Week 2 ATI Review Module Chapter Notes

Question 1

what does HELLP stand for?

Answer 1

. H: Hemolysis

. EL: Elevated liver enzymes

. LP: Low platelets

Question 2

What is the function of uterine spiral artery remodeling?

Answer 2

to support pregnancy by increasing blood flow to the fetus

Question 3

what is the purpose of fetal ultrasound?

Answer 3

to monitor fetal growth and amniotic fluid volume.

Question 4

What is the purpose of antenatal steroid administration?

Answer 4

to increase lung maturity to reduce respiratory distress of premature infant.

Question 5

common CBC lab findings of pregnant client with Hyperemesis Gravidarum (HG)

Answer 5

low hemoglobin (anemia) due to insufficient nutrition.

Question 6

Secretion of hCG from the placenta stimulates an ________
secretion of progesterone from the corpus luteal cyst and a________secretion of TSH from the pituitary gland.

Answer 6

increased, lower.

Question 7

Two main pharmacological therapies for hyperthyroidism in pregnancy

Answer 7

Propylthiouracil and methimazole

Question 8

what is the preferred therapy for diabetes in pregnancy?

Answer 8

use of insulin.

Question 9

what would the medication change be for a pregnant client w/ hypothyroidism and is currently taking levothyroxine as baseline?

Answer 9

the provider will increase the dose by 30 to 50%

Question 10

pathophysiology of hypothyroidism

Answer 10

when TSH are elevated and T4 are decreased.

Question 11

what are increased risk for Gestational Diabetes

Answer 11

obesity.
age over 40 .
having a history of gestational DM.

Question 12

which medication is expected for a pregnant client with hyperthyroidism?

Answer 12

Propylthiouracil is considered the safest medication option for treating hyperthyroidism.

Question 13

when does Gestational diabetes typically occur?

Answer 13

during 2nd or 3rd trimester

Question 14

contributing factors of gestational diabetes

Answer 14

dysfunction of the pancreatic beta cells.

Insulin resistance.

Question 15

what are some risk factors of hypothyroidism for a pregnant client?

Answer 15

Having surgical procedure on the thyroid gland increases risk for hypothroidsim.

getting treatment for hyperthyroid increases a risk for hypothyroid.

Individuals who had multiplle births are at an increased risk of developing hypothyroidism.

Question 16

what is the baby weight at birth which gives risk of developing GDM in future pregnancies

Answer 16

Giving birth to a baby weighing 4.08 kg (9 lb) or more increases the risk

Question 17

why is Uterine relaxation between contractions important?

Answer 17

to ensure adequate fetal oxygenation.

Question 18

Monitor of uterine activity during labor

Answer 18

to identify contraction strength, frequency, and duration.

Question 19

Fetal lie

Answer 19

is the relationship of the fetus’ spine to the pregnant mom’s spine.

Question 20

Fetal attitude

Answer 20

is the flexion or extension of fetal head toward or away from fetal chest

Question 21

Fetal presentation

Answer 21

how the baby is positioned to come out ( head/cephalic, breech, transverse, etc).

Question 22

Fetal position

Answer 22

how the baby is positioned inside the uterus

Question 23

name the 5 P’s of labor

Answer 23

Passenger,
passageway,
power,
position,
psyche

Question 24

Describe maternal cardiovascular changes in labor.

Answer 24

increased cardiac output & HR.
Blood volume shift.
Blood pressure fluctuations.

Question 25

contraction frequency

Answer 25

measured beginning of one contraction to the beginning of the next contraction.

Question 26

contraction duration

Answer 26

the onset of one contraction until the contraction resolves

Question 27

External TOCO Monitoring

Answer 27

device applied to the abdomen to monitor uterine contraction frequency and durations

Question 28

what is IUPC

Answer 28

stands for intrauterine pressure catheter, a device used to measure the frequency, duration, and strength of contractions.

Question 29

what is FSE

Answer 29

a scalp electrode placed under the skin of the presenting part (head or buttocks) to transmit the fetal heart rate signal.

Question 30

Fetal heart rate variability

Answer 30

irregular fluctuations of the heart rate

Question 31

FHR Deceleration

Answer 31

a temporary drop in the baby's heart rate during labor.

Question 32

Late Deceleration

Answer 32

drop of hear rate to at least 15 beats per minute due to placental insufficiency

Question 33

Describe intrauterine resuscitation measures.

Answer 33

measures to improve fetal oxygenation and well-being when there are signs of fetal distress. - reposition client - administer 10L/min oxygen via non-rebreather - increase IV infusion rate

Question 34

when should the client start pushing the baby out?

Answer 34

The client should wait until full cervical dilation and until they feel the urge to push for a shorter pushing time and fewer complications.

Question 35

glottis technique

Answer 35

natural way of pushing out the baby, which improves Apgar scores and decreases time spent pushing complications.

Question 36

Vitamin K administration routes, frequency, and why it is given to newborns

Answer 36

. IM, once at birth . PO, several doses over weeks/months · Given to prevent vitamin K deficiency bleeding

Question 37

Components of Apgar score

Answer 37

. Heart rate . Breathing effort . Muscle tone . Reflex irritability with stimulation . Color

Question 38

Expected newborn vital signs

Answer 38

· Temperature 36.5 to 37.5° C (97.7 to 99.5° F) . Heart rate 110 to 160/min . Respiratory rate 30 to 60/min . Blood pressure only done if murmur heard with auscultation

Question 39

3 signs of placental separation

Answer 39

. Surge of blood from vaginal opening . Lengthening of umbilical cord . Globular shaped fundus

Question 40

expected fundal findings

Answer 40

· Firm . Midline . At the umbilicus

Question 41

benefits of massaging a boggy fundus

Answer 41

decrease bleeding and firm the fundus

Question 42

indications of 2nd stage of labor

Answer 42

1. full dilation f 10 cm 2. +2 fetal station 3. client has urge to push

Question 43

purpose of oxytocin during labor

Answer 43

to assist the uterus in strengthening and increasing contractions.

Question 44

newborn's respiratory rate

Answer 44

between 30 to 60/min.

Question 45

Preterm labor

Answer 45

onset of contractions that cause cervical change before 37 weeks.

Question 46

cervical cerclage

Answer 46

may help prolong the pregnancy due to cervical insufficiency.

Question 47

2 things that need to be ensured when oxytocin is administered

Answer 47

client should have continuous electronic monitoring 1 to 1 care

Question 48

Manifestations of preterm premature rupture of membranes (PPROM) the nurse should monitor for

Answer 48

Fever, tachycardia, or leukocytosis accompanied by uterine tenderness

Question 49

Nitrazine test

Answer 49

Swab test that usually turns blue to check if rupture of membranes has occurred

Question 50

Contraindications for amnioinfusion

Answer 50

. Placenta previa · Vaginal bleeding · Polyhydramnios . Active herpes infection or maternal HIV infection . Uterine anomalies

Question 51

what is amnioinfusion

Answer 51

introduction of a sterile fluid (saline or lactated Ringer’s solution) into the uterus during labor

Question 52

Shoulder dystocia

Answer 52

emergency when the fetal shoulder becomes impacted behind mom's pubic bone after birth of the head

Question 53

Purpose of tocolytic therapy

Answer 53

Decrease uterine contractions, delay cervical change, and prolong pregnancy

Question 54

What is the purpose of amniotomy (breaking of water)?

Answer 54

to induce or accelerate labor and assessment/monitor of fluid.

Question 55

accelerations

Answer 55

Occasional increase in FHR 15 beats per minute over 15 seconds

Question 56

Complications of PROM (premature rupture of membrane)

Answer 56

Maternal or fetal infection; fetal lung hypoplasia; intraventricular hemorrhage; neonatal respiratory distress syndrome; placental abruption; neurodevelopmental impairment

Question 57

chorioamnionitis

Answer 57

elevated body temperature, tachycardia, smelling vaginal discharge and uterine tenderness. Treatment is abx.

Question 58

A nurse is assessing a client who is in labor. Which of the following manifestations is an indication of an umbilical cord prolapse? Vaginal bleeding Sudden severe pain with contractions Oligohydramnios Fetal heart rate abruptly decreases to less than 110/min

Answer 58

Fetal heart rate abruptly decreases to less than 110/min. The most common initial manifestation associated with an umbilical cord prolapse is a sudden abrupt decrease in the fetal heart rate that is persistent (prolonged deceleration) and results in fetal bradycardia (fetal heart rate less than 110/min). Other non-reassuring fetal heart rate characteristics, such as recurring late and variable decelerations, may also be seen during an umbilical cord prolapse.

Question 59

A nurse is reviewing the medical record of several clients on the labor unit. Which of the following clients should the nurse identify as being at increased risk of uterine rupture? The client who has a history of ectopic pregnancy. The client who has a history of appendicitis. The client who has a history of cesarean birth. The client who has a history of stable chronic hypertension.

Answer 59

The client who has a history of cesarean birth.

Question 60

class 1 abruption

Answer 60

Slight uterine tenderness

Question 61

class 2 abruption

Answer 61

significant tenderness

Question 62

class 3 abruption

Answer 62

uterus is board-like to palpation.

Question 63

cause of late decelerations

Answer 63

Late decelerations are associated with diminished oxygenation from the placenta to the fetus.