Nursing Alerts and Procedures in Obstetrics
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Questions and Answers

What indicates a non-reactive non-stress test?

  • Deceleration of FHR lasting 20 seconds or more.
  • Baseline FHR remains unchanged for more than 15 seconds.
  • Acceleration of FHR less than 15 beats per minute above baseline. (correct)
  • Acceleration of FHR greater than 15 beats per minute above baseline.

    • What action should be taken if a patient voids prior to a pelvic ultrasound?

  • Teach the patient the importance of not voiding beforehand. (correct)
  • Reassess the patient’s hydration status.
  • Schedule the ultrasound for a later date.
  • Provide immediate catheterization for analysis.

    • Why is RhoGam administered to Rh negative women during pregnancy?

  • To improve fetal heart rate response.
  • To prevent maternal diabetes development.
  • To enhance fetal blood circulation.
  • To prevent sensitization due to possible fetal blood entering maternal circulation. (correct)

    • After a percutaneous umbilical cord blood sampling (PUBS) procedure, what is critical to monitor?

    <p>Fetal heart rate through a non-stress test.</p> Signup and view all the answers

    What is the main purpose of conducting a Papanicolaou smear during the first prenatal visit?

    <p>To ensure absence of precancerous or cancerous conditions.</p> Signup and view all the answers

    What is the primary purpose of conducting a Non Stress Test (NST) during pregnancy?

    <p>To evaluate fetal activity and well-being</p> Signup and view all the answers

    In a Non Stress Test, which equipment is primarily used to monitor fetal heart rate?

    <p>Fetal heart rate transducer</p> Signup and view all the answers

    During a Non Stress Test, how is fetal activity assessed?

    <p>Observation of fetal heart rate deceleration patterns</p> Signup and view all the answers

    What is the primary purpose of the fourth maneuver in Leopold's maneuvers?

    <p>To assess the fetal attitude and extension into the pelvis</p> Signup and view all the answers

    What is a common indication for performing a Non Stress Test in pregnant women?

    <p>Concern for fetal distress</p> Signup and view all the answers

    In a Non Stress Test, what does a non-reactive result indicate?

    <p>Further evaluation may be needed</p> Signup and view all the answers

    In which situation might Leopold's maneuvers be particularly challenging to perform?

    <p>In obese women or those with a tight abdominal wall</p> Signup and view all the answers

    What is the recommended total weight gain for a woman with a normal Body Mass Index during pregnancy?

    <p>25 – 35 lbs</p> Signup and view all the answers

    What is typically required from a patient prior to conducting a Non Stress Test?

    <p>Hydration through fluid intake</p> Signup and view all the answers

    What is the ideal position for a pregnant woman during a Non Stress Test?

    <p>Supine</p> Signup and view all the answers

    What weight gain pattern is expected during the first trimester?

    <p>3-4 lbs total</p> Signup and view all the answers

    What does an elevated alpha-fetoprotein (AFP) level indicate?

    <p>Neural tube defects</p> Signup and view all the answers

    Which of the following findings in a Non Stress Test is considered reassuring?

    <p>Increased baseline variability</p> Signup and view all the answers

    What is the aim of an amniocentesis during pregnancy?

    <p>To assess fetal growth and determine genetic disorders</p> Signup and view all the answers

    How long is a typical Non Stress Test performed for optimal assessment?

    <p>30 to 40 minutes</p> Signup and view all the answers

    What factor is considered more important than the total amount of weight gained during pregnancy?

    <p>Pattern of weight gain</p> Signup and view all the answers

    During a Non Stress Test, which condition does a positive result indicate?

    <p>Fetal distress is likely</p> Signup and view all the answers

    What is a potential consequence of failure to gain appropriate weight during pregnancy?

    <p>Ominous sign for pregnancy health</p> Signup and view all the answers

    Study Notes

    Nursing Alerts and Procedures

    • Chorionic Villus Sampling: Conducted between 14-16 weeks AOG to assess chromosomal abnormalities; after 35 weeks AOG to check fetal lung maturity.
    • L/S Ratio: A ratio of 1:2 indicates fetal lung maturity.
    • Patient Instructions: Advise to void if gestation exceeds 20 weeks; position in supine; report fetal movement changes and any abnormal symptoms.

    Risk Factors and Complications

    • Complications of procedures may include placental, cord, and bladder puncture, as well as spontaneous abortion and infection for chorionic villus sampling.
    • Coombs Test: Direct Coombs test indicates erythroblastosis fetalis in newborns due to maternal antibodies.

    Fetal Monitoring Tests

    • Contraction Stress Test (CST): Evaluates uteroplacental insufficiency. A negative test indicates no abnormal decelerations; a positive test indicates abnormal fetal heart rate with decelerations.
    • Types of CST: Includes nipple-stimulated CST and intravenous oxytocin methods to measure uterine response.

    Fetal Heart Rate Monitoring

    • Early Deceleration: Indicates fetal head compression; no treatment required.
    • Late Deceleration: Reflects placental insufficiency, requiring oxygen administration.
    • Variable Deceleration: Indicates cord compression; change patient position and provide oxygen.

    Non-Stress Test

    • Procedure: Involves a pregnant woman lying down with belts attached for monitoring fetal heart rate (FHR).
    • Reactive Test: FHR accelerates by more than 15 beats for at least 15 seconds, indicating fetal well-being.
    • Non-Reactive Test: Less than a 15 beat increase indicates potential fetal jeopardy.

    Additional Assessments

    • Pelvic Ultrasound: Requires increased fluid intake before the procedure to enhance organ visibility.
    • Percutaneous Umbilical Cord Blood Sampling (PUBS): Removes blood from the umbilical vein for assessment; involves monitoring the fetus pre and post-procedure.

    Weight Gain Guidelines

    • Recommended Gain: Total of 25-35 lbs for women with normal BMI, varying throughout trimesters (1 lb/month in first trimester; 0.9-1 lb/week in second; 0.5-1 lb/week in third).
    • Importance of Patterns: Emphasis on normal weight gain patterns for maternal and fetal health; inadequate weight gain signals potential health issues.

    Diagnostic Tests

    • Alpha-Fetoprotein Levels: Elevated AFP levels indicate neural tube defects; decreased levels suggest Down’s syndrome.
    • Amniocentesis: Used to assess fetal growth/maturity, determine genetic disorders, and identify fetal sex.

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    Description

    This quiz covers critical nursing alerts and procedures related to obstetrics, including chorionic villus sampling and fetal monitoring tests. Understand key risk factors, complications, and patient instructions for safe prenatal care. Test your knowledge on essential practices and assessments for maternal-fetal health.

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