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Flashcards in Maternal Newborn 2 Deck (79):
1

Crib slats should be no more than how far apart to prevent entrapment/fractures/suffocation?

2.25 inches

2

Space between mattress and the sides of the crib?

Less than two finger widths (.8 inches)

3

How often to check smoke detectors to ensure proper functioning?

How often to replace batteries?

Once a month

Twice per year

4

Set water heater to what degree?

Set bath water to?

120.2 F or less

100 F

5

16 weeks pregnant with diabetes and BMI of 31 (overweight) what to include in teaching about diet ??

If BMI greater than 30- limit total caloric intake to 25 kcal/day or less

Do not skip a meal (eat on a schedule) to prevent hypoglycemia and ketoacidosis

Carbs 55% , Protein 20%, Fat 25%

Eat large bedtime snack with at least 25g of complex carbs

6

How often one should formula feed newborn?

3-4 hours

7

How much will new born drink of formula during first 24-48 hrs?

15-30mL

8

Why not to feed newborn water between feedings

Formula Contains enough water to meet newborns fluid needs

Feeding water between feedings can lead to improper calorie intake

9

How often to burp newborn during feeding ?

A few times during the feeding

to reduce spitting up after feeding

10

How to listen to fetal heart tones at 12 weeks (3 months)

Ultrasound stethoscope

11

When should the nurse obtain a blood sample for the MSAFP (maternal serum alpha - fetoprotein) screen?

Between 15 and 20 weeks of gestation

The AFP blood test determines how much AFP is in the mother's blood.

High levels of AFP may suggest the developing baby has a neural tube defect such as spina bifida or anencephaly

12

When should the nurse collect a vaginal and anal specimen for GBS? Guillain-Barré syndrome (Streptococcus group B) (rare disorder in which a person’s own immune system damages their nerve cells, causing muscle weakness and sometimes paralysis)

35 -37 weeks

13

When to measure Fundal height for gestational age?

Between 18 and 30 weeks

14

What actions should the nurse take for a client who is 18 hours postpartum and his 4th° perineal laceration? Client says the pain is a 4

Witch hazel pads

(cleanse and condition your skin gently and thoroughly. helps tighten pores and tone skin without drying, leaving skin feeling clean, soft and refreshed)

Give ice packs

Cool water sitz bath

Practice relaxation techniques

15

Client teaching before taking medroxyprogesterone acetate injection for contraception ?

Client may gain weight on this med

Client may also have decrease in bone density (take calcium supplement)

This medication is safe with lactation, however client should wait six weeks after delivery to start medication if breast-feeding

Client will receive injection every 11 to 13 weeks (3 months) as a form of contraception

16

What finding to report to dr at 38 weeks ?

Glycosuria - (excess sugar in urine - complication of gestational diabetes)



17

Expected finding of pregnancy?

Leg cramps- poor circulation

Insomnia- physical discomforts

Leukorrhea - Due to an increased amount of cervical mucus from hormonal changes

18

Best source of folate ? How much a day?

1 cup cooked spinach

600 mcg

19

What to do for a client receiving betamethasone for preterm labor)

Inject IM in vastus lateralis

20

Side effect of terbutaline? (treatment of asthma)

Dizziness

21

Which electrolyte level to monitor for when giving magnesium sulfate?

Magnesium

22

What is a contraindication (when not to use) for the use of oral contraceptives?

Frequent headaches with visual changes

(It can indicate a cardiovascular conditions such as hypertension) It can lead to increase risk of stroke, heart attack, thromboembolism

Some Antibiotics and antiviral meds (for oral contraceptives- reduce effectiveness)

Serious disorders such as gallbladder disease and liver cirrhosis






23

UTI prevention teaching for 25 week gestation ?

Empty bladder before going to bed at night
(a full bladder Provides environment that can grow bacteria)

Wipe from front to back

Where all cotton undergarments to avoid trapping heat and moisture

24

Education about prevention of newborn abduction?

An alarm will sound of someone removes the newborn safety device

The client should only transport newborn between the nursery and room in a bassinet

Never leave a newborn unattended even while showering

Only facility personnel with badges indicating that the individual work specifically in the maternal newborn unit should transport newborns

25

What is a non-stress test?

Used to determine FHR, baby’s movement, contractions (changes of heart rhythm when moving and contractions )

26

Client teaching about non-stress test at 33 weeks?

Press the button when you feel the baby move

Eat and drink as usual prior to the test

The stress monitors for accelerations in the fetal heart rate with fetal movement

27

contraction stress test teaching?

measure the baby's heart rate during uterine contractions During contractions, the flow of blood and oxygen to the placenta temporarily slows down.

measure the baby's heart rate during uterine contractions

Might require a IV infusion for the administration of Oxytocin

Might require the client to perform nipple stimulation to initiate contractions

28

Postpartum discharge teaching instructions

Do not use powder on newborn due to aspiration

Use a firm mattress in the newborns crib to reduce SIDs

Do not put pillows or comforters in crib

Place in Supine position

29

Car seat safety with a newborn

Place in car seat rear facing in the middle of the backseat until two years old or until weight and height restrictions are ok

Position the retainer clip at the level of the babies armpits

Play shoulder harness straps in the slats at or below the level of the newborn shoulders

The guardian should position the newborn in the car seat at 45° angle to prevent the newborns head from falling forward which can lead to airway obstruction

30

What to do for constipation and pregnancy?

Drink 2L water/ day

Do not take mineral oil - depletes vit A,D, E, K

Avoid enemas because it can trigger labor or cause injury to client or fetus

Do not take docusate sodium because it can cause dependence and electrolyte imbalance

31

What to report with a pt taking oxytocin

(Stimulates uterine contractions)

If urine output is less than 120 mL q 4 hours -
can indicate urine retention which can lead to hyponatremia and water intoxication

Nausea, vomiting, headache, hypotension

More than five contractions in 10 minutes or single contractions lasting longer than two minutes

32

Formula preparation teaching?

Spitting up can indicate over feeding or gastroesophageal reflex

Over diluted formula can result in an adequate growth and too much formula can stress the newborns renal system

Client may use tapwater after running from faucet for two minutes. The client should then boil it for 1 to 2 minutes and cool it for no longer than 30 minutes. Sterile bottled water is also safe

Client should discard any formula that remains in a bottle if you’re feeding

33

What report in the active phase of the first stage of labor?

Report fetal heart rate below 110 or above 160

Report Uterine contractions lasting shorter than 40 seconds or more than 90 seconds

Report Green fluid from the vagina which indicates that the fetus has passed meconium stool.

Early decelerations are expected in this phase of labor

34

Postpartum complications after 18 hours of birth?

The funds should be located at the level of the umbilicus for the first 24 hours after birth. After that it should decrease 1 cm each day.

A temperature of 100.4°F is an expected finding in the first 24 hours after birth due to dehydration

Lochia that is bright red or contains large blood clots (may indicate excessive bleeding)
Login with small blood clots is an expected finding in the first 24 hours

35

How to administer phytonadione? (Vit k)

IM

Until the newborn can produce its own

36

To report to the provider for a client who is receiving magnesium sulfate?

Absent deep tendon reflexes Which can lead to respiratory or cardiac arrest

Report a urinary output of less than 25 to 30 mL per hour

37

One hour oral glucose tolerance test client who is pregnant teachings?

Avoid caffeine in the morning because it can increase glucose levels

38

Three hour glucose tolerance test teachings?

Be sure to ingest A proper amount of carbohydrates for at least three days before the test,
except for the overnight 12 hrs fast immediately before the test

urine sample at the start of the test

39

What to know about hgb?

During the postpartum. The clients Hgb little can decline moderately for 3 to 4 days

40

What to know what WBC during postpartum?

During the first 10 to 12 days after birth the clients WBC can increase it to 25,000 and still be in the expected reference range,

anything over can indicate an infection

41

How long is normal time for newborns First void to occur?

24 hours

42

How should the newborns umbilical cord look?

Two arteries and one vein

(If only 1 Artery nb could have renal anomaly)

43

Time frame to report jandauce

First 24 hours of life

44

Actions to take to decrease the clients risk of developing thrombophlebitis?

Instructed to ambulate several times a day to increase circulation

Report any pain or tenderness in the legs

Do not give an NSAIDS

Apply warm compresses to the Legs to prevent clot formation

45

Breastfeeding teaching for 12 hour newborn ?

Awake newborn to feed every 4 hours for first 24-48 hours after birth

Do not remove colostrum from nipples

After 6 months- feed iron rich foods

Use breast pump after feeding only if newborn is not able I feed at the breast.

46

Intrauterine device teachings?

Report late, abnormal spotting, or bleeding to the provider

Report pain during intercourse

Report to the provider if you can not feel the strings because it can be an indication of dislodgment

Report exposure to infection or unusual vaginal discharge

47

How often to bathe newborn?

Hair?

Bath water temp?

Q 2-3 days to protect skin

Wash hair 1-2x weekly

Keep water temperature at 100°F

48

How to take nb blood glucose

Wash hands and put on gloves
Warm infants heel
Cleanse site with alcohol and dry
Apply pressure using gauze
Cuddle and comfort infant

49

Report to provider 48 hours after delivery?

Reddened area on the calf

Dysuria (painful and difficult urination)

Cracked nipples – can lead to mastitis (inflammation in breast gland/utter)

50

What to do FIRST for Client receives Iv fentanyl 10 minutes ago for pain and has slurred speech and altered mental status?

Take O2 saturation

Apply tocotranducer to abdomen (Monitor clients contractions)

Administer naloxone

Ask the patient to rate the pain from a scale of 0 to 10 because of reverse effects of pain medication

51

Risk factors for developing being pre-eclampsia at 26 weeks of gestation

Rheumatoid arthritis – systemic lupus (Connective tissue diseases increases clients risk)

BMI greater than 30

Multifetal gestation (more than one fetus)

Infection

Chronic hypertension (headache)

Abnormal Uric acid level

52

What to recommend to someone with hyperemesis gravidarum (severe prolonged vomiting)

Monitor intake and output to determine clients hydration status

Eat foods and drink fluids separately

Eat cold or room temp foods

Low fat and high protein diet

Collect specimens for your analysis, CBC, electrolytes, liver enzymes, Bilirubin levels

53

If the funders is 2 cm above the umbilicus at two hours postpartum and is boggy what is the likely cause of this?

Bladder distention (pushing on uterus)



54

This is a slow, oozing trickle of blood, during which the funders can remain firm?

Cervical laceration

55

Is uterine bleeding and expected findings after delivery?

Yes. It often contains large clots resulted from a relaxed distended

56

This can lead to uterine atony (loss of muscle tone) and excessive vagina bleeding?

Retention of placental fragments

57

Interventions for a patient with eclampsia priority following a seizure?

Administer oxygen by facemask at 10 L a minute FIRST

The nurse should use an 18 gauge catheter to administer magnesium sulfate

Insert a indwelling urinary catheter to monitor the clients Output

The nurse should raise the side rails of the bed and pad the rails with blankets or pillows to ensure safety

58

What is a kosher diet?

Avoid eating meat and dairy together

59

Understanding the purpose of carboprost (oxytocin properties) after postpartum ?

Reduce bleeding/hemorrhage after birth


60

When to receive Rh immune globin?

If mother is Rh negative (to treat Rh incompatibility)

61

What to receive to treat anemia ?

Iron supplements

62

Finding to expect with a client who is a primigravida (pregnant for the first time) and has hyperthyroidism?

Diaphoresis (sweating)

63

Expected finding of hypothyroidism?

Cold intolerance

Hoarseness

Hair loss

64

Report to doctor if happens around 37 weeks as a sign of hypertension or preeclampsia?

Blurred vision

65

Newborn umbilical cord care teaching?

Report any drainage from babies umbilical cord- could be infection

Only use warm water to wash cord

The cord should fall off within 10 to 14 days

Secure the diaper below the cord to prevent infection and promote drying

66

Discharge teaching with a client who has mastitis (inflammation of breast gland or nipple) of the left breast?

Pump breast frequently- to prevent growth of bacteria and increase comfort

Continue breast feeding or pump (does not contaminate milk)

67

How to relieve Engorgement (blocked milk ducts) pain in breasts?

Apply cold cabbage leaves

68

When might client experience leukorrhea (White or gray vagina discharge from estrogen increase) in pregnancy?

Throughout the entire pregnancy

69

When should the client expect abdominal enlargement by?

The 14th week of pregnancy

70

When should the client feel fetal movement in pregnancy also known as quickening?

At 16 to 20 weeks

71

Potential complication of giving birth to a newborn who is large for gestational age (LGA)

InCrease of the risk of hemorrhage to do uterine atony (stress on muscles)

72

Expected findings for a client who is postpartum?

Deep tendon reflex is between 1+ and 2+

Leukocytosis for 4-7 days

Elevated temperature during the first 24 hours after birth

73

Magnesium sulfate IV for preeclampsia- What is indication of magnesium sulfate toxicity that you should report to the provider?

Respiratory depression

Decreased urine output

74

Proteinuria is an indication of what during pregnancy?

Preeclampsia

75

What are expected findings for someone who has Endometritis (inflammation of inner pinning of uterus) and is 48 hours post partum following a C-section

*Elevated HR

Elevated respiration’s

Fever

Chills

Nausea

Anorexia

Fatigue

Pelvic pain

Lochia with foul odor

76

Normal WBC range

Erythrocyte sedimentation rate

12k-25k

rate of 20mm/hr

77

Common adverse effect of metronidazole? (Do not need to tell dr)

Metallic taste in mouth

78

What medication can reduce effectiveness of contraceptives?

Penicillins and tetracycline

79

If breastfeeding and prescribed metronidazole, what to educate patient?

Do not breast feed for 8-10 days

-pump and dump while taking medication and for 24-48 hours after last dose.