NURS 340 Final Exam Review

• Estrogen influences pregnancy and postpartum clients

Alcohol During Pregnancy

• No amount of alcohol is safe to consume

Fetal Alcohol Syndrome (FAS) Presentations

• Microcephaly (small head)
• Small eye openings
• Smooth philtrum (area between nose and upper lip)
• Thin upper lip

Neonatal Abstinence Syndrome (NAS) Presentations

• A high-pitched cry during diaper changes and assessments

Addiction Resources

• Community resources for substance addiction should be provided

Anemia in Pregnancy Interventions

• Consult with the provider regarding iron supplementation

Lordosis Impact

• Increases the chance of back pain due to the enlarging uterus pulling on the lower back

Role in Surgical Procedures

• Nurses must remain unbiased and identify informed consent

Patient Assessment Priority

• Assess a patient experiencing supine hypotension first when leaving the shift

Premature Lung Function

• Surfactant is used to improve this

Group B Streptococcus (GBS) Treatment

• Treatment is necessary to prevent GBS pneumonia in the newborn

Early Decelerations Interventions

• Documenting findings and continue monitoring is important

Variable Decelerations Interventions

• Change maternal position and administer an IV bolus

Prolonged Decelerations Interventions

• Prepare the patient and partner for a cesarean section
• Change maternal position and administer an IV bolus
• Stop the oxytocin infusion
• Inform the provider and charge nurse

Skin-to-Skin Contact

• Helps maintain newborn temperature and bonding
• Assists in stabilizing vital signs and improves milk production

Newborn Skin

• Vernix, a creamy white substance, may be found on the newborn

APGAR Scores

• Indicates the newborn's adjustment to extrauterine life

Identifying Successful Resuscitation

• Indicated by SpO2 increasing from 80% to 98%

Normal Newborn Vitals

• Heart Rate (HR): 110-160 beats per minute
• Respiratory Rate (RR): 30-60 breaths per minute
• Temperature (T): 36.5-37.5 degrees Celsius

Palpating Newborn Clavicles

• To check for a clavicle fracture resulting from birth trauma

Enlarged Testicles Education

• Maternal hormones can affect the newborn

Respiratory Distress Likelihood

• More likely in newborns experiencing cold stress

Newborn Respiratory Distress Causes

• Hypothermia
• Respiratory secretions
• Mechanism aspiration

Respiratory Distress Signs

• Grunting
• Flaring
• Retractions

Hepatitis B Vaccine Rationale

• It is the first in the series of vaccines

Breastfeeding

• Provides immunological benefits

Ideal Breastfeeding Initiation

• During the first period of reactivity, when the newborn is alert and may appear hungry

Breastfeeding Education

• To increase milk production, breastfeed every 2-3 hours, as more stimulation increases production

Hypoglycemia Signs

• Jitteriness
• Lethargy
• Cyanosis
• Low temperature
• Poor intake

Maintaining Newborn Body Temperature

• Swaddle the newborn and keep the head covered

Potential Complication Indicator

• New born blood sugar of 38

Newborn Pain Indicators

• Heart rate of 164
• Flailing of arms
• Facial grimacing
• Crying

Immature Liver Complication

• Increases the likelihood of physiological jaundice

Bilirubin Level Improvement

• Determined through lab value assessment

Phototherapy Nursing Interventions

• Protect the eyes
• Place lights according to policy
• Turn every 2 hours

Normal Newborn Skin Characteristics

• Erythema toxicum
• Acrocyanosis
• Milia

Normal Newborn Reflexes

• Sucking
• Rooting
• Startle (Moro)
• Fencing

SIDS Risk Reduction

• Place the newborn on their back in the crib

Postpartum (PP) Assessments

• Performed every 15 minutes in recovery to identify postpartum hemorrhage (PPH)

Expected Fundal Assessment

• Firm, midline, at the umbilicus

Ice Pack Use

• Applied to the perineum for the first 24 hours after delivery

Lochia Concerns

• Multiple clots and saturating a peri pad in less than an hour is a concern

Saturated Peripad Action

• Ask the patient when they last changed the peri pad

Complication Indication

• Blood pressure of 156/92

Common Cause of PPH

• Uterine atony/boggy uterus
• Check fundus every 15 minutes for the first hour, then every 30 minutes for the second hour

Clinical Signs of PPH

• Heart rate 120, respiratory rate 22, blood pressure 90/50, pulse oximetry 93%, and increased lochia

Possible Infection

• Redness with a foul odor to drainage

Standard PP Labs

• Complete Blood Count (CBC) and Hemoglobin/Hematocrit (H/H) to check for anemia

Excess IVF Removal

• The body removes excess IV fluids through sweating and urine

Possible PP Blues

• Becoming teary-eyed while watching a sentimental commercial

Higher Coagulations Risk

• Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE)

Breastfed Newborn Education

• The newborn will breastfeed every 2-3 hours

Couvade Syndrome

• The partner experiences similar symptoms as the pregnant client