ATI RN Maternal Newborn Nursing Final Review guaranteed pass

ATI RN Maternal Newborn Nursing Final Review guaranteed pass Defined as a woman in her first pregnancy - Primagravida Defined as a woman who has had two or more pregnancies - Multigravida Defined as the number ...

ATI RN Maternal Newborn Nursing Final Review guaranteed pass Defined as a woman in her first pregnancy - Primagravida Defined as a woman who has had two or more pregnancies - Multigravida Defined as the number of pregnancies in which the fetus or fetuses reach viability (20 weeks) regardless of whether the fetus is born alive - Parity What does the GTPAL acronym stand for? - Gravidity Term births (38+ weeks) Preterm births Abortions/miscarriages Living children When should Rho (D) immune globulin be given to the client? - When a mother is Rh- and the newborn is Rh+ What should be done when there is mastitis in the left breast? - pump the affected breast frequently How to do a heel stick on a newborn? - warm the newborn's heel What should be done when taking medroxyprogesterone? - instruct the client to increase their calcium intake Directions when taking nifedipine? - change positions slowly Advice for nausea and vomiting at 9 weeks gestation? - consume small frequent meals What are good sources of iron? - lentils, oysters, and beef liver How to prevent engorgement to a client who is bottle feeding their baby? - Apply cold cabbage leaves to the breasts daily What is an important part of postpartum teaching plan? - use a firm mattress in the baby's crib Advice for a client who is experiencing constipation in her 2nd trimester? - consume 28g of fiber per day How long should a newborn feed? - 20-30 minutes What is the 1st thing you should do for a seizing pregnant woman with preeclampsia? - turn the client's head to the side What is nifedipine given for? - to stop uterine contractions When should a cerclage be removed? - 37 weeks gestation What should be reported to the provider for an 8 hour old newborn? - apical heart rate of 90/min while awake When is it okay to use jet hydrotherapy in labor? - you should be in the active phase of the 1st stage of labor to use the tub Interventions for breast feeding with mastitis - apply a warm compress to the affected area Instructions after a vastectomy? - use contraception temporarily after the procedure What is supine hypotension syndrome? - Pressure of the uterus on the vena cava, decreasing venous blood flow to the heart What is chloasma? - Pigmentation increases on the face, normal during pregnancy What is line nigra? - Dark line of pigmentation from the umbilicus extending to the pubic area What are some disadvantages of internal fetal monitoring? - Membranes must be ruptured- can introduce infection Cervix must be dilated to a minimum of 2-3cm Presenting part must descent to place electrode Specially trained personnel must do procedure A nurse is caring for a client in the third stage of labor. What findings indicate that placental separation has occurred? - Lengthening of the umbilical cord Appearance of dark blood from the vagina Fundus is firm upon palpation (due to uterus contracting) A nurse is caring for a client who is in the transition phase of labor and reports that she needs to have a bowel movement with the peak of contractions. What is the appropriate nursing intervention? - Prepare for an impending delivery- the urge to have a bowel movement indicates fetal descent and complete dilation A nurse is caring for a client who is in the first stage of labor and encourages the client to void every 2 hours. Why is this important? - Distended, full bladder reduces pelvic space needed for birth & impedes fetal descent Signs that a woman may have that make her think that she is pregnant. Including: Amenorrhea, fatigue, nausea/vomiting, breast changes, uterine enlargement - Presumptive signs of pregnancy Approximately how long should a mother spend breastfeeding on each breast? - 15-20 minutes per breast & 30-40 minutes total feeding Chadwick's sign - Blueish-purple coloration of vagina and cervix -A probable sign of pregnancy Hegar's sign - Softening of lower uterus -A probable sign of pregnancy Ballottment - Light tap of the examiner's fingers on cervix causes the fetus to rise in the amniotic fluid, then rebound to it's original position (rebound of unengaged fetus); occurs at 16-18 wks -A probable sign of pregnancy Quickening - A woman's first awareness of fetal movement; flutter movements of fetus, occurs around 16-20 wks -*Presumptive sign* of pregnancy (observed by woman that makes her suspicious of being preg.) What IV solution should the nurse plan to give prior to administering a pain anesthetic solution to a patient in labor? - The nurse should plan to administer 500-1,000 mL of LR's or 0.9% NS at 15 to 30 minutes prior to admin. of the first dose of anesthetic solution to decrease the risk of maternal hypotension. The nurse should NOT admin. Dextrose 5% (or any %) because it can cause maternal hyperglycemia and neonatal hypoglycemia A nurse is caring for a pt. who is at 15 wks gestation, is rh-negative, and just had an Amniocentesis. Which of the following interventions is the nurse's priority following the procedure? A.) Check Pt.'s temp. B.) Observe for UC's C.) Admin. Rho-Immunoglobulin D.) Monitor the FHR - Answer= D- greatest risk to pt. and fetus is fetal death. Rationale= C- the nurse should admin. Rho-immunoglobulin to prevent sensitization. However, this is not the PRIORITY nursing intervention A nurse is providing care for a pt. who is at 32 wks gestation & has Placenta Previa. The nurse notes that the pt. is actively bleeding. Which of the following medications should the nurse anticipate will be prescribed? A.) Betamethasone: Given to promote lung maturity if delivery is anticipated* B.) Indomethacin is given to pt. in preterm labor C.) Nifedipine is given to pt.'s in preterm labor D.) Methylergonovine is prescribed to pt. experiencing postpartum hemorrhage A nurse at a clinic is caring for a pt. who is at 4 months of gestation. The pt. reports continued N/V & scant, prune-colored discharge. She has no wt. loss and has a fundal height greater than expected. Which of the following complications should the nurse expect? A. Hyperemesis Gravidarum B. Threatened Abortion C. Hydatiform mole D. Preterm labor – + Hydatiform mole. Pt.'s with Hydatiform mole exhibits increased fundal height is is inconsistent with wk. of gestation, and excessive N/V due to ↑↑ hCG levels. Scant, dark discharge occurs in the 2nd trimester. A nurse is caring for a pt. who has a Dx of ruptured ectopic pregnancy. Which of the following findings is seen with this condition? A. No alteration in menses B. Transvaginal US indicates a fetus in uterus C. ↑↑ serum progesterone levels greater than expected range D. Report of severe shoulder pain - Ectopic Pregnancy- Expected findings? - -Lower unilateral abdominal pain and tenderness -Delayed, lighter than usual, or irregular menses -*Referred shoulder pain* -Report of s/s of shock (faintness, dizziness) -S/S of hemorrhage and shock (↓ BP, ↑ HR) What is Methotrexate used for in an Ectopic Pregnancy? - Methotrexate is a medication that dissolves pregnancy PT. EDUCATION= avoid alcohol consumption and vitamins containing folic acid Gestational Trophoblastic Disease (Hydatiform Mole) Expected findings? - #1= Excessive N/V d/t ↑ hCG levels -Rapid uterine growth and fundal height greater than expected for gestational age -Bleeding that varies in color from dark brown to dark red and may be scant or profuse, lasting days to weeks -Anemia from blood loss Nursing Care for pt. with Hydatiform Mole? - -Measure fundal height -Assess vag. bleeding and D/C -Assess G.I. and appetite -Monitor for s/s of preeclampsia -Admin meds as ordered (Chemo agents for malignant cells, rh-immunoglobulin for rh-neg. pt.s) -Advise pt.'s to save clots and tissue for evaluation Kleinhaur-Betke test evaluates ________? - Kleinhaur-Betke test is used to detect the presence of fetal blood in maternal circulation What is the leading cause of Maternal Death? - Abruptio Placenta