Term
| What instructions should the nurse give the woman with a threatened abortion? |
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Definition
| Maintain Strict bed rest for 24-48 hours. avoid sexual intercourse for 2 weeks |
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Term
| Identify the nursing plans and interventions for a woman hospitalized with hyperemesis Gravidarum |
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Definition
| Weigh daily, Check urine ketone three times daily, give progressive diet, check FHR every 8 hours, monitor for electrolyte imbalances |
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Term
| Describe discharge counseling for a woman after hydatidform mole evacuation by D&C |
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Definition
| Prevent pregnancy for 1 year. Return to clinic or MD for monthly HCG levels for 1 year. Post-op D&C instructions: call if bright red vaginal bleeding or foul smelling vaginal discharge occurs or temperature spikes over 100.4*F |
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Term
| What condition should the nurse suspect if a woman of childbearing age presents to an ER with bilateral and unilater abdominal pain, with or without bleeding? |
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Definition
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Term
| List three symptoms of abruptio placentae |
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Definition
| Fetal Distress; Ridgid board like abdomen; pain; dark red or absent bleeding |
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Term
| List three symptoms of Placenta previa |
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Definition
| Pain free, bright red vaginal bleeding normal FHR soft uterus |
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Term
| What specific info should the nurse include when teaching about HPV detection and treatment? |
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Definition
| Detection of dry wartlike growths on vulva and rectum. Need for pap smear in the prenatal period. Treatment with laser ablation (cannont use podophyllin during pregnancy). Associated with cervical carcinoma in mother and respiratory papilomatosis in neonate. Teach about immunization for females age 9 to 30 with Gardasil. |
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Term
| State three principles pertinent to counseling and teaching a pregnant adolescent? |
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Definition
| Nurse must establish trust and rapport before counseling and teaching begin. Adolescents do not respond to an authoritarian approach. Consider the developmental tasks of identity and social and individual intimacy. |
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Term
| What complications are pregnant adolescents particulary prone to develop? |
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Definition
| Preeclampsia; IUGR;CPD;STDs; anemia |
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Term
| All pregnant women should be taught preterm labor recognition. describe the warning symptoms of preterm labor. |
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Definition
| More than five contractions per hour; cramps; low dull backache; pelvic pressure; change in vaginal discharge |
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Term
| List factors predisposing a woman to preterm labor |
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Definition
| Urinary tract infection; overdistention of uterus;diabetes; preeclampsia; cardiac disease; placenta previa; psychosocial factors such as stress |
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Term
| When is preterm labor able to be arrested? |
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Definition
| Cervix <4cm dilated, 50% effacement, and membranes are intact and not bulging out of the cervical os. |
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Term
| What is the major side effect of beta-adrenergic tocolytic drugs (Terbutaline/Ritodrine)? |
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Definition
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Term
| What special actions should the nurse take during the intrapartum pd if preterm labor is unable to be arrested? |
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Definition
| Monitor the FHR continuously and limit drugs that cross placental barriers so as to prevent fetal depression or further compromise. |
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Term
| A prolonged latent phase for a multipara is________and Nullipara is_____. |
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Definition
Multipara: >14 hours
Nullipara:>20 hours |
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Term
| Multiparas' average cervical dilation is _______cm/hr in the active phase; and Nullipara average cervical dilation is ______cm/hr in the active phase. |
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Definition
Multipara:1.5
Nullipara: 1.2 |
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Term
| What are the major goals of nursing care r/t pregnancy induced hypertension with preeclampsia? |
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Definition
| Maintenance of uteropalcental perfusion;prevention of seizures, prevention of complications such as HELLP syndrome; DIC; and abruption |
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Term
| Magnesium Sulfate is used to treat PREECLAMPSIA! What is the purpose of admin magnesium sulfate? What is the Main action of Mag Sulfate? |
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Definition
| To prevent seizures by decreasing CNS irritability; Central nervous system depression (seizure prevention) |
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Term
| What is the antidote for mag sulfate? List three main assessment findings indicating toxic effect of mag sulfate? |
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Definition
Calcium gluconate;
Toxic effects: Reduced urinary output, reduced RR, decreased reflexes |
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Term
| What are the major symptoms of preeclampsia? |
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Definition
| Increase in BP of 30mmHg systolic and 15 mmHg diastolic over previous baseline; hyperflexia; proteinuria (albuminuria); CNS disturbances; Headache and visual disturbances; epigastric pain |
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Term
| What is the priority nursing action after spontaneous or artifical rupture of membranes? |
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Definition
| Assessment of the fetal heart rate |
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Term
| What is the most common complication of oxytocin augmentation or induction of labor? List three actions the nurse should take if the complication occurs? |
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Definition
| Tetany. Turn off pitocin. turn pregnant woman onto side, admin 02 by mask |
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Term
| List the symptoms of water intoxication resulting from the effect of pitocin (oxytocin) on the antidiuretic hormone (ADH). |
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Definition
| N/V, headache, hypotension |
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Term
| State three nursing interventions during forceps delivery. |
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Definition
| Ensure empty bladder. Ausculate FHR before application, during process, and between traction periods. Observe for maternal lacerations and newborn cerebral or facial trauma. |
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Term
| What is the cause of preeclampsia. |
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Definition
| exact cause is unknonwn! The underlying pathophysiology appears to be generalized vasospasm with increased peripheral resistance and vascular damage. this decreased perfusion results in damage to numerous organs. |
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Term
| What interventions should the nurse implement to prevent further CNS irritability in the preeclampsia client? |
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Definition
| Darken Room, limit visitors, maintain close 1:1 nurse client ratio, place in private room, Place nursing intervention all at the same time so client is disturbed as little as possible |
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Term
| A woman on Orinase (oral hypoglycemic) asks the nurse if she can continue this medication during pregnancy. How should the nurse respond? |
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Definition
| NO! oral hypoglycemic meds are teratogenic to the fetus. Insulin will be used |
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Term
| Name three maternal and three fetal complications of gestational diabetes |
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Definition
Maternal:(Hypoglycemia, hyperglycemia, ketoacidosis)
Fetal:(Macrosomia, hypoglycemia at birth, fetal anomalies) |
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Term
| When should the nurse hold the dose of Magnesium Sulfate and call the physician? |
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Definition
| when the clients respirations are <12/mins, DTRs are absent, or urinary output is <100mL/4hrs |
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Term
| State three priority nursing actions in the postdelivery pd for the client with preeclampsia. |
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Definition
| Monitor for signs of blood loss. Continue to assess BP and DTRs every 4 hours. Monitor for uterine atony |
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Term
| What are two most difficult times for control in the pregnant diabetic? |
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Definition
| Late in the third trimester and in the postpartum period, when insulin needs drop sharply (the diabetogenic effects of pregnancy drop precipitously) |
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Term
| Why is regular insulin used in labor? |
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Definition
| It is short acting, predictable, can be infused IV and can be discontinued quickly if necessary |
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Term
| List three conditions clients with diabetes mellitus are more prone to develop. |
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Definition
| Preeclampsia; hydramnios; infection |
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Term
| When is cardiac disease in pregnancy most dangerous |
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Definition
| At peak plasma volume increase=btwn 28-32 wks gestation; and during the second stage of labor |
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Term
| Does insulin cross placenta-breast barrier? |
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Definition
| NO. therefore, insulin dependent women may breast feed |
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Term
| The goal for diabetic management during labor is euglycemia. How is it defined? |
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Definition
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Term
| What contraceptive technique is recommended for diabetic women? |
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Definition
| Diaphragm with spermicide; clients should avoid birth control pills, which contain estrogen, and IUDs which are an infection risk |
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Term
| List the symptoms of cardiac decompensation in a laboring client with cardiac disease |
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Definition
| Tachycadia, tachypnea, dry cough, rales in lung bases, dyspnea, and orthopnea |
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Term
| What interventions can the nurse implement to maintain cardiac perfusion in laboring cardiac client? |
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Definition
| Position the client in a semi or high fowler position. Prevent Valsalva maneuvers. Position client in a side-lying position for regional anesthesia. Avoid stirrups bc of possible popliteal vein compression and decreased venous return |
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Term
| Gentle counterpressure agaisnt the perineum during an emergency delivery prevents___________and ___________. |
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Definition
| Maternal Lacerations; Fetal cerebral Trauma |
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Term
| When may a vaginal birth after a cesarean (VBAC) be considered by a woman with a previous cesarean section? |
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Definition
| If a LOW UTERINE TRANSVERSE INCISION was performed and can be documented and if the original complication does not recur (ex:CPD) |
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Term
| Prior to anesthesia for cesarean delivery, the mother may be given an antacid or gastric antisecretory dry (histamine receptor antagonist). State the reason theses drugs are given. |
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Definition
| Antacid buffers alkalize the stomach secretions. If aspiration occurs, less lung damage ensues. An antisecretory drug reduce gastric acid, reducing the risk for gastric aspiration |
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Term
| Clients who have had a cesarean section are prone to what post-op complication? |
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Definition
| Paralytic Ileus, infection, Thromboembolism, respiratory complications, and impaired maternal-infant bonding |
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