth because this deficiency can lead to bleeding.
What are signs of abruptio placentae?
A client who has abruptio placentae can experience persistent uterine contractions, board-like abdomen, and dark red vaginal bleeding.
Bright red vaginal bleeding may be a sign of what?
Placenta previa
What is Naegele’s Rule?
Subtract 3 months, add 7 days to the client’s last menstrual period date
At what frequency should new foods be introduced to a 6-month-old infant?
The parents should introduce new foods one at a time over 3 to 5 days to identify potential food allergies.
What is the purpose of administering magnesium sulfate?
To prevent seizures in a client who has preeclampsia
What is the purpose of administering terbutaline?
To decrease contractions during preterm labor
Complications of severe preeclampsia
HELLP
Hemolysis
Elevated lipid enzymes
Low platelet count
Dystocia
4 P’s
Powers
Passageway
Passenger
Psych
APGAR
Appearance
Pulse
Grimace
Activity
Respiratory effort
GTPAL
Gravida
Term
Preterm
Abortions (SAB, TAB)
Living children
Veal Chop
Relates to fetal heart rate
Variable decels –> cord compression
Early decels –> head compression
Accelerations –> O2
Late decels –> Placental utero insufficiency
Placenta previa or abruptio placenta?
Bright red, painless
Placenta previa
Placenta previa or abruptio placenta?
Premature separation of placenta
Abruptio placenta
T/F: Use of witch hazel compresses can reduce edema.
True
T/F: The nurse should offer a warm sitz bath to a client who reports unrelieved episiotomy pain.
False. During the first 24 hr, ice packs and cool water sitz baths are used. They reduce edema and promote comfort.
T/F: For breast engorgement, fresh cabbage leaves placed inside the breast can help alleviate associated pain.
True
T/F: The nurse should apply lotion to the newborn’s skin twice daily if they are receiving phototherapy.
False. The nurse should avoid applying lotions or ointments to the skin during phototherapy because they absorb heat and can cause burns.
Which medication should the nurse have available to counteract the effects of meperidine?
Naloxone. Meperidine used to relieve severe pain.
What action will the client need to complete prior to an amniocentesis?
Empty the bladder.
Post vacuum-assisted delivery, what are manifestations of cerebral irritation?
Listlessness and poor sucking
T/F: Endometriosis increases the risk of developing ovarian cancer.
True
What is raloxiphine used to treat?
Osteoporosis
T/F: You want an empty bladder for an ultrasound.
False. You need a full bladder for an ultrasound.
A negative contraction stress test does not have what kind of decelerations?
Negative test has no late decelerations
What is GTPAL?
Gravida
Term
Preterm
Abortion
Living
What is protein in the urine is indicative of?
Preeclampsia
When is Neural Tube Defect screening done?
16-18 weeks
When is group B strep screening done?
35 weeks
When is diabetes screening done?
28 weeks
What foods are a source of B12?
Liver, yogurt, eggs, milk
Only found in animal products
T/F: Sudden weight gain can be indicative of preeclampsia.
True
What are symptoms of severe preeclampsia?
CNS irritability
Liver involvement
Oliguria
What are grape-like clusters caused by rapid uterine growth called?
Hydatidiform moles
T/F: Placenta previa will present with a board-like abdomen with dark red bleeding.
False. Abruptio placenta will present with a board-like abdomen with dark red bleeding.
Placenta previa will present with painless, bright red bleeding.
What is the priority action for a client who is in active labor preparing for an epidural?
Infuse an isotonic IV bolus
T/F: A client who is in the transitional phase of labor reports lightheadedness and tingling hands. The nurse should instruct the client to breathe into her cupped hands.
True.
What are tocolytics?
Medication that can slow down the labor.
indomethacin and nifedipine
What medication augment labor?
Oxytocin
T/F: For a client who is breastfeeding, the client should avoid giving the infant a bottle at night.
True, bc this causes nipple confusion
T/F: For a client who is 2 hours postpartum, two perineal pads saturated since delivery is normal.
False. 1 saturated pad in 2 hours is better. Two pads in two hours is too much!
How many veins and arteries are on the umbilical cord of a newborn?
Two arteries, one vein (AVA)
What are symptoms of menopause?
Hot flashes/night sweats
Palpitations
Vaginal atrophy
Osteoporosis
What vitamin helps with absorption of calcium?
D3
When are APGAR scores calculated?
one and five minutes after delivery
What are the stages of labor?
Early/latent (dilation until 3cm)
Active (dilation from 3 to 7cm)
Transition (dilation from 7 to 10cm)
T/F: Prematurely born infants are at greatest risk for necrotizing enterocolitis (NEC).
True. Preterm birth places a newborn at risk for NEC. This could be due to lack of oxygen during delivery and a weakened immune system
T/F: Lithium poses few risks to the fetus in the second and third trimester.
True. Lithium crosses the placenta and is associated with teratogenic effects in the first trimester. During the second and third trimesters, the benefits may outweigh the risks in a client who has bipolar disorder.
A patient with an IUD reports abrupt, sharp, lower abdominal pain and bright red vaginal bleeding. What finding is most liking?
Ectopic pregnancy. Ectopic pregnancy is a risk increased by IUDs. This manifests as unilateral lower quadrant pain that can occur with or without bleeding.
What is quickening?
Sensation of fluttering movements or motions the client can feel.
What is Goodell sign?
Softening of the cervix that the provider can detect upon examination.
Probable examples of pregnancy.
What is Ballottement?
Sensation of a flating object within the uterus. Detected by provider gently pushing upward on cervix and waiting for a rebound sensation.
Probable examples of pregnancy.
What are examples of presumptive signs of pregnancy?
Fatigue
N/V
Breast changes
Amenorrhea
Urinary frequency
Quickening
What are examples of probable signs of pregnancy?
Goodell, Hegar, Chadwick signs
Ballottement
Positive pregnancy test
What are examples of positive signs of pregnancy?
Ultrasound visualization of fetus
Auscultation of fetal heart tones
Palpation of fetal parts
T/F: As a foley catheter is being inserted, the nurse should instruct the patient to breathe slowly through their mouth.
False. The nurse should instruct the client to bear down as the foley is being inserted.
T/F: Administration of spinal anesthetic medications can cause maternal hypotension that results in fetal hypoxia, a cause of fetal bradycardia.
True
What type of dressing is used for the sac before a myelomeningocele repair?
A moist, sterile, nonadhesive dressing
T/F: Dark brown vaginal discharge is an expected finding who a client who has a hydatidiform mole.
True.
For a client with severe pre-eclampsia, what is the most accurate assessment to determine a client’s fluid and electrolyte status?
Daily weight
T/F: Uterine fibroids increase the risk for postpartum hemorrhage.
True
What is the purpose of betamethasone?
Betamethasone stimulates fetal lung maturity. Used during preterm labor to prevent respiratory depression.
What is the purpose of methylergonovine?
Stimulate uterine contractions for a client who is experiecing postpartum hemorrhage
What is the purpose of poractant alfa?
It is a synthetic lung surfactant for preterm newborns who are experiencing respiratory distress
Should the client have a full or empty bladder for abdominal ultrasounds?
Full, to help lift uterus out of the pelvis during examination
When are nonstress tests done?
26 weeks of gestation
Is it normal for clients to have a feeling of warmth while receiving magnesium sulfate infusions?
Yes.
For clients with Rh-negative blood, when should they receive the Rh0 immune globulin?
28 weeks of gestation and within 72 hr if the client’s newborn is Rh-positive
What is polyhydramnios?
Presence of excessive amniotic fluid surrounding the unborn fetus
What are expected findings of a client with polyhydramnios?
Gastrointestinal malformations and neurologic disorders
What is oligohydramnios?
Volume of amniotic fluid less than 300mL during third trimester of pregnancy and occurs when there is a renal system dysfunction or obstructive uropathy
Excess progestin levels in combination OCs can cause what condition?
Depression
Weight gain
Acne dt strong androgenic effects
Progestin deficiency in combination OCs can cause what condition?
Amenorrhea
For a client prescribed DMPA, when should the RN schedule the first dose?
At 6 weeks postpartum
Second dose administered 3 months after first dose
T/F: Infants have longer intestinal tracts.
True
T/F: Infants have less extracellular fluid.
False. Infants have larger fluid volume and more rapid water loss
T/F: Clients who have neural tube defects are at risk for latex allergy.
True
How much weight loss is expect of a lactating client?
2.2lbs each month
How much weight loss is expect of a non-lactating client?
0.5 to 0.9kg (1.1 to 2lb) each week
How often should diaphragms be replaced?
Every 2 years
What structure expels the ovum?
The Graffian follicle expels the mature ovum
What is normal bilirubin levels for a newborn?
4 to 6mg/dL
What is normal glucose levels for newborns?
40-60mg/dL
What factors can put mothers at risk for uterine atony?
Magnesium sulfate infusion
Distended bladder
Prolonged labor
What are manifestations of biliary atresia in infants?
Yellowing sclerae
Abdominal distention
Dark urine
Acholic or gray stools
Difficult metabolizing fats (poor weight gain)
What are contraindications for OCs?
Liver disease
Breast cancer
Thrombophlebitis
T/F: A client who has had a past cesarean delivery cannot receive misoprostol.
True. Misoprostol can cause uterine tachysystole, and therefore can cause uterine rupture for clients with hx of cesarean delivery
What is the expected range of head circumference for a newborn?
32 to 36.8cm
What is the expected weight of a newborn?
2500 to 4000 grams
What is the expected respiratory rate of a newborn?
30 to 60 respirations/min
