OB/WOMENS HEALTH

Question 1

A client at 32 weeks gestation goes into cardiac arrest. What is the nurse’s best action while performing CPR for this client?

Answer 1

Perform chest compressions slightly higher on the sternum.

• During pregnancy, the heart is displaced toward the left because the growing uterus pushes upward on the diaphragm, particularly in the third trimester.
• The uterus should also be manually displaced

Question 2

Preterm birth is defined as ______.

Answer 2

Birth before 37 weeks and 0 days gestation.

Question 3

What is strongly associated with preterm labor, particularly when untreated?

Answer 3

INFECTION: Periodontal disease, UTIs

Question 4

Other risk factors of preterm birth include:

Answer 4

• Hx of spontaneous preterm birth in a previous pregnancy
• Previous cervical surgery
• Tobacco/drug use
• <17yo
• > 35 yo

Question 5

First signs of uterine rupture:

Answer 5

1. Abnormal fetal heart rate and patterns
2. Constant abdominal pain
3. Loss of fetal station
4. Sudden cessation of uterine contractions

Question 6

Nonshivering thermogenesis:

Answer 6

Neonates are unable to generate heat by shivering due to their lack of muscle tissue and immature nervous systems; they produce heat by increasing their metabolic rates through NST.

Question 7

Brown adipose tissue:

Answer 7

Developed in the third trimester; metabolized for thermogenesis when available
-Once BAT is depleted, NST is less effective and the neonate may experience cold stress, possibly leading to death

Question 8

Clinical manifestations of cold stress:

Answer 8

1. Neuro = AMS (irritability or lethargy)
2. Cardiovascular = bradycardia
3. Respiratory = tachypnea early, followed by apnea and hypoxia
4. GI = high gastric residuals, emesis, hypoglycemia
5. Musculoskeletal = hypotonia, weak suck and cry
   * Frequent temp monitoring is the best method to assess if an infant is cold

Question 9

FTT RF:

Answer 9

• Poverty
• Social or emotional isolation
• Cognitive disability or mental health disorder
• Lack of nutrition education

Question 10

Systemic disease characterized by HTN and proteinuria after the 20th gestational week with unknown etiology

Answer 10

Pre-eclampsia

Question 11

Eclampsia:

Answer 11

The onset of convulsions or seizures that cannot be attributed to other causes in a women with preeclampsia

Question 12

What is the only cure for preeclampsia-eclampsia syndrome?

Answer 12

Delivery

Question 13

Central nervous system depressant used to prevent/control seizure activity in preeclampsia/eclampsia clients:

Answer 13

Mag sulfate

Question 14

Signs of mag toxicity:

Answer 14

• Decreased deep-tendon reflexes
• Respiratory depression
• Decreased urine output

Question 15

Therapeutic mag level =

Answer 15

4-7

Question 16

Ectopic pregnancy:

Answer 16

Occurs when a fertilized egg implants and begins to grow outside the uterine cavity, frequently in the fallopian tubes. If untreated, continued growth can lead to fallopian tube rupture, resulting in hemorrhage
*Shoulder pain in a client with ectopic pregnancy indicated intra-abdominal bleeding from a rupture

Question 17

Risk factors for pelvic inflammatory disease:

Answer 17

1. Multiple sexual partners
2. History of chlamydia or gonorrhea
3. History of PID
4. Partner with STI
5. Lack of consistent barrier contraception use
6. Age 15-25

Question 18

Placenta accreta:

Answer 18

Condition of abnormal placental adherence in which the placenta implants directly in the myometrium rather than the endometrium.

Question 19

Major complication of placenta accreta:

Answer 19

• Life threatening hemorrhage which occurs during attempted placental separation
• 2 large bore IVs and a blood type and crossmatch are priority in case of blood transfusion

Question 20

The nurse should use sterile gloves during a vaginal exam in the presence of ruptured membranes. T/F

Answer 20

TRUE to prevent infection

Question 21

What is a nitrazine pH test?

Answer 21

Inserted into the vagina to differentiate between amniotic fluid and vaginal fluid.
Blue color= indicates positive result and probable rupture of membranes
Yellow = negative result and membranes are intact

Question 22

Asymptomatic hypoglycemia:

Answer 22

Newborns with BG <35mg/dL; if younger than 4 hours should be treated with feeding

Question 23

Ideal BG for a newborn:

Answer 23

Greater than or equal to 40-45

-BG lower than 40-45 should be confirmed with a plasma blood sample, but the newborn should feed without waiting

Question 24

Dietary sources of folic acid:

Preggo women need 400 mcg of folic acid per day

Answer 24

• Asparagus
• Turnip.mustard greens
• Fortified breakfast cereal
• Cooked dried beans
• Liver
• Broccoli
• Spinach
• Green peas
• Fresh-cooked beets
• Pasta
• RIce
• PB

Question 25

Vaginal hematoma:

Answer 25

Formed when trauma of the tissues of the perineum occurs during delivery
-Client will report severe vaginal pain or a feeling of fullness

Question 26

Inversion of the uterus:

Answer 26

Presents with a large, red mass protruding from the introitus

Question 27

Uterine atony:

Answer 27

Boggy uterus on palpation and an increase in vaginal bleeding

Question 28

Postpartum hemorrhage:

Answer 28

If excessive bleeding occurs after initial interventions, second line uterotonic drugs may be given: carboprost, methylergonovine (cx. in clients w/ high BP), misoprostol

Question 29

Breast engorgement:

Answer 29

Ice packs, cold cabbage leaves, wear a supportive bra, ibuprofen

Question 30

Infertility:

Answer 30

Diagnosed when a couple fails to conceive after 12 months (women age <35); or 6 months for women who are older than 35