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Questions and Answers
Why must the nurse monitor the patient's fluid intake and output closely during oxytocin administration?
Why must the nurse monitor the patient's fluid intake and output closely during oxytocin administration?
- Oxytocin is toxic to the kidneys
- Oxytocin has a diuretic effect
- Oxytocin causes water intoxication (correct)
- Oxytocin causes excessive thirst
Rh isoimmunization in a pregnant client develops when which condition occurs?
Rh isoimmunization in a pregnant client develops when which condition occurs?
- Rh-positive maternal blood crosses into fetal blood
- Rh-negative maternal blood crosses into fetal blood
- Rh-negative fetal blood crosses into maternal blood
- Rh-positive fetal blood crosses into maternal blood (correct)
Which laboratory test would likely be ordered for a newborn of an Rh (-) maternal blood?
Which laboratory test would likely be ordered for a newborn of an Rh (-) maternal blood?
- Platelet count
- Direct Coomb's (correct)
- Blood culture
- Indirect Coomb's
Which assessment finding should the nurse expect in a patient with abruptio placentae?
Which assessment finding should the nurse expect in a patient with abruptio placentae?
Which prescription should the nurse question for a client suspected of having placenta previa?
Which prescription should the nurse question for a client suspected of having placenta previa?
Upon finding abruptio placentae during an ultrasound, which prescription should the nurse anticipate?
Upon finding abruptio placentae during an ultrasound, which prescription should the nurse anticipate?
What is a common complication associated with Rh-negative mothers during pregnancy?
What is a common complication associated with Rh-negative mothers during pregnancy?
What assessment finding is typically NOT associated with abruptio placentae?
What assessment finding is typically NOT associated with abruptio placentae?
Which finding would lead a nurse to suspect a miscarriage in an 8-week pregnant patient?
Which finding would lead a nurse to suspect a miscarriage in an 8-week pregnant patient?
Which medication is indicated for medical management of abortion by causing cervical ripening?
Which medication is indicated for medical management of abortion by causing cervical ripening?
What complication should the nurse suspect in a 17-week pregnant patient with fast, fresh vaginal bleeding and a larger than expected fundic height?
What complication should the nurse suspect in a 17-week pregnant patient with fast, fresh vaginal bleeding and a larger than expected fundic height?
Which of the following is not typically associated with hydatidiform mole?
Which of the following is not typically associated with hydatidiform mole?
What dietary adjustment should a nurse recommend for a diabetic pregnant client in the second half of pregnancy?
What dietary adjustment should a nurse recommend for a diabetic pregnant client in the second half of pregnancy?
What is the most appropriate nursing action for a postpartum client feeling faint and dizzy?
What is the most appropriate nursing action for a postpartum client feeling faint and dizzy?
Where would you hear the fetal heartbeat best when the fetal back is at the left side of the mother in breech presentation?
Where would you hear the fetal heartbeat best when the fetal back is at the left side of the mother in breech presentation?
What does a soft, broad mass that moves with the rest of the presenting part most likely indicate during fundal grip?
What does a soft, broad mass that moves with the rest of the presenting part most likely indicate during fundal grip?
What is the expected time frame for the return of bowel function after giving birth?
What is the expected time frame for the return of bowel function after giving birth?
What should be the priority nursing consideration for a postpartum client who had an episiotomy and hemorrhoids?
What should be the priority nursing consideration for a postpartum client who had an episiotomy and hemorrhoids?
In a left-anterior breech presentation, where would the fetal heart rate be most audible?
In a left-anterior breech presentation, where would the fetal heart rate be most audible?
What does a presenting part at station plus two indicate during labor?
What does a presenting part at station plus two indicate during labor?
What is the most appropriate nursing intervention when the uterine fundus is noted to be soft and boggy after delivery?
What is the most appropriate nursing intervention when the uterine fundus is noted to be soft and boggy after delivery?
When a fetal heart rate of 90 bpm is noted during auscultation, what is the most appropriate first action?
When a fetal heart rate of 90 bpm is noted during auscultation, what is the most appropriate first action?
When observing clots in the lochia larger than 1 cm during a postpartum assessment, which nursing action is appropriate?
When observing clots in the lochia larger than 1 cm during a postpartum assessment, which nursing action is appropriate?
How should the result of a negative contraction stress test (CST) be interpreted?
How should the result of a negative contraction stress test (CST) be interpreted?
Which of the following decelerations is considered normal during a contraction stress test?
Which of the following decelerations is considered normal during a contraction stress test?
What should the nurse's initial response be for a client who has saturated a perineal pad in 15 minutes, 2 hours postpartum?
What should the nurse's initial response be for a client who has saturated a perineal pad in 15 minutes, 2 hours postpartum?
Which sign is considered an early indication of excessive blood loss in the immediate postpartum period?
Which sign is considered an early indication of excessive blood loss in the immediate postpartum period?
What would the nurse interpret if a late decrease in fetal heart rhythm was noted during a contraction stress test?
What would the nurse interpret if a late decrease in fetal heart rhythm was noted during a contraction stress test?
Which self-care instruction should be included for a postpartum client diagnosed with mastitis?
Which self-care instruction should be included for a postpartum client diagnosed with mastitis?
Which statement by the client indicates a need for further instruction regarding mastitis prevention?
Which statement by the client indicates a need for further instruction regarding mastitis prevention?
Which of the following instructions should be emphasized for a client to prevent postpartum complications?
Which of the following instructions should be emphasized for a client to prevent postpartum complications?
When assessing a client for signs of postpartum complications, which observation is most concerning?
When assessing a client for signs of postpartum complications, which observation is most concerning?
What is the most likely cause of a late deceleration in fetal heart rate?
What is the most likely cause of a late deceleration in fetal heart rate?
Which action is most appropriate when late decelerations are noted during a contraction stress test (CST)?
Which action is most appropriate when late decelerations are noted during a contraction stress test (CST)?
What is Leila's GTPAL score given her obstetric history?
What is Leila's GTPAL score given her obstetric history?
What is Sheila's GTPAL score considering her pregnancy history?
What is Sheila's GTPAL score considering her pregnancy history?
What is Meila's GTPALI score based on her obstetric history?
What is Meila's GTPALI score based on her obstetric history?
How should the nurse record the obstetrical history for a patient who had a son at 38 weeks, a daughter at 30 weeks, and a miscarriage at 8 weeks?
How should the nurse record the obstetrical history for a patient who had a son at 38 weeks, a daughter at 30 weeks, and a miscarriage at 8 weeks?
What instruction should the nurse provide to a pregnant patient scheduled for amniocentesis?
What instruction should the nurse provide to a pregnant patient scheduled for amniocentesis?
Which of the following values is considered a normal lecithin-sphingomyelin ratio for assessing fetal lung maturity?
Which of the following values is considered a normal lecithin-sphingomyelin ratio for assessing fetal lung maturity?
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Study Notes
Fetal Heart Rate Auscultation
- In a breech presentation with the fetal back on the left side of the mother, the fetal heart rate will be best heard in the left lower quadrant.
Leopold's Maneuvers
- During fundal grip, a soft, broad mass that moves with the presenting part is likely the fetal buttocks.
Fetal Positioning
- A fetus in the left-anterior breech presentation will have the fetal heart rate most audible above the maternal umbilicus and to the left of midline.
Station
- Station plus two means the presenting part is 2 cm below the plane of the ischial spines.
Fetal Heart Rate Assessment
- A fetal heart rate of 90 bpm in one full minute is abnormal and requires immediate notification of the doctor.
Contraction Stress Test
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A negative Contraction Stress Test (CST) indicates a normal test result.
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Late decelerations during CST are considered abnormal and are most likely caused by insufficient placental circulation.
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In response to a late deceleration, the most appropriate action is to stop the test, place the patient on the left side-lying position, and provide oxygen support.
GTPAL
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GTPAL: Gravidity, Term, Premature, Abortions, Living -
A woman who is 26 weeks pregnant with her third pregnancy, has had two term deliveries, no premature deliveries, one abortion, and two living children would have a GTPAL score of G3 T2 P0 A1 L2.
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A woman who is 25 weeks pregnant with twins, has had five children born at term, one born prematurely, one abortion, and five living children would have a GTPAL score of G6 T5 P1 A1 L5.
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A woman who is 13 weeks pregnant with her fifth pregnancy, has had one term delivery, one premature delivery, two abortions, and three living children would have a GTPAL score of G5 T1 P1 A2 L3.
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A woman who has had two children born at term and one miscarriage would have a GTPAL score of G3 T2 P0 A0 L2.
Amniocentesis
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Informed consent must be signed prior to the procedure.
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A normal lecithin-sphingomyelin (L/S) ratio for fetal lung maturity is 2:1.
Naegele's Rule
- Naegele's rule calculates the expected date of delivery by adding 280 days to the first day of the last menstrual period.
Oxytocin Administration
- Oxytocin can cause water intoxication, so monitoring fluid intake and output is crucial during administration.
Rh Isoimmunization
- Rh isoimmunization occurs when Rh-positive fetal blood crosses into Rh-negative maternal blood, stimulating the production of maternal antibodies.
Newborn Testing
- A direct Coomb's test is performed on a newborn of an Rh-negative mother to determine if the baby has been affected by Rh isoimmunization.
Abruptio Placentae
- Abruptio placentae is characterized by uterine tenderness and abdominal pain due to bleeding behind the placenta.
Placenta Previa
- A manual pelvic examination is contraindicated for patients with suspected placenta previa.
Postpartum Hemorrhage
- An increase in pulse rate and a decrease in blood pressure are early signs of postpartum hemorrhage.
Postpartum Mastitis
- To prevent postpartum mastitis, women should breast-feed every 2 to 3 hours, change breast pads frequently, wash hands well before breast-feeding, and avoid decompression of the breasts by breast-feeding or breast pump.
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