Ob midterm study guide Flashcards
Anatomy of umbilical cord
2 arteries(carries deoxygenated blood), 1 vein (carries oxygenated blood)
Pt comes in labor, contracting q2-3 mins, VS taken, fetal hr 122, maternal hr 128, bp 88/46 what is priority?
Reposition (Left side, off back)
Primary vit in food that reduces change of neurologic defects?
Folic acid
Late Decelerations shows:
uteral deficiency // variable declarations: cord
SIgns of ectopic pregnancy?
Sharp abdominal pain on one side (unilateral).
Fetal head location and descent to the ?
-3 is up , +3 is out?
A nurse in a prenatal clinic is caring for a client who is at 38 weeks gestation and undergoing a contraction stress test. The test results are negative. Which of the following interpretations of this finding should the nurse make?
A. There is no evidence of cervical incompetence.
B. There is no evidence of two or more accelerations in fetal heart rate in 20 min.
C. There is no evidence of uteroplacental insufficiency.
D. There are less than 3 uterine contractions in a 10 min period.
C. There is no evidence of uteroplacental insufficiency.
A nurse is assessing a client who is in active labor and notes that the presenting part is at 0 station. Which of the following is the correct interpretation of this clinical finding?
A. The fetal head is in the left occiput posterior position.
B. The largest fetal diameter has passed through the pelvic outlet.
C. The posterior fontanel is palpable.
D. The lowermost portion of the fetus is at the level of the ischial spines.
D. The lowermost portion of the fetus is at the level of the ischial spines.
Decelerations- V E Acceleration Late placenta?
V: Variable Decelerations
E: Early Decelerations
A: Acceleration
L: Late Decelerations
Corresponding causes:
C: Cord Compression (for Variable Decelerations)
H: Head Compression (for Early Decelerations)
O: Oxygenation (for Accelerations)
P: Placental Insufficiency (for Late Decelerations)
Last menstrual period: June 4. Estimated delivery day?
March 11
After the start of contraction, fetal heart rate starts decreasing what is your intervention:
reposition on lateral side if not an option choose oxygen
Baby’s head is at -1, this means:
1 cm above ischial spine
A nurse on the labor and delivery unit is caring for a client following a vaginal examination by the provider which is documented as: -1. Which of the following interpretations of this finding should the nurse make?
A. The presenting part is 1cm above the ischial spines.
B. The presenting art is 1cm below the ischial spines.
C. The cervix is 1cm dilated.
D. The cervix is effaced 1cm.
A. The presenting part is 1cm above the ischial spines.
A nurse in a clinic is reviewing the medical records of a group of clients who are pregnant. The nurse should anticipate the provider will order a maternal serum alpha-fetoprotein (MSAFP) screening for which of the following clients?
A. A client who has mitral valve prolapse
B. A client who has been exposed to AIDS
C. All of the clients
D. A client who has a history of preterm labor.
C. All of the clients
Maternal serum fetal alpha protein order on:
every patient!
End of NST, 30 mins, baseline 140, minimal variability, no accelerations, 2 decel:
Non
reactive
atient comes in 38 weeks preg, what are signs of going into labor:
baby dropping,
nesting (surge of energy), lightning ( baby head drops down)
Major complications of epidural block:
hypotension
Pt on epidural bp 88/42, fetal hr 130 what do you do?
Reposition
s/s of hyperemesis gravidarum:
wt loss (due to n/v), dehydration. Help pt by
meds such as reglan, IV fluids to help with hydration, small amounts of food and fluid, monitor I&O
A nurse in a clinic is caring for a client who is at 39 weeks of gestation and who asks about the signs that precede the onset of labor. Which of the following should the nurse identify as a sign that precedes labor?
A. Decreased vaginal discharge
B. A surge of energy
C. Urinary retention
D. Weight gain of 0.5 to 1.5 kg
B. A surge of energy
A nurse is assessing a client in labor who has had epidural anesthesia for pain relief. Which of the following findings should the nurse identify as a complication from the epidural block?
A. Vomiting
B. Tachycardia
C. Respiratory depression
D. Hypotension
D. Hypotension
A nurse on a labor unit is admitting a client who reports painful contractions. The nurse determines that the contractions have a durtiong of 1min and a frequency of 3min. The nurse obtains the following vitals: fetal heart rate 130/min, maternal heart rate 128/min, and maternal blood pressure 92/54mmHg. Which of the following is the priority action for the nurse to take?
A. Notify the provider of the findings.
B. Position the client with one hip elevated.
C. Ask the client if she needs pain medication.
D. Have the client void.
B. Position the client with one hip elevated.
A pregnant patient tells the nurse that she has been nauseated and vomiting. How will the nurse explain that hyperemesis gravidarum is distinguished from morning sickness?
a. Hyperemesis gravidarum usually lasts for the duration of the pregnancy.
b. Hyperemesis gravidarum causes dehydration and electrolyte imbalances.
c. Sensitivity to smells is usually the cause of vomiting in hyperemesis gravidarum.
d. The woman with hyperemesis gravidarum will have persistent vomiting without weight loss.
b. Hyperemesis gravidarum causes dehydration and electrolyte imbalances.
Recommend rubella immunizations occur
AFTER delivery
Signs of Placenta previa?
Placenta is covering cervix, bright red and painless bleeding
Pt w preeclampsia, receiving mag sulfate. RR 10, DTR +1, u will FIRST:
STOP giving
the med
Reason to do maternal serum alpha fetoprotein:
for spinal, neural, and abdominal wall defects
A nurse is caring for a client who is at 36 weeks of gestation and who has suspected placenta previa. Which of the following findings support this diagnosis?
a. Painless red vaginal bleeding
b. Increasing abdominal pain with a non relaxed uterus
c. Abdominal pain with scant red vaginal bleeding
d. Intermittent abdominal pain following passage of bloody mucus
a. Painless red vaginal bleeding
A nurse is assessing a client who received magnesium sulfate to treat preterm labor. Which of the following clinical findings should the nurse identify as an indication of toxicity to magnesium sulfate therapy and report to the provider?
A. Respiratory depression
B. Facial flushing
C. Nausea
D. Drowsiness
A. Respiratory depression
A nurse is preparing to administer magnesium sulfate IV to a client who is experiencing preterm labor. Which of the following is the priority nursing assessment for this client?
A. Temperature
B. Fetal heart rate (FHR)
C. Bowel sounds
D. Respiratory rate
D. Respiratory rate
Taking hx, smokes half a cig a day
educate to stop smoking bc of IUGR (tiny bby)
Where do we expect fetal heart tones on pregnant mom?
Lower abdomen
Most common RF that leads to placental abruption
HTN
Gate control theory of pain?
Redirect pain, so massage shoulders and remove
sensitization and distract them from pain
Lower back pain with contraction the baby is in
occipital posterior position
Pt comes in HA, spots in eyes, BP 150/90 u will
administer an antihypertensive(to lower BP), mag sulfate(to prevent seizures), then check protein in urine
Pt comes in and has vaginal spotting, RLQ pain what are we suspecting:
Meds to give?
ectopic pregnancy.
Methotrexate.
Know pt blood type because RH sensitization, Watching Beta HCG blood level (will decrease if med working)
Amniocentesis
empty the bladder, we do it on week 14 of gestation bc thats when amnio fluid starts building
Late decelerations on fetal monitor:
reposition on side
A nurse is completing a health history for a client who is at 6 weeks of gestation. The client informs the nurse that she smokes one pack of cigarettes per day. The nurse should advise the client that smoking places the client’s newborn at risk for which of the following complications?
A. Hearing loss
B. Intrauterine growth restriction
C. Type 1 diabetes mellitus
D. Congenital heart defects
B. Intrauterine growth restriction
Nurse is caring for patient who’s pregnant and at end of her 1st trimester. Nurse should place Doppler ultrasound stethoscope in which locations to begin assessing fetal heart tones (FHT)?
Just above the umbilicus
Just above the symphysis pubis
The right lower quadrant
The left lower quadrant
Just above the symphysis pubis
A nurse in a provider’s office is caring for a client who is at 34 weeks of gestation and at risk for placental abruption. The nurse should recognize that which of the following is the most common risk factor for abruption?
A. Cocaine use
B. Hypertension
C. Blunt force trauma
D. Cigarette smoking
B. Hypertension
A nurse is caring for a client who is in labor. Which of the following nursing actions reflects application of the gate control theory of pain?
A. Administer prescribed analgesic medication
B. Encourage the client to rest between contractions
C. Massage the client’s back
D. Turn the client onto her left side
C. Massage the client’s back
