Maternal Newborn

Question 1

Hyperemesis gravidarum (severe vomiting and nausea with preganancy)

Indication that one has it?

Answer 1

Ketonuria - which occurs due to breakdown of fat due to malnutrition or starvation

Tachycardia / dehydration

Tachypnea

Question 2

Indication of preeclampsia

Answer 2

Proteinuria

Question 3

Nausea and vomiting during pregnancy?

Answer 3

Avoid not eating because it increases nausea

EatSmall frequent meals throughout the day

Eat foods that are served cold or at room temperature

Drinking fluids with meals increases nausea-Alternate every 2 to 3 hours between food and fluids

Eat a snack High in carbohydrates such as crackers before getting out of bed in the morning to decrease nausea

Question 4

Who can transport the newborn to a different room?

Answer 4

Only facility staff with appropriate identification badges that indicate the nurse works specifically in the maternal newborn unit can transport newborns

Also the newborn must be in a designated bassinet

Question 5

Interventions to treat breast engorgement During breast-feeding

Answer 5

Breast-feed the newborn every two hours during engorgement. This will soft in the breast and decrease pain

Drink enough fluids to satisfy Thirst

Apply cold pack compressed to the breast after feeding to decrease discomfort

A warm shower immediately before breast-feeding will soften the breasts

Use a breast pump during engorgement too soft in the breasts prior to breast-feeding

Question 6

Hypotonic uterus (weak contractions) with vagina bleeding priority action of the nurse

Answer 6

Patient is at risk for postpartum hemorrhage

The first action the nurse should take is provide fundal massage to increase uterine muscle tone and move blood clots from uterus Which will decrease bleeding

Then…

Urinary cathedar to eliminate Bladder distention

Methylergonvine IM to enhance uterine contractions

Administer oxygen by face mask to increase o2 in cells

Question 7

Butorphanol teaching?

Answer 7

This medication is an opioid medication which can cause:

dizziness, sedation, hallucinations

respiratory depression

Duration of action is 3 to 4 hours

constipation, nausea, vomiting, confusion, seems

Question 8

What to report in second trimester of pregnancy

Answer 8

Frequent uterine contractions (can cause cervix to open early and start preterm labor)

Question 9

Expected findings in pregnancy

Leukorrhea?

Hyper-pigmentation of face ?

Varcriose veins ?

Tingling of fingers ?

Leg cramp?

Wbc count of 15k

Labia edema

Firm fundus at belly button 6 hrs after birth

Answer 9

This is the whiteish discharge due to the hormonal changes that occur during pregnancy

This is known as the mask of pregnancy due to hormonal changes

Hormonal influence on the smooth muscle walls of veins

Tingling of fingers is a common discomfort of pregnancy cause by traction on the brachial plexus and slumping of the shoulders

Leg cramps are common and caused by compression Of the nerves by the enlarged uterus

Apply ice pack for labia edema and pain

Question 10

Normal heart beat of newborn

Answer 10

110-160

100-180? While crying

Question 11

Calcium level normal nb range?

Answer 11

7.6-10.4

Question 12

Normal glucose for newborn ?

Answer 12

30-60

Question 13

Normal newborn temp

Answer 13

97.7-99.5

Question 14

Potential complication of pregnancy ?

Answer 14

Epigastric pain

Question 15

Sign of postpartum hemorrhage and should be reported to doctor ?

Answer 15

Soaking a pad in 15 minutes or less

Question 16

Expected findings in new born

Answer 16

Vernix in the skin folds

Positive Moro reflex from birth to 8 weeks

Apneic episode of 20 seconds or less - shallow and irregular respiration’s

Question 17

What medication is contra indicated with the use of Nifedipine?

Answer 17

Magnesium sulfate (treatment of hypertension or sezures In preeclampsia) can cause weakness or paralysis

Question 18

This medication is a hormone, which is used to facilitate the induction of labor or to control postpartum bleeding after expulsion of the placenta

Answer 18

Oxytocin

Question 19

This is an antiemedic

Use for the prevention of nausea and vomiting

Answer 19

Promethazine

Question 20

A Nurse should administer terbutaline to a client who is experiencing preterm labor by which route?

Answer 20

Subcutaneous-

It relaxes the smooth muscles and uterine activity. It should be administered every four hours

Question 21

Mastitis teaching?

Answer 21

Warm compress to affected breast

Antibiotic medication

No underwire bra

Continue breast feeding

Question 22

Contraception methods ?

Answer 22

Only water soluble lubricants should be used with Male condoms

The diaphragm should be left in place for at least six hours after intercourse

The sponge should be left in place for at least six hours but less than 24 hours after intercourse due to risk of toxic shock syndrome

The patch is changed weekly for three weeks following by one week in which the client does not wear the patch

Question 23

How to prevent infant abduction

Answer 23

Ask the nurse to take care of the baby in the nursery when mother needs a nap – Never leave infant alone

Always wheel infant in a bassinet when transported to another location

Staff should always wear identification

Always make sure the newborn security band is in place – if removed alarm will sound

Question 24

When to report maternal bp ?

Fetal hr ?

Fundal height ?

Weight?

Answer 24

140/90 or higher

110-160 is normal

Fundal height is same number of weeks of gestation plus or minus 2cm

Gain about .9 lbs per week in mom

Question 25

Why folic acid is important ?

Answer 25

Prevent birth defects Prevent neural tube defects and storage of iron in fetus liver

Question 26

Best source of folate ?

Answer 26

0.5 cup- Dried peas (green split peas)

Question 27

Tonic neck reflex? Crawling reflex? Moro reflex ? Magnet reflex ?

Answer 27

Neck turned to one side Placed on abdomen Fingers form C shape Pressure against soles of feet

Question 28

How to prevent engorgement during lactation

Answer 28

Apply cold cabbage leaves or ice pack to breasts Take mild analgesics Wear well fitted bra with no underwire Do not use pump or massage breasts because it can increase milk production

Question 29

Consistent headache at 37 weeks of gestation? What does it mean

Answer 29

This could mean pre-clampSia

Question 30

What does numbness of fingers at 26 weeks mean ?

Answer 30

Brachial plexus traction syndrome Drooping of the shoulders

Question 31

What to do for hypovolemic shock ?

Answer 31

Out in side or elevate right hip Elevate legs 30 degrees Administer oxytocic medication to increase contraction Give 10L oxygen to improve oxygen Insert urinary cathedar to monitor output

Question 32

What medication causes uterine relaxation

Answer 32

Terbutaline

Question 33

Formula feeding on newborn

Answer 33

Will drink about 15-30mL per feeding Feed for 20-30 min Burp through out feeding

Question 34

Ecchymosis/edema pain of 6 out of 10 and fundus of 2cm above belly botton - what isnoriority ?

Answer 34

Help client to toilet to empty bladder first ... Then breadfeeding , ice pack, pain meds

Question 35

Infant car seat safety

Answer 35

Rear facing until 2 y old Turn of airbag if no backseat Place car seat at 45 degrees Secure seat with cars seat belt

Question 36

Normal findings during the postpartum. Within 24 hours of delivery?

Answer 36

Diuresis (increase urine) Discharge of clear yellow fluid from the breasts which is called colostrum Lower ab cramping due to the uterus decreasing in size

Question 37

When does lochia serosa occur ? Pink or brown a vagina discharge

Answer 37

3 to 4 days after delivery

Question 38

Hydrotherapy teaching?

Answer 38

You need to be active in labor before using it Water temperature should be between 96.8 to 98.6 The client may retain in the tub for as long as they want as long as the fetal heart rate remains with an expected reference range with breaks after 30 to 60 minutes The nurse will use a Doppler stethoscope to monitor the fetal heart rate

Question 39

The mother is receiving magnesium sulfate and has preeclampsia. What to include in teaching?

Answer 39

Just your clients fluid intake to no more than 125 mL per hour to prevent fluid overload Blood pressure should be taking every 15 to 30 minutes because hypotension is an adverse effect of the medication The medication can cause respiratory depression and the nurse should monitor the clients respiratory status every 15 minutes The fetal heart rate will be continually monitored while receiving this medication

Question 40

Newborn normal labs ? Hemoglobin? Platelets ? Glucose? WBC?

Answer 40

14-24 150k-300k 30-60 9k-30k

Question 41

What nifedipine does ? Dexamethasone? (Glucocorticoid) Glyburide? Antiemetic/ metoclopramide?

Answer 41

Decrease uterine contractions Acceleration of lung maturity Control glucose Decrease nausea

Question 42

Indications of respiratory distress

Answer 42

Tachypnea – heart rate greater than 60 /minute Nasal flaring Retractions Expiratory grunting

Question 43

When to give phytonadione? Needle? Where?

Answer 43

Immediately after birth or after initial breast-feeding to prevent hemorrhagic disease 5/8- inch needs Vastus lateralis Single dose

Question 44

Finding to report at 30 weeks ?

Answer 44

2+ urinary protein (preeclampsia)

Question 45

Report to provider of 40 weeks active labor ?

Answer 45

Prolonged deceleration of FHR Temp 100.4 or above

Question 46

Normal contraction times in active labor

Answer 46

Q 3-5 min

Question 47

What to do to promote comfort in client in active labor?

Answer 47

Breathing exercises

Question 48

When to tell client to push?

Answer 48

10 cm in second stage

Question 49

When should sedative be given in labor ?

Answer 49

No less than 12 hour prior to birth

Question 50

When to give nerve block ? In labor

Answer 50

Second stage of labor 10-20 min before birth

Question 51

Antidote for magnesium sulfate toxicity?

Answer 51

Calcium gluconate

Question 52

Antidote for heparin toxicity

Answer 52

Protamine

Question 53

Treatment of allergies And decreases the symptoms associated with histamines

Answer 53

Diphenhydramine

Question 54

How to prevent supine hypotension at 16 weeks of gas station

Answer 54

Lay on left side with head elevated on a pillow

Question 55

When apply stockings were vercose veins

Answer 55

Before getting out of bed

Question 56

How much sodium to intake during pregnancy

Answer 56

1.5 to 2.3 g daily

Question 57

Hep B instructions

Answer 57

Handwashing, and do not share razors or toothbrushes, use a condom, Do not share drinking glasses or silverware Receive the hepatitis B immune Globin immediately Begin receiving vaccine series within 14 days of last known exposure to the virus or following positive test result It can be transmitted to the fetus but risk is reduced when infection occurs before the end of the third trimester

Question 58

Normal labs ? Bun ? Hematocrit? Creatine?

Answer 58

10-20mg 33 or higher .5-1

Question 59

Methylergonovine adverse effect

Answer 59

Herpertention

Question 60

To report to the doctor at 36 weeks

Answer 60

Blurred vision because it is an indication of preeclampsia

Question 61

The nurse should do what for the infant who is receiving phototherapy

Answer 61

Place mask over eyes Position the infant every 2 to 3 hours during phototherapy Is your infant is adequately hydrated

Question 62

Circumcision plan of care teachings

Answer 62

Monitor the site for bleeding and apply gentle pressure with sterile guys at the site Apply diaper loosely Wash penis with plain warm water Apply petroleum got to the penis for the first 24 hours after circumcision

Question 63

How to bathe newborn?

Answer 63

Keep newborn wrap tomorrow washing her hair which will help prevent heat loss Avoid checking power on to the newborn skin due to possible rest of inhalation Hunted swabs can cause injury to the newborns ears. Use washcloth Do not rent under running water due to possible temperature change

Question 64

What do you teach a client who has a prescription for serious sulfate?

Answer 64

Increase fluid intake while taking this medication to at least 2 L of water per day to decrease constipation Take on an empty stomach Do not take with milk or tea Vitamin C such as fruit increases absorption Take a Mr. Smith and 13 hours at the scheduled time but do not double dose