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ATI Maternal Newborn Study Guide

Terms in this set (68)

What is Naegel's formula?
a simple method for calculating the estimated date of delivery based on the last menstrual period.

Add 7 days and 9 months to the last menstrual day

(ex. last menstrual period was January 10th 2021 + 7 days + 9 months= October 17th, 2021 due date)
what are the risk factors for developing gestational diabetes?
obesity, maternal age greater than 25, family hx of diabetes
A nurse is planning care for a newborn who requires phototherapy for hyperbilirubinemia. Which of the following actions should the nurse include in the plan of care?
Baby should have has much skin exposed as possible, frequent feedings should be administered so the baby can excrete excess bilirubin in the stool, baby should remain free of lotion/skin products due to risk of burn during phototherapy, gently close the baby's eyes before applying goggles to prevent corneal damage from the light
A nurse is planning care for a client who is pregnant and is Rh-negative. In which of the following situations should the nurse administer Rh(D) Immune Globulin?
While the client is in labor

Following an episode of influenza during pregnancy

Prior to a blood transfusion

At 28 weeks of gestation <----ANSWER

The nurse should administer Rh(D) Immune Globulin to a client who is pregnant and has Rh-negative blood at 28 weeks of gestation. Rh(D) Immune Globulin consists of passive antibodies against the Rh factor, which will destroy any fetal RBCs in the maternal circulation and block maternal antibody production.
A nurse is caring for a client who is at 34 weeks of gestation and has a prescription for terbutaline for preterm labor. Which of the following statements by the client is the priority?
"My ankles are swollen at the end of the day."

"I can feel the baby kicking my ribs, and it is very uncomfortable."

"I'm growing more and more worried every day."

"My heart feels as if it is racing." <----ANSWER
the nurse should apply the urgent versus nonurgent priority-setting framework. Using this framework, the nurse should consider urgent needs to be the priority need because they pose more of a threat to the client. Using the urgent vs nonurgent framework, the nurse should assess the client's heart rate. The primary action of terbutaline is to cause bronchodilation and relax smooth muscles. However, an adverse effect is tachycardia. If the pulse is greater than 130/min, the terbutaline needs to be held until the provider is notified.
A nurse is caring for a client who is at 39 weeks of gestation and is in active labor. Which of the following actions should the nurse include in the plan of care?
keep four side rails up while the client is in bed.

Monitor fetal heart rate every hour.

Insert an indwelling urinary catheter.

Check the cervix prior to analgesic administration. <---- Correct
Prior to administering an analgesic during active labor, the nurse must know how many centimeters the cervix is dilated. If administered too close to the time of delivery, the analgesic could cause respiratory depression in the newborn.
A nurse is planning care for a client who is at 35 weeks of gestation. Which of the following laboratory tests should the nurse obtain?
Rubella titer
Blood type
Group B streptococcus ß-hemolytic <-----correct
1-hour glucose tolerance test

The nurse should obtain a vaginal/anal group B streptococcus ß-hemolytic (GBS) culture at 35 to 37 weeks of gestation to screen for infection. Prophylactic antibiotics should be given during labor to the client who is positive for GBS.
A nurse is caring for a newborn whose mother received magnesium sulfate to treat preterm labor. Which of the following clinical manifestations in the newborn indicates toxicity due to the magnesium sulfate therapy?
Respiratory depression <-----Correct
Hypothermia
Hypoglycemia
Jaundice

Magnesium sulfate can cause respiratory and neuromuscular depression in the newborn. The nurse should monitor the newborn for clinical manifestations of respiratory depression.
A nurse is caring for a client who is in labor and has an epidural for pain relief. Which of the following is a complication from the epidural block?

Nausea and vomiting
Tachycardia
Hypotension
Respiratory depression
Maternal hypotension is an adverse effect of epidural anesthesia. The nurse should administer an IV fluid bolus prior to the placement of epidural anesthesia in order to decrease the likelihood of this complication.
A nurse is caring for a client who has trichomoniasis and a prescription for metronidazole. Which of the following instructions should the nurse provide to the client about the treatment plan?

"Your partner needs to be cultured and be treated with metronidazole only if his cultures are positive."

"You and your partner need to take the medication and use a condom during intercourse until cultures are negative."

"If both you and your partner are treated simultaneously, you may continue to engage in sexual intercourse."

"only you will need to take the metronidazole, but you should not have intercourse until your culture is negative."
B.
Trichomonas vaginalis is the organism that causes the sexually transmitted infection trichomoniasis. Both men and women can be infected with trichomoniasis. Clinical findings include yellowish to greenish, frothy, mucopurulent, copious discharge with an unpleasant odor, as well as itching, burning, or redness of the vulva and vagina. Trichomoniasis can be treated easily with metronidazole. However, for the treatment to work, it is important to make sure both sexual partners receive treatment to prevent reinfection. Instruct the client to use condoms during sexual intercourse while being treated.
A nurse in a prenatal clinic is caring for a client who is within the recommended guideline for weight. The client asks the nurse how much weight is safe for her to gain during her pregnancy. Which of the following responses should the nurse make?

"Your provider can discuss an appropriate amount of weight gain with you."

"A weight gain of about 14 pounds each trimester is suggested."

"If you eat nutritious foods when you feel hungry, the amount of weight gain is insignificant."

"A weight gain of about 25 to 35 pounds is good."
D
A weight gain of 25 to 35 lb is associated with a good fetal outcome. A gain of 4 lb in the first trimester and 12 lb each for the second and third trimester is recommended.
A nurse is caring for a client who has a prescription for naloxone. Which of the following is the intended action of the medication in relation to the central nervous system (CNS)?

Accentuate effects of narcotics on the CNS

Depress activity of the CNS

Block effects of narcotics on the CNS

Stimulate activity of the CNS
C
By blocking the effects of narcotics on the CNS, naloxone prevents CNS and respiratory depression in the newborn following delivery.
A nurse is discussing diaphragm use with a client. Which of the following statements by the client indicates an understanding of the teaching?

"I should clean my diaphragm with alcohol each time I use it."The diaphragm should be cleaned with mild soap and water and dried gently.

"I should replace my diaphragm every 2 years."

"I should use a vaginal lubricant to insert my diaphragm."
C
The diaphragm is a flexible rubber cup that is filled with spermicide and is inserted over the cervix prior to intercourse. The diaphragm is a prescribed device fitted by the provider. It should be replaced every 2 years.
A nurse is teaching a client about a nonstress test. Which of the following statements by the client indicates an understanding of the teaching?

"I know not to eat anything after midnight."

"I will have medication given to me to cause contractions."

"I should press the button on the handheld marker when my baby moves."

"I will have to stimulate my breast to cause contractions."
C
the purpose of the test is to assess fetal well-being. The client should press the button on the handheld marker when she feels fetal movement.
A nurse is caring for a client who is 2 hr postpartum. The nurse notes the client's perineal pad has a large amount of lochia rubra with several clots. Which of the following actions should the nurse take first?

Check for a full bladder.

Massage the fundus.

Measure vital signs.

Administer carboprost IM.
B
the nurse should apply the safety and risk reduction priority-setting framework when answering this item. This framework assigns priority to the factor or situation posing the greatest safety risk to the client. When there are several risks to client safety, the one posing the greatest threat is the highest priority. The primary cause of early postpartum bleeding is uterine atony manifested by a relaxed, boggy uterus. Thus, the greatest risk for the client is hemorrhage. The nurse should massage the client's fundus first. The nurse should use Maslow's hierarchy of needs, the ABC priority-setting framework, or nursing knowledge to identify which risk poses the greatest threat to the client.
A nurse is caring for a preterm newborn who is receiving oxygen therapy. Which of the following findings should the nurse identify as a potential complication from the oxygen therapy?
Atelectasis
Retinopathy
Interstitial emphysema
Necrotizing enterocolitis
B
Oxygen therapy can cause retinopathy of prematurity, especially in preterm newborns. It is a disorder of retinal blood vessel development in the premature newborn. In newborns who develop retinopathy of prematurity, the vessels grow abnormally from the retina into the clear gel that fills the back of the eye. It can reduce vision or result in complete blindness.
A nurse is caring for a client who is receiving oxytocin for induction of labor. Which of the following actions should the nurse take?
Perform continuous fetal heart rate monitoring.
Measure maternal temperature every hour.
Evaluate maternal contraction pattern every hour.
Check blood pressure every 5 min.
A
When oxytocin is administered to an antepartum client, the fetal monitor must be used to continuously monitor the fetal heart rate and maternal contractions
A nurse is assessing a client on the first postpartum day. Findings include fundus firm and one fingerbreadth above and to the right of the umbilicus, moderate lochia rubra with small clots, temperature 37.3° C (99.2° F), and pulse rate 52/min. Which of the following actions should the nurse take?
Report the vital signs to the provider.
Massage the fundus.
Ask the client when she last voided.
Administer an oxytocic agent.
C
Because the muscles supporting the uterus have been stretched during pregnancy, the fundus is easily displaced when the bladder is full. The fundus should be found firm at midline. A deviated, firm fundus indicates a full bladder. The nurse should assist the client to void.
A nurse is assessing a newborn who is 12 hr old and notes mild jaundice of the face and trunk. Which of the following actions should the nurse take?
Administer phytonadione IM.
Obtain a stat prescription for a bilirubin level.
Obtain a bagged urine specimen.
Perform a gestational age assessment.
B
Jaundice in the first 24 hr of life is pathologic. The nurse should notify the provider and obtain a stat prescription for a bilirubin level.
A nurse is speaking with an expectant father who says that he feels resentful of the added attention others are giving to his wife since the pregnancy was announced several weeks ago. Which of the following responses should the nurse make?
"Has your wife sensed your anger toward her and the baby?"
"These feelings are common to expectant fathers in early pregnancy."
"I'm sure that it's really hard to accept this when it's your baby, too."
"It would be wise for you to speak to a therapist about these feelings."
B
The father needs reassurance that these feelings are expected. The nurse should reassure him that when the pregnancy becomes obvious he will feel more involved. This therapeutic response addresses the client's feelings by providing information.
A nurse is caring for a client who is at 36 weeks of gestation and has pre-eclampsia. Which of the following findings should the nurse identify as the priority?
1+ proteinuria
Blood pressure 140/98 mm Hg
Nonreactive nonstress test
Fundal height 33 cm
C
The nurse should apply the urgent versus nonurgent priority-setting framework when answering this item. Using this framework, the nurse should consider urgent needs to be the priority need because they pose more of a threat to the client. Using the urgent vs nonurgent approach to client care, the nurse determines that the priority finding is a nonreactive nonstress test. A nonstress test measures fetal heart rate (FHR) accelerations with normal movement. A fetal acceleration is a positive sign present when the FHR increases 15/min and lasts 15 seconds. In a nonreactive nonstress test, there are no accelerations. Absence of FHR accelerations suggests that the fetus might be going into distress. The nurse might also need to use Maslow's hierarchy of needs, the ABC priority-setting framework, or nursing knowledge to identify which finding is the most urgent
A nurse is caring for a client who is at 8 weeks of gestation with twins and primigravida. The client states that even though she and her husband planned this pregnancy, she is experiencing many ambivalent feelings about it. Which of the following responses should the nurse make?
"Have you told your husband about these feelings?"
"These feelings are quite normal at the beginning of pregnancy."
"Perhaps you should see a counselor to discuss these feelings."
"I am quite concerned about these feelings. Could you explain more?"
B
This client needs reassurance that these feelings are normal and there is no reason for concern.
A nurse receives report on a client who is in labor and is experiencing contractions 4 min apart. Which of the following patterns should the nurse expect on the fetal monitoring tracing?
Contractions that last for 60 seconds each with a 4-min rest between contractions
Contractions that last for 60 seconds each with a 3-min rest between contractions
A contraction that lasts 4 min followed by a period of relaxation
Contractions that last 45 seconds each with a 3-min rest between contractions
B
A contraction interval is how often a uterine contraction occurs. The nurse will measure the interval from the beginning of one contraction to the beginning of the next contraction. A contraction lasting 60 seconds with a relaxation period of 3 min is equivalent to contractions every 4 min.
A nurse is discussing epidural anesthesia with a client who is receiving oxytocin for induction of labor. Which of the following statements should the nurse make?
"An epidural given too early during labor can cause maternal hypertension."
"An epidural given too early during labor will not be effective in active labor."
"An epidural given too early can cause fetal depression."
"An epidural given too early can prolong labor."
C
Clients who receive anesthesia before the active phase of labor usually find the progression of their labor to slow. The medication depresses the central nervous system. Therefore, it will take longer for the cervix to dilate and efface.
A nurse is caring for a newborn who was born to a client who has a narcotic use disorder. Which of the following nursing actions should the nurse identify as a contraindication for the care of the newborn?
Promoting maternal-newborn bonding
Tight swaddling of the newborn
Small frequent feedings
Frequent stimulation
D
This newborn needs a quiet, calm environment with minimal stimulation to promote rest and reduce stress. A stimulating environment can trigger irritability and hyperactive behaviors.
A nurse is preparing to administer naloxone to a newborn. Which of the following conditions can require administration of this medication?
IV narcotics administered to the mother during labor
Maternal drug use
Hyaline membrane disease
Meconium aspiration
b
The nurse should administer naloxone to reverse respiratory depression due to acute narcotic toxicity, which can result from IV narcotics administration during labor.
A nurse is planning care for a client who has a prescription for oxytocin. Which of the following is a contraindication for the use of this medication?
Prolonged rupture of membranes at 38 weeks of gestation
Intrauterine growth restriction
Postterm pregnancy
Active genital herpes
D
The use of oxytocin is contraindicated for clients who have an active genital herpes infection. The newborn can acquire the infection as they pass through the birth canal. Therefore, a cesarean birth is recommended for clients who have an active genital herpes infection.
A nurse is caring for a client who desires an intrauterine device (IUD) for contraception. Which of the following findings is a contraindication for the use of this device?
Hypertension
Menorrhagia
History of multiple gestations
History of thromboembolic disease
B
An IUD is a small plastic or copper device placed inside the uterus that changes the uterine environment to prevent pregnancy. An IUD is contraindicated for women who have menorrhagia, severe dysmenorrhea, or history of ectopic pregnancy.
A nurse in an antepartum clinic answers a phone call from a client who is at 37 weeks of gestation and reports, "I became very dizzy while lying in bed this morning, but the feeling went away when I turned on my side." Which of the following actions should the nurse take?
Instruct the client about vena cava syndrome and measures to prevent it.
Arrange for the client to come to the clinic for an assessment.
Check the client's chart for gestational diabetes mellitus.
Schedule a nonstress test for the client.
A
This is the typical finding of vena cava syndrome, or hypotension that occurs in clients who are pregnant upon assuming a supine position. It is caused by compression of the inferior vena cava by the gravid uterus with a consequent reduction in venous return. A side lying position promotes uterine perfusion and fetoplacental oxygenation.
A nurse is caring for a newborn who has irregular respirations of 52/min with several periods of apnea lasting approximately 5 seconds. The newborn is pink with acrocyanosis. Which of the following actions should the nurse take?
Administer oxygen.
Place the newborn in an isolette.
Continue to routinely monitor the newborn.
Assess the newborn's blood glucose.
C
This newborn is exhibiting a normal respiratory rate and rhythm. No additional measures are needed at this time.
A nurse is providing discharge teaching to a client following the removal of a hydatidiform mole. Which of the following statements should the nurse include in the teaching?
"Do not become pregnant for at least 1 year."
"Seek genetic counseling for yourself and your partner prior to getting pregnant again."
"You should have an hCG level drawn in 6 weeks."
"Have your blood pressure checked weekly for the next month."
A
Hydatidiform moles are uncontrolled growths in the uterus arising from placental or fetal tissue in early pregnancy. There is an increased incidence of choriocarcinoma associated with molar pregnancies. Pregnancy must be avoided for 1 year so the client can be closely monitored for manifestations of this condition.
A nurse is assessing a client who is receiving magnesium sulfate as treatment for pre-eclampsia. Which of the following clinical findings is the nurse's priority?
Respirations 16/min
Urinary output 40 mL in 2 hr
Reflexes +2
Fetal heart rate 158/min
B
The nurse should apply the urgent versus nonurgent priority-setting framework when answering this item. Using this framework, the nurse should consider urgent needs to be the priority need because they pose more of a threat to the client. Using the urgent vs nonurgent framework, the nurse should report the client's urinary output immediately. Urinary output is critical to the excretion of magnesium from the body. The nurse should discontinue the magnesium sulfate if the hourly output is less than 30 mL/hr. The nurse may also need to use Maslow's hierarchy of needs, the ABC priority-setting framework, or nursing knowledge to identify which finding is the most urgent.
A nurse is caring for a client whose membranes have ruptured and is in active labor. The fetal monitor tracing reveals late decelerations. Which of the following actions should the nurse take first?
Turn the client onto her left side.
Palpate the client's uterus.
Administer oxygen to the client.
Increase the client's IV fluids.
A
Using the urgent vs nonurgent framework, the nurse should turn the client onto her left side. Late decelerations indicate that the client is experiencing uteroplacental insufficiency. The client might be experiencing pressure on the inferior vena cava, which decreases the oxygen to the placenta and thus to the fetus. Turning the client onto her left side will relieve the pressure and facilitate better blood flow to the placenta, thereby increasing the fetal oxygen supply.
A nurse is caring for a client who is at 16 weeks of gestation and has severe iron-deficiency anemia. The provider prescribes an injection of iron dextran IM. Which of the following methods should the nurse use to administer the medication?
Use a 20-gauge needle, and administer the medication using the Z-track method.
Use a 22-gauge needle, and administer the medication deep into the thigh.
Use a 25-gauge needle, and administer the medication into the deltoid muscle.
Use an 18-gauge needle, and administer the medication into the rectus femoris muscle.
A
The nurse should administer iron using the Z-track method to prevent staining of tissue. A 20-gauge needle is the correct size.
A nurse administers betamethasone to a client who is at 33 weeks of gestation to stimulate fetal lung maturity. When planning care for the newborn, which of the following conditions should the nurse identify as an adverse effect of this medication?
Hyperthermia
Decreased blood glucose
Rapid pulse rate
Irritability
B
Betamethasone causes hyperglycemia in the client, which predisposes the newborn to hypoglycemia in the first hours after delivery. It is important to assess the newborn's blood glucose level within the first hour following birth and frequently thereafter until blood glucose levels are stable.
A nurse is caring for four newborns. Which of the following newborns is at greatest risk for hypoglycemia?
A newborn who is large for gestational age
A newborn who has an Rh incompatibility
A newborn who has pathologic jaundice
A newborn who has fetal alcohol syndrome
A
Large for gestational age (LGA) newborns are those newborns whose weight is at or above the 90th percentile. One of the most common etiologies of LGA newborns is a mother who is diabetic. LGA newborns, especially those born to mothers who have diabetes, are at increased risk for hypoglycemia. Other newborns at risk for hypoglycemia are small for gestational age (SGA) newborns (those below the 10th percentile), premature newborns, and newborns who have perinatal hypoxia.
A nurse is caring for a client who is in labor. The client questions the application of an internal fetal scalp monitor. Which of the following responses should the nurse make?
"Don't worry. Your baby is fine."
"You will need to ask your provider."
"Your provider feels it would be best."
"We need to observe your baby more closely."
D
The client has asked an information-seeking question. This therapeutic response provides information to the client in an honest, nonthreatening manner. The use of an internal fetal scalp monitor, or an internal spiral electrode, provides a more accurate assessment of fetal well-being during labor.
A nurse is teaching a client who has active genital herpes simplex virus, type 2. Which of the following statements should the nurse include in the teaching?
"You will have a cesarean birth prior to the onset of labor."
"Your baby will receive erythromycin eye ointment after birth to treat the infection."
"You should take oral metronidazole for 7 days prior to 37 weeks of gestation."
"You should schedule a cesarean birth after your water breaks."
A
Whenever possible, the cesarean birth should be scheduled prior to the onset of labor or rupture of membranes to reduce the risk of neonatal transmission of herpes.
A nurse is caring for a newborn who has neonatal abstinence syndrome. Which of the following clinical findings should the nurse expect?
Extended periods of sleep
Poor muscle tone
Respiratory rate 50/min
Exaggerated reflexes
D
A newborn who has neonatal abstinence syndrome usually exhibits clinical findings of hyperactivity within the central nervous system (CNS). Exaggerated reflexes are indicative of CNS irritability.
A nurse is caring for a client who is in labor. A vaginal examination reveals the following information: 2 cm, 50%, +1, right occiput anterior (ROA). Based on this information, which of the following fetal positions should the nurse document in the medical record?
Transverse
Breech
Vertex
Mentum
C
ROA describes the relationship of the presenting part of the fetus to the client's pelvis. In this case, the occipital bone is the presenting part and is located anteriorly in the client's right side. Based on the presentation of the fetus, the position is vertex.
A nurse is caring for a client who has clinical manifestations of an ectopic pregnancy. Which of the following findings is a risk factor for an ectopic pregnancy?
Anemia
Frequent urinary tract infections
Previous cesarean birth
Pelvic inflammatory disease (PID)
D
An ectopic pregnancy occurs when the fertilized egg implants in tissue outside of the uterus and the placenta and fetus begin to develop there. The most common site is within a fallopian tube, but ectopic pregnancies can occasionally occur in the ovary or the abdomen. Most cases are a result of scarring caused by a previous tubal infection or tubal surgery. Therefore, PID places the client at risk for an ectopic pregnancy.
A nurse is caring for a client who is pregnant and reports nausea and vomiting. Which of the following instructions should the nurse provide the client?
"You should eat some crackers before rising from bed in the morning."
"You should eat foods served at warm temperatures."
"You should sip whole milk with breakfast."
"You should brush your teeth immediately after meals."
A
Morning sickness is caused by the buildup of human chorionic gonadotropin (hCG) in the mother's system. Dry foods eaten before rising in the morning tend to reduce the risk of nausea in clients who are pregnant.
what is gestational trophoblastic disease (molar pregnancy) ?
disease of abnormal growth of trophoblastic vili in the placenta. resemble grape like clusters. prevent embryo from developing properly and can develop into choriocarcinoma. (S&S: dark brown prune juice bleeding, N&V, abnormally high HCG lvls)
Diagnostic: ultrasound
TX: evacuation via curatage/chemotherapy
what is placental previa?
placental implantation adjacent to or overlying the internal cervical os
results in bleeding
3 types: complete/total, incomplete/partial, marginal/low lying
S&S: painless bright red bleeding in 2nd/3rd trimester
Diagnostic: ultrasound
Do not perform vaginal exams/introduce anything into vaginally
administer blood products/fluids, educate pt on need for bed rest
administer corticosteroids to promote lung growth in baby
what is abruptio placentae?
premature separation of the placenta from the uterine wall, usually in 3rd trimester.
risk factors: HTN, trauma, cocaine use, smoking
S&S: intense uterine pain, dark red bleeding, decreased H&H, hypovolemic shock
what are the sterilization techniques of females and males?
Females
transcervical sterilization: flexible agents inserted into fallopian tubes, causes scarring and eventual closing of fallopian tubes. (b/c needs to be used until 3mo. after procedure) (no general anesthesia required)
Tubal Ligation: severing/burning of the fallopian tubes (general anesthesia required)

Males
Vasectomy: severing of the Vas deferens. alternative b/c required for 20 ejaculations
what is infertility?
unable to conceive after attempting for at least 12 months
Semen analysis is performed first
Hysterosalpingography: checks patency of fallopian tubes using contrast dye
Laparoscopy: performed under general anesthesia, abdomen is blown up using Co2 and cameras are used to view the fallopian tubes/uterus for an abnormalities
what are signs of pregnancy?
presumptive signs: amenorrhea (no period), N&V, urinary frequency, breast changes, quickening, uterine enlargement (can potentially be explained by other things)

probable signs: positive pregnancy test, Hegars sign, Chadwicks sign, Goodall's sign, balognant, braxton hicks contractions,

positive signs: (no other explanation) fetal heart tones, fetal movement, ultrasound visualization
how is fundal height measured?
Measure from symphysis pubis to the top of the fundus

between 18 and 32 weeks of gestation, the fundal height will equal the gestational age (ie. 20cm funal height, mother is around 20 weeks gestation)
what is GTPAL?
G: gravidity (number of times mother has been pregnant)
T: term births (number of births that have occurred at 38 weeks or greater)
P: preterm births (births that have occurred at 20 weeks and 37 weeks gestation)
A: abortion/miscarriages
L: living (living children)
expected changes during pregnancy?
increased CO, increased blood volume, increased HR, oxygen needs increase, lung volume decreases, RR increases, enlarged breast w/ larger areolas, stretch marks: striae gravidarum
what is supine vena cava syndrome?
mother gets hypotension due to weights of the uterus on the vena cava while laying on back.

teach pt to lay on left side, semi fowler position, or place wedge under 1 hip to prevent vena cava compression
a late deceleration is indicative of?
Late decelerations are indicative of uteroplacental insufficiency
what is a sign of severe pre-eclampsia?
blurred vision
proteinuria
severe headaches
A nurse in a prenatal clinic is assessing a group of clients. Which of the following clients should the nurse see first?

A client who is at 11 weeks of gestation and reports abdominal cramping
A client who is at 15 weeks of gestation and reports tingling and numbness in right hand
A client who is at 20 weeks of gestation and reports constipation for the past 4 days
A client who is at 8 weeks of gestation and reports having three bloody noses in the past week
A
When using the urgent vs nonurgent approach to client care, the nurse should determine that the priority finding is a client who is at 11 weeks of gestation and reports abdominal cramping. Abdominal cramping can indicate an ectopic pregnancy or manifestations of spontaneous abortion. The nurse should request that the provider see this client first.
A nurse is teaching a newly licensed nurse about collecting a specimen for the universal newborn screening. Which of the following statements should the nurse include in the teaching?

"Obtain an informed consent prior to obtaining the specimen."
"Collect at least 1 milliliter of urine for the test."
"Ensure that the newborn has been receiving feedings for 24 hours prior to obtaining the specimen."
"Premature newborns may have false negative tests due to immature development of liver enzymes."
C
The nurse should ensure that the newborn has been receiving regular feedings for at least 24 hr prior to testing.
A nurse is creating a plan of care for a client who is postpartum and adheres to traditional Hispanic cultural beliefs. Which of the following cultural practices should the nurse include in the plan of care?

Protect the client's head and feet from cold air.
Bathe the client within 12 hr following birth.
Ambulate the client within 24 hr following birth.
Offer the client a glass of cold milk with her first meal.
A
Protecting the client's head and feet from cold air should be included in the plan of care because this is a traditional Hispanic practice during the postpartum period.
what is the antidote to magnesium toxicity?
calcium gluconate
what is the expected range of the fetal heart rate (FHR)?
110-160 bpm
what is a nuchal cord?
The umbilical cord becomes wrapped around the fetal neck leading to potential interruption of normal blood, nutrient, and oxygen exchange
what is a leopold meaneuver?
The aim of Leopold maneuvers is to determine the fetal presentation and position by systematically palpating the gravid abdomen.
This allows the nurse to determine the best location for the fetal heart transducer as well as if a C-section is necessary.
what is the normal WBC?
5,000-10,000/mm3
what is an amniocentesis?
the sampling of amniotic fluid using a hollow needle inserted into the uterus, to screen for developmental abnormalities in a fetus.
A high BUN can indicate?
dehydration
what are risk factors for preeclampsia?
pregestational diabetes, preexisting HTN, Lupus, and rheumatoid arthritis
a normal occurrence that results in a blotchy, brown hyperpigmentation of the skin over the cheeks, nose, and forehead in pregnancy is termed?
chloasma
what medication is commonly given during pregnancy to decrease contractions of the uterus/delay preterm labor?
terbutaline
an adverse effect is hypokalemia so monitor for that
what is normal bilirubin?
2-6
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