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Questions and Answers
What is the primary mechanism through which newborns generate heat?
What is the primary mechanism through which newborns generate heat?
Which of the following reflexes is characterized by the baby extending their arms and then bringing them back towards the body?
Which of the following reflexes is characterized by the baby extending their arms and then bringing them back towards the body?
What is the expected respiratory rate for a newborn?
What is the expected respiratory rate for a newborn?
What condition is characterized by elevated bilirubin levels in newborns?
What condition is characterized by elevated bilirubin levels in newborns?
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Which finding is NOT typically assessed immediately after birth?
Which finding is NOT typically assessed immediately after birth?
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What does the fundus feel like during a proper postpartum assessment?
What does the fundus feel like during a proper postpartum assessment?
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What is a normal characteristic of lochia rubra?
What is a normal characteristic of lochia rubra?
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Which factor can contribute to after-birth pains after childbirth?
Which factor can contribute to after-birth pains after childbirth?
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What does the term involution refer to in the postpartum period?
What does the term involution refer to in the postpartum period?
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What should be monitored for signs and symptoms of postpartum infection?
What should be monitored for signs and symptoms of postpartum infection?
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What should not occur once lochia has changed from rubra to serosa?
What should not occur once lochia has changed from rubra to serosa?
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Which symptom might suggest endometrial infection during the postpartum period?
Which symptom might suggest endometrial infection during the postpartum period?
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What vital sign change would be concerning postpartum?
What vital sign change would be concerning postpartum?
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What does a foul odor from the meconium indicate in a newborn?
What does a foul odor from the meconium indicate in a newborn?
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What is the primary intervention for a prolapsed cord during labor?
What is the primary intervention for a prolapsed cord during labor?
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Which position is recommended to relieve pressure on the umbilical cord during a prolapsed cord situation?
Which position is recommended to relieve pressure on the umbilical cord during a prolapsed cord situation?
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Which of the following factors increases the risk of umbilical cord prolapse?
Which of the following factors increases the risk of umbilical cord prolapse?
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Shoulder dystocia is primarily characterized by which issue during delivery?
Shoulder dystocia is primarily characterized by which issue during delivery?
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What maternal conditions are risk factors for shoulder dystocia?
What maternal conditions are risk factors for shoulder dystocia?
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In assessing a newborn for potential nerve damage, which reflex would be evaluated?
In assessing a newborn for potential nerve damage, which reflex would be evaluated?
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What is the term for the process of the uterus returning to its original shape after delivery?
What is the term for the process of the uterus returning to its original shape after delivery?
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What is the purpose of administering Rhogam to an Rh- woman?
What is the purpose of administering Rhogam to an Rh- woman?
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Which nursing action is appropriate for variable decelerations in fetal heart rate monitoring?
Which nursing action is appropriate for variable decelerations in fetal heart rate monitoring?
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What complication is most important to monitor after administering systemic analgesia during labor?
What complication is most important to monitor after administering systemic analgesia during labor?
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What distinguishes true labor contractions from false labor contractions?
What distinguishes true labor contractions from false labor contractions?
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During which stage of labor does full cervical dilation occur?
During which stage of labor does full cervical dilation occur?
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Which fetal station indicates that the fetus is at the level of the ischial spine?
Which fetal station indicates that the fetus is at the level of the ischial spine?
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What is the primary purpose of performing an epidural block during labor?
What is the primary purpose of performing an epidural block during labor?
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What indicates a breach presentation during labor?
What indicates a breach presentation during labor?
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What should be checked immediately after the rupture of membranes?
What should be checked immediately after the rupture of membranes?
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What characteristic defines the latent phase of the first stage of labor?
What characteristic defines the latent phase of the first stage of labor?
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What is the recommended limit for white tuna consumption during pregnancy?
What is the recommended limit for white tuna consumption during pregnancy?
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Which of the following foods should be avoided due to the risk of listeria monocytogenes during pregnancy?
Which of the following foods should be avoided due to the risk of listeria monocytogenes during pregnancy?
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What is the maximum amount of caffeine recommended per day for pregnant individuals?
What is the maximum amount of caffeine recommended per day for pregnant individuals?
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Which vitamin is best absorbed with iron to enhance its effectiveness during pregnancy?
Which vitamin is best absorbed with iron to enhance its effectiveness during pregnancy?
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What is a significant weight gain expectation during the second and third trimesters of pregnancy?
What is a significant weight gain expectation during the second and third trimesters of pregnancy?
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Which symptom is considered a danger sign during pregnancy?
Which symptom is considered a danger sign during pregnancy?
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In a Non-Stress Test (NST), what indicates a reactive outcome?
In a Non-Stress Test (NST), what indicates a reactive outcome?
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What score is considered normal in a Biophysical Profile?
What score is considered normal in a Biophysical Profile?
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What indicates a possible need for a glucose screening test between 24-28 weeks of pregnancy?
What indicates a possible need for a glucose screening test between 24-28 weeks of pregnancy?
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Which of the following actions may help alleviate morning sickness?
Which of the following actions may help alleviate morning sickness?
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What is an essential factor for early screening during prenatal visits?
What is an essential factor for early screening during prenatal visits?
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What is a characteristic sign of placenta previa?
What is a characteristic sign of placenta previa?
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Which of the following is NOT a risk factor for placental abruption?
Which of the following is NOT a risk factor for placental abruption?
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What indicates a diagnosis of placental abruption?
What indicates a diagnosis of placental abruption?
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Which statement about Rh incompatibility is correct?
Which statement about Rh incompatibility is correct?
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Which management step is crucial for suspected placental abruption?
Which management step is crucial for suspected placental abruption?
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What is the expected abdomen presentation in placental abruption?
What is the expected abdomen presentation in placental abruption?
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What is a preventive measure for Rh incompatibility?
What is a preventive measure for Rh incompatibility?
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What characterizes the bleeding seen with placenta previa?
What characterizes the bleeding seen with placenta previa?
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Which of the following is a sign that requires immediate medical attention during pregnancy?
Which of the following is a sign that requires immediate medical attention during pregnancy?
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Study Notes
Antepartum Nutrition and Weight Gain
- Foods to avoid: Fish (due to mercury), shark, swordfish, king mackerel, tilefish; limit white tuna to 6 oz/week; certain soft cheeses and ready-to-eat meats (unless heated until steaming).
- Substances to avoid: Alcohol (no safe amount), ETOH (is a teratogen), tobacco. Limit caffeine to 300 mg/day.
- Nutritional Requirements: Increase protein by 10g/day; Folic acid is crucial for neurological development, increase iron from 15-30 mg/day. Iron supplements increase maternal RBC mass and is absorbed best with vitamin C. Calcium is essential for bone/tooth formation. Drink 2-3 liters of fluids daily, preferably water, milk, or fruit juice.
- Nutritional help for common problems: Morning sickness - crackers before rising, protein snack at bedtime, avoid fatty/spicy meals; Take prenatal vitamins at night and ginger tea/cookies for constipation. Fiber at 30 g/hydrate.
Danger Signs of Pregnancy
- Pain on urination
- Vaginal bleeding
- Urinary urgency
- Cramping
- Blurry vision
- Headaches
Fetal Well-being Assessment
- Non-stress test (NST): Widely used to evaluate fetal well-being during the third trimester. Monitors the fetal heart rate's response to fetal movement.
- Biophysical profile: Assesses fetal well-being by measuring 5 parameters, with scores of 2 for normal and 0 for abnormal findings, in response to breathing movements, fetal movements, tone, reactive fetal heart, and amniotic fluid volume.
High Risk Antepartum Conditions
- Pregnancy-induced hypertension (PIH): Pregestational diabetes (Type 1 requiring insulin, Type 2 using diet and exercise; Gestational diabetes usually occurs in the latter half of pregnancy). Pre-existing diabetes (Type 1 – total insulin deficiency, Type 2 – insulin resistance). Hyperemesis gravidarum (excessive nausea and vomiting).
Risks to Mother and Fetus
- Risks to mother: Spontaneous abortion, vaginal/urinary infections, polyhydramnios (over-distension of uterus), ketoacidosis from uncontrolled blood sugar, hypoglycemia from skipping meals, difficult labor, or the need for Cesarean delivery due to macrosomia or enlargement of the baby.
- Risks to fetus: Congenital anomalies (due to elevated blood sugar during the first trimester), macrosomia, intrauterine growth restriction (IUGR), perinatal death, hypoglycemia, hyperbilirubinemia, or respiratory distress syndrome.
Risk Factors for Gestational Diabetes
- Gestational diabetes in previous pregnancy, overweight/obesity (BMI >30), family history of diabetes, previous delivery of a baby weighing over 9 lbs, polycystic ovary syndrome (PCOS), and maternal age over 35.
Carbohydrate Intolerance
- Carbohydrate intolerance with onset during the second or third trimester of pregnancy. Elevated blood glucose develops during the first trimester; pregestational type 1 or 2 diabetes.
Hyperemesis Gravidarum
- Excessive nausea and vomiting lasting longer than 12 weeks of gestation.
- Resulting in dehydration, nutritional deficiencies, electrolyte imbalance; risk for IUGR, SGA (small for gestational age), preterm delivery.
Placenta Previa
- Bright red painless vaginal bleeding during the second or third trimester. Non-tender uterus; fundal height greater than expected; fetal malposition (breech, oblique, or transverse).
Placenta Abruption
- Premature separation of the placenta from the uterine wall. Sudden onset intense, firm rigid abdomen and dark red vaginal bleeding.
- Risk factors: maternal hypertension, preeclampsia, GHTN, blunt trauma to the abdomen, cocaine use, previous abruption, smoking, chorioamnionitis, uterine rupture, or polyhydramnios.
Rh/ABO Incompatibility
- Rh incompatibility occurs when the mother is Rh-negative and the fetus is Rh-positive.
- ABO incompatibility occurs when the mother's blood type is O and the fetus's is A or B.
- RhoGAM helps to prevent this issue.
Intrapartum Issues
- Prolapsed cord: Cord slips down after membrane rupture, compressing between fetus and pelvis and decreasing oxygen to fetus.
- Shoulder dystocia: Difficulty or inability to deliver anterior shoulder from difficult labor, fetal hypoxia, or death. Cord compression, fractured clavicle (collar bone) or humerus/brachial plexus palsy.
Postpartum
- Fundal assessment: 14 days after childbirth, the fundus should no longer be palpable.
- Lochia: Vaginal bleeding after childbirth. Lochia rubra (1-3 days), Lochia serosa (4-10 days), Lochia alba (day 11-6 weeks).
Newborn Assessment
- Thermogenesis: Newborns may need to increase metabolic rate and muscular activity to produce heat.
- Hyperbilirubinemia: Elevated bilirubin levels may occur in 50% of term and 80% of preterm newborns. Factors that increase this include: Asian, Native American, and Eskimo ethnicity/cultures.
Other Important Notes
- Tocolytic drugs: Indicated when contractions are > 6 /hr and cervical change, goal is to suppress contractions to delay birth.
- Monitoring: Assess maternal and fetal status frequently and carefully.
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Description
Explore essential nutritional guidelines for expectant mothers during the antepartum phase. This quiz covers foods and substances to avoid, nutritional requirements, and strategies for managing common pregnancy issues. Enhance your knowledge to support maternal and fetal health effectively.
