Possible OB? FINAL Flashcards
A woman is suspected of having abruptio placentae. Which of the following would the nurse expect to assess as a classic symptom?
Knife-like” abdominal pain
The nurse is caring for a multigravid who experienced a placental abruption 4 hours ago. For which potential situation will the nurse prioritize assessment?
Uterine atony
RhoGAM is given to Rh-negative women to prevent maternal sensitization. In addition to pregnancy, Rh-negative women would also receive this medication after which of the following?
Therapeutic or spontaneous abortion
The nurse is caring for an Rh-negative nonimmunized client at 14 weeks’ gestation. What information would the nurse provide to the client
Obtain Rho(D) immune globulin at 28 weeks’ gestation.
After teaching a woman about hyperemesis gravidarum and how it differs from the typical nausea and vomiting of pregnancy, which statement by the woman indicates that the teaching was successful?
I need to avoid strong odors, perfumes, or flavors.
A woman has been diagnosed as having pregnancy-induced hypertension. Which of the following is the most typical symptom of this?
Blood pressure elevation
A woman is being admitted to your hospital unit for severe preeclampsia. When deciding on where to place her, which of the following areas would be most appropriate?
In the back hallway where there is a quiet, private room
A client visits a health care facility with complaints of amenorrhea for 10 weeks, fatigue, and breast tenderness. Which of the following additional signs and symptoms suggest the presence of molar pregnancy? Select all that apply.
Elevated hCG levels
Absence of fetal heart sound
Hyperemesis gravidarum
A client at 9 weeks’ gestation was unable to control the nausea and vomiting of hyperemesis gravidarum through conservative measures at home. With nausea and vomiting becoming severe, the client was omitted to the obstetrical unit. Which action should the nurse prioritize?
establish IV for rehydration
A nurse is caring for a client with hyperemesis gravidarum. Which nursing action is the priority for this client?
Administer IV normal saline with vitamins and electrolytes
In returning to the hospital floor after a weekend off, the nurse takes over care of a pregnant patient who is resting in a darkened room. The patient is receiving betamethasone and magnesium sulfate. What could the nurse deduce from those findings?
The patient is suffering from severe preeclampsia and the care team is attempting to prevent advancement of the disorder to eclampsia; they are attempting to help the baby’s lungs mature quickly so that they can deliver as soon as possible.
At 37 weeks’ gestation, a client presents to labor and delivery reporting intense, knife-like abdominal pain that started suddenly about 1 hour ago and has not subsided. On palpation, the abdomen is rigid and board-like and no vaginal bleeding is evident. What should the nurse do next?
Assess fetal heart rate
A client at 11 weeks’ gestation experiences pregnancy loss. The client asks the nurse if the bleeding and cramping that occurred during the miscarriage were caused by working long hours in a stressful environment. What is the most appropriate response from the nurse?
“I can understand your need to find an answer to what caused this. Let’s talk about this further.”
What makes the diagnosis of gestational hypertension different from the diagnosis of preeclampsia?
Proteinuria
A woman in week 35 of her pregnancy with severe hydramnios is admitted to the hospital. The nurse recognizes that which of the following is the biggest concern regarding this client?
Preterm rupture of membranes followed by preterm birth
A new young mother has tested positive for HIV. When discussing the situation with the client, the nurse should advise the mother that she should avoid which activity?
breastfeeding
A nurse is assessing a newborn and suspects that newborn may have been exposed to alcohol during gestation. The nurse suspect this based on which newborn findings? Select all that apply
thin upper lip
small head circumference
limb abnormality
The nurse is assessing a newborn of a woman who is suspected of abusing alcohol. Which newborn finding would provide additional evidence to support this suspicion?
Thin upper lip
A pregnant client has developed iron-deficiency anemia and has been prescribed 200 mg of elemental iron per day. The nurse should encourage the client to take this medication with which substance?
orange juice
The nurse is caring for a pregnant client who indicates that she is fond of meat, works with children, and has a pet cat. Which instructions should the nurse give this client to prevent toxoplasmosis? Select all that apply
Eat meat cooked to 160° F (71° C).
Avoid cleaning the cat’s litter box.
Avoid outdoor activities such as gardening.
A nurse is conducting a class for a group of pregnant women about ways to minimize the risk of infection during pregnancy. One of the infections that the nurse is discussing is toxoplasmosis. The nurse determines that the class was successful when the group identifies which action(s) as helpful in preventing this infection. Select all that apply
Any cutting surface used for raw meats should be washed afterwards with hot, soapy water.”
“Peeling any raw vegetables is a good idea before eating them.”
“It is important to wear gardening gloves when digging in the soil.”
A pregnant client with type I diabetes asks the nurse about how to best control her blood sugar while she is pregnant. The best reply would be for the woman to:
check her blood sugars frequently and adjust insulin accordingly
The nurse is preparing information for a client who has just been diagnosed with gestational diabetes. Which instruction should the nurse prioritize in this information?
Maintain a daily blood glucose log
A woman at 26 weeks’ gestation is undergoing screening for diabetes with a 1-hour oral glucose challenge test. On the client’s return visit, the nurse anticipates the need to schedule a 3-hour glucose challenge test based on which result of the previous test?
146 mg/dL
A young client experiencing contractions arrives at the emergency department. After examining them, the nurse learns that the client is at 33 weeks’ gestation. What treatment can the nurse expect this client to be prescribed?
tocolytic therapy
The nurse is monitoring the uterine contractions of a client in labor. The nurse determines the client is experiencing hypertonic uterine dysfunction based on which contraction finding?
erratic
A client has been in labor for 10 hours, with contractions occurring consistently about 5 minutes apart. The resting tone of the uterus remains at about 9 mm Hg, and the strength of the contractions averages 21 mm Hg. The nurse recognizes which condition in this client?
hypotonic contractions
A nurse assesses a client in labor and suspects dysfunctional labor (hypotonic uterine dysfunction). The client’s membranes have ruptured and fetopelvic disproportion is ruled out. Which intervention would the nurse expect to include in the plan of care for this client?
administering oxytocin
The nurse is teaching a pregnant woman with iron-deficiency anemia about her prescribed iron supplement. The nurse determines that the teaching was successful when the client states that she will take the supplement with:
citrus juice.
A pregnant client with sickle cell anemia is admitted in crisis. Which nursing intervention should the nurse prioritize?
I.V. fluids
A pregnant woman with sickle cell anemia is very concerned her infant will also develop the disease and questions the nurse about that possibility. Which is the best response from the nurse?
Both parents have to carry the trait.
When teaching a class of pregnant women about the effects of. substance abuse during pregnancy, which of the following would the nurse most likely include?
Low-birth-weight infants
A woman experiences an amniotic fluid embolism as the placenta is delivered. The nurse’s first action would be to:
administer oxygen by mask.
After teaching a group of nursing students about risk factors associated with dystocia, the instructor determines that the teaching was successful when the students identify which of the following as increasing the risk? (Select all that apply.)
Short maternal stature
Maternal age over 35
Breech fetal presentation
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After teaching a group of nursing students about the impact of pregnancy on the older woman, the instructor determines that the teaching was successful when the students state which of the following?
Women over age 35 and are pregnant have an increased risk for spontaneous abortions.
A neonate born to a mother who was abusing heroin is exhibiting signs and symptoms of withdrawal. Which of the following would the nurse assess? (Select all that apply.)
Hypertonicity
Excessive sneezing
Tremors
A nurse has been invited to speak at a local high school about adolescent pregnancy. When developing the presentation, the nurse would incorporate information related to which of the following? (Select all that apply.)
Peer pressure to become sexually active
Latinas as having the highest teen birth rate
Loss of self-esteem as a major impact
A client in preterm labor is receiving magnesium sulfate IV and appears to be responding well. Which finding on assessment should the nurse prioritize?
depressed deep tendon reflexes
A nurse assesses a client in labor and suspects dysfunctional labor (hypotonic uterine dysfunction). The woman’s membranes have ruptured and fetopelvic disproportion is ruled out. Which intervention would the nurse expect to include in the plan of care for this client?
administering oxytocin
A woman has been in labor for the past 8 hours, and she has progressed to the second stage of labor. However, after 2 hours with no further descent, the provider diagnoses an “arrested descent.” The woman asks, “Why is this happening?” Which response is the best answer to this question?
More than likely you have cephalopelvic disproportion (CPD) where baby’s head cannot make it through the canal.
A client at 38 weeks’ gestation has an ultrasound performed at a routine office visit and learns that her fetus has not moved out of a breech position. Which intervention does the nurse anticipate for this client?
external cephalic versionf
A nurse is caring for a postpartum client who has a history of thrombosis during pregnancy and is at high risk of developing a pulmonary embolism. For which sign or symptom should the nurse monitor the client to prevent the occurrence of pulmonary embolism?
calf swelling
A nurse is assessing a client with postpartum hemorrhage; the client is presently on IV oxytocin. Which interventions should the nurse perform to evaluate the efficacy of the drug treatment? Select all that apply
Assess the client’s uterine tone.
Monitor the client’s vital signs.
Get a pad count.
One of the primary assessments a nurse makes every day is for postpartum hemorrhage. What does the nurse assess the fundus for?
Consistency, shape, and location
The nurse is caring for a postpartum woman who exhibits a large amount of bleeding. Which areas would the nurse need to assess before the woman ambulates?
Blood pressure, pulse, reports of dizziness
The nurse is teaching a client about mastitis. Which statement should the nurse include in her teaching?
Symptoms include fever, chills, malaise, and localized breast
After the nurse teaches a local woman’s group about postpartum affective disorders, which statement by the group indicates that the teaching was successful?
Postpartum depression develops gradually, appearing within the first 6 weeks.”
A nurse is caring for a client in the postpartum period. When observing the client’s condition, the nurse notices that the client tends to speak incoherently. The client’s thought process is disoriented, and she frequently indulges in obsessive concerns. The nurse notes that the client has difficulty in relaxing and sleeping. The nurse interprets these findings as suggesting which condition?
postpartum psychosis
When monitoring a postpartum client 2 hours after birth, the nurse notices heavy bleeding with large clots. Which response is most appropriate initially?
massaging the fundus firmly
Which of the following would be most appropriate when massaging a woman’s fundus?
Wait until the uterus is firm to express clots.
A nurse suspects that a postpartum client is experiencing postpartum psychosis. Which of the following would most likely lead the nurse to suspect this condition?
Delirium
A group of students are reviewing risk factors associated with postpartum hemorrhage. The students demonstrate understanding of the information when they identify which of the following as associated with uterine tone? (Select all that apply.)
Rapid labor
Hydramnios
A nurse is developing a plan of care for a woman who is at risk for thromboembolism. Which of the following would the nurse include as the most cost-effective method for prevention?
Early ambulation
The nurse recognizes that the postpartum period is a time of rapid changes for each client. What is believed to be the cause of postpartum affective disorders?
drop in estrogen and progesterone levels after birth
The nurse observes an ambulating postpartum woman limping and avoiding putting pressure on her right leg. Which assessments should the nurse prioritize in this client?
Assess for warmth, erythema, and pedal edema.
A client experienced prolonged labor with prolonged premature rupture of membranes. The nurse would be alert for which of the following in the mother and the newborn?
Infection
The nurse is assessing a client 48 hours postpartum and notes on assessment: temperature 101.2oF (38.4oC), HR 82, RR 18, BP 125/78 mm Hg. The nurse should suspect the vital signs indicate which potential situation?
Infection
A new parent is diagnosed with a venous thromboembolism in their left calf. Which risk factor is associated with this problem? Select all that apply.
Obesity
C-section
TOXOPLASMOSIS?
Drink water from a bottle from other country’s…
HYDROZYCHLORIQUINE
NO CLUE
Nicotine also causes
Preterm labor, ectopic pregnancy
Placenta previa, low birth weight
Knife like pain is also
Placental previa
Blood glucose level parameter high is
120 mg
GBS newborn is developing parents infection
Increased temp
Preterm
<37 wk 6 day
Breast stimulation to
Stimulate labor. Prostaglandin & cytotec
Amniotic fluid embolism
Lactoid syndrome ( dyspnea, cyanosis, low bp)
Dystopia =
Have intubation equipment ready
Use of regional anesthesia
Monitor for infection
Encourage to breastfeed when
Pp hemorrhage
Do not fundal massage with
Shoulder dystocia
Endometritis
Pain in both sides of abd, leukocytosis, signs of infection, inflammation
Traumatic birth
Give methedrine, iron iv
4 weeks pp still bleeding
Involution of uterine
Perineal hematoma
Call doctor
Preeclampsia bp
Swelling of hands or extremities, flashing lights, headache
Analgecis
Don’t relieve preeclampsia symptoms
Clues for pp hemorrhage
Uterine assessment
Bp
Hr
