Nursing 107 Final

Question 1

What is the order of the cardinal movements that the baby undergoes during labor and delivery?

Answer 1

1. Descent
2. Flexion
3. Internal Rotation
4. Extension
5. Restitution
6. External Rotation
7. Expulsion

Question 2

What complications are most likely for the infant of a diabetic mother after birth?

Answer 2

Hypoglycemia

Question 3

What are the s/s of hypoglycemia in neonates?

Answer 3

Tremors
Irritability
Lethargy
Apnea
Seizures
Poor feeding, suck
Pallor, cyanosis
Hypothermia
Hypotonia
High pitched cry

Question 4

What is the appropriate treatment of hypoglycemia in a neonate?

Answer 4

Immediate feeding, either breast, formula or both
If <25mg/dl, may require D10 IV infusion
Follow up CBGs to monitor status.

Question 5

What is the measurement of fetal station and descent during labor?

Answer 5

A measurement of the presenting part of the baby to the ischial spines of the mother’s spine. (-5, 0, +5).

Question 6

Define postpartum hemorrhage?

Answer 6

Blood loss greater than 500ml in the 24 hours following delivery. There can also be late pp hemorrhage 7-14 day’s after delivery.

Question 7

What are the causes of pp hemorrhage?

Answer 7

Uterine atony: most common cause
Lacerations
Hematoma
Retained placental fragments
Inversion of the uterus
Disseminated intravascular clotting

Question 8

What are the s/s of pp hemorrhage?

Answer 8

Signs of shock
Bleeding can be slow, steady or perfuse
Large, boggy uterus
Clots

Question 9

What is the management of pp hemorrhage

Answer 9

Assist the uterus to contract: massage, Rx
Monitor bleeding: weigh pads
Maintain fluid balance
Monitor vital signs
Admin O2
Physician may need to assess for retained placenta

Question 10

What are the nursing management of a laboring pt and rationales related to each?

Answer 10

During transition: do not leave laboring pt alone
Pain management in labor inc:
Non-pharmacologic methods: effleurage, massage, water therapy, aroma therapy, hypnosis
Pharmacologic methods: Iv narcotic, admiin, epidural anesthesia, spinal, local, and general anesthesia
Evaluate bladder q 2hrs: bladder must be emptied to avoid inhibiting descent of the presenting part and to prevent bladder trauma from increased pressure
Frequent checks of fundus to determine if contracted

Question 11

What are the health screenings done to a newborn at birth and at time they are discharged?

Answer 11

Phenylketonuria: PKU
Cystic fibrosis
Galactosemia: disorder how the body process sugar
Congenital hypothyroidism
Sickle cell trait
Hearing screening

Question 12

What are the meds given at birth and time frame for admin

Answer 12

Erythromycin ophthalmic ointment: one dose at birth
Vit K: one time dose at birth unless mom has been on anticoags then a second dose may be ordered
Hep B: admin within 12hrs of birth.

Question 13

Identify antenatal testing and why each would be performed?

Answer 13

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Question 14

What is the normal rate of blood volume expansion during pregnancy?

Answer 14

45% increase in blood volume and pulse increases 10-15 beats/min

Question 15

What is the difference between postpartum blues, depression, and psychosis?

Answer 15

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Question 16

Differentiate between dilation, effacement, and station in labor.

Answer 16

5 from Labor Patient

Question 17

Explain the difference between acrocyanosis and central cyanosis.

Answer 17

6 Neonate

Question 18

What are the sources of heat loss in an infant and what actions can you take to prevent them?

Answer 18

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Question 19

How do you calculate a woman’s due date and document her obstetrical history?

Answer 19

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Question 20

What are the signs and symptoms related to the stages and phases of labor?

Answer 20

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Question 21

What are the expectations for weight gain during pregnancy?

Answer 21

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Question 22

What are the presumptive, probable, and positive signs of pregnancy?

Answer 22

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