Nursing Care and Interventions Quiz

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Questions and Answers

Which symptom is NOT associated with deep vein thrombosis (DVT)?

Cool extremities (correct)

Warmth/Redness

Calf pain/tenderness

Edema

What is the recommended intervention to prevent venous pooling?

Using pillows under the knees

Leaving the legs up in stirrups for long periods

Increasing fluid intake (correct)

Crossing legs for long periods

Which of the following is a sign of hypovolemic shock?

Warm extremities

Increased capillary refill time

Increased urine output

Postural hypotension (correct)

What is a key symptom of infection?

Fever above 38°C (100.4°F) Signup and view all the answers

What treatment is priority for managing a confirmed DVT?

Administration of heparin Signup and view all the answers

What does meconium-stained fluid indicate during labor?

Fetal distress Signup and view all the answers

Which characteristic of amniotic fluid might indicate an infection?

Cloudy or purulent Signup and view all the answers

How is bonding described in relation to attachment?

One-directional feeling from parents to baby Signup and view all the answers

What is a recommended comfort measure for episiotomy care during the first 24 hours?

Ice pack to reduce edema Signup and view all the answers

What is the purpose of using a peri bottle after childbirth?

To cleanse the perineal area Signup and view all the answers

Which statement about attachment is correct?

It is reciprocal, involving both baby and parent. Signup and view all the answers

What strategy is suggested for preventing straining after an episiotomy?

Increased fiber intake Signup and view all the answers

What type of odor should amniotic fluid have to be considered normal?

Mild and musty Signup and view all the answers

What is the primary function of brown fat in infants?

To generate heat in response to cold exposure Signup and view all the answers

Which method is NOT an effective way to prevent heat loss in a newborn?

Placing the crib near cold outer walls Signup and view all the answers

How does convection contribute to heat loss in infants?

By heat flowing to cooler surrounding air Signup and view all the answers

What is a consequence of cold stress in newborns?

Potential for hypothermia Signup and view all the answers

What is the main cause of heat loss due to evaporation?

Liquid evaporating from the infant's skin Signup and view all the answers

Which practice should be avoided to minimize heat loss in a newborn?

Placing the baby near air vents Signup and view all the answers

What happens during conduction heat loss?

Heat is transferred between two objects in direct contact Signup and view all the answers

What is the purpose of delaying a baby's initial bath?

To stabilize the baby's temperature Signup and view all the answers

What is the primary reason for administering magnesium sulfate in patients with eclampsia?

To prevent seizures Signup and view all the answers

What is a common sign of magnesium sulfate toxicity?

Dysrhythmias Signup and view all the answers

When is cervical cerclage typically placed for best results?

12-14 weeks of gestation Signup and view all the answers

Which laboratory findings are associated with HELLP syndrome?

Hemolysis, elevated liver enzymes, low platelets Signup and view all the answers

Which of the following is NOT a potential complication of HELLP syndrome?

Increased appetite Signup and view all the answers

What is the main purpose of magnesium sulfate as a tocolytic?

To stop preterm labor Signup and view all the answers

What is the recommended action when magnesium sulfate toxicity occurs?

Administer calcium gluconate or calcium chloride Signup and view all the answers

What should be done with cervical cerclage when spontaneous labor occurs?

It should be removed at that time Signup and view all the answers

What is the primary method of HIV transmission from mother to baby during pregnancy?

Before birth, during birth, or through breastfeeding Signup and view all the answers

What is the purpose of administering antiretroviral medication to the newborn after birth?

To reduce the possibility of infection within the first few hours of life Signup and view all the answers

Which communication strategy is recommended when addressing fetal demise with a patient?

Use the word 'died' without euphemisms Signup and view all the answers

In the case of umbilical cord prolapse, what is the immediate nursing action that should be taken?

Insert two fingers to lift the presenting part off the cord Signup and view all the answers

What position is NOT recommended to relieve pressure on the cord during umbilical cord prolapse?

Supine position Signup and view all the answers

What type of monitoring is performed to indicate fetal hypoxia during umbilical cord prolapse?

Looking for variable decelerations Signup and view all the answers

Which of the following should be applied to the visible portion of the umbilical cord to maintain blood flow?

Warm, sterile, saline-soaked cloth Signup and view all the answers

What is the primary goal when managing a patient with umbilical cord prolapse?

To prepare for immediate birth and relieve pressure on the cord Signup and view all the answers

What is a potential risk associated with vacuum extraction during delivery?

Cephalohematoma Signup and view all the answers

Which birthing position helps relieve backache and assists in the rotation of the baby?

On all fours Signup and view all the answers

What advantage does the squatting position provide during labor?

Wider pelvic outlet Signup and view all the answers

Which situation is an indication for using vacuum extraction during delivery?

Prolonged second stage of labor Signup and view all the answers

How does standing during labor benefit the mother?

Encourages fetal line up with pelvis Signup and view all the answers

Which position is particularly helpful for relaxing the perineum during labor?

Sitting on toilet Signup and view all the answers

What is a significant risk to both the mother and baby associated with the use of vacuum extraction?

Potential for tissue trauma Signup and view all the answers

What benefit does sitting upright provide during labor compared to lying down?

Increased gravity advantage Signup and view all the answers

Which birthing position might be most effective if the woman feels no urge to push?

Squatting Signup and view all the answers

What is a primary advantage of the side-lying position during labor?

Slows a rapid second stage Signup and view all the answers

Study Notes

Condoms

Condoms are important, but no specific STD questions were included in the text.

Pregnancy Tests

A positive pregnancy test is a likely sign of pregnancy, not a definitive one.
The test measures the hormone Human Chorionic Gonadotropin (hCG).
An abnormal result (ectopic or molar pregnancies) may also indicate a problem.

True vs. False Labor

True Labor:
- Contractions are regular, becoming closer together, usually 4-6 minutes apart, lasting 30-60 seconds.
- Contractions increase in strength over time.
- Discomfort typically begins in the back and radiates toward the front of the abdomen.
- Contractions continue, regardless of position changes.
False Labor:
- Contractions are irregular and not close together.
- Contractions may frequently be weak and don't intensify over time.
- Pain typically occurs in the front of the abdomen.
- Contractions may stop or slow down with position changes.

Bonding

En face position (face-to-face) with the baby shortly after birth promotes bonding for parents.
Skin-to-skin contact and kangaroo care are also beneficial.

Physical Signs of Pregnancy

Chadwick Sign: bluish-purple vaginal mucosa and cervix coloration.
Goodell Sign: cervix softening.
Hegar Sign: lower uterine segment softening.
Increased vaginal secretions (more acidic, white, thick) and leukorrhea (vaginal discharge).

GI Changes

Gums may appear inflamed and swollen (hyperemic).
Excess saliva (ptyalism).
Hemorrhoids (due to constipation and increased internal pressure).
Slowed gastric emptying, heartburn, nausea, and vomiting.

Cardiovascular Changes

Increased blood volume, cardiac output, and heart rate.
Potential small decrease in blood pressure during the first half of pregnancy.
Increased red blood cell count and plasma volume.

MSK Changes

Softening and stretching of pelvic ligaments.
Increased lordosis (swayback).
Waddling gait may occur.

Urinary Changes

Increased glomerular filtration rate (GFR).
Increased urine flow and volume.
Hyperpigmentation (facial melasma/chloasma).

Integumentary Findings

Dark patches (facial melasma/chloasma).
Linea nigra (dark vertical line down the abdomen).
Striae gravidarum (stretch marks).
Varicosities (spider veins).
Palmar erythema (redness of palms).

Neural Tube Defects

The cause of neural tube defects (NTDs) is unknown.
Maternal supplementation with folic acid can reduce the risk of NTDs.
High maternal alpha-fetoprotein (AFP) levels could indicate NTD presence.

Gravida/Para

Gravida: the total number of pregnancies.
Para: the total number of pregnancies that progressed to at least 20 weeks gestation.

Teaching for Pregnant Women

Urinary frequency or incontinence: pelvic floor exercises and reducing fluid intake after dinner.
Fatigue: Schedule daily naps, and rest when tired.
Nausea and vomiting: Avoid empty stomachs, eat small meals, avoid brushing teeth right after meals, and drink fluids between meals.

Birthing Process (The 5 Ps of Labor)

Power: Contraction strength and frequency.
Passageway: Pelvic shape and size.
Passenger: Fetal attitude, lie, presentation, and size.
Position: Maternal positioning.
Psyche: Mental state of the woman.

Stages of Labor

First Stage (Cervical dilation):
- Latent phase: mild contractions every 5-10 minutes.
- Active phase: moderate contractions every 2-5 minutes.
Second Stage (Birth of the baby):
- Pelvic phase: fetal descent.
- Perineal phase: active pushing.
Third Stage (Placental Delivery):
- Separation and delivery of the placenta.
- Monitor for potential hemorrhage.

Postpartum Hemorrhage

Signs include postpartum bleeding, saturating pads quickly, passing large clots, and tachycardia.
Common causes include uterine atony, retained placenta fragments, and precipitous labor.
Preeclampsia, prolonged labor, and oxytocin usage are risk factors.

Postpartum Depression (PPD)

PPD occurs within the first year of birth.
Risk factors include decreased social support, anxiety about parenting, low self-esteem, history of prior depressive disorders, and unintended pregnancies.

Education on Birth Control

Menstruation may return 7-9 weeks postpartum if not breastfeeding, and longer with breastfeeding (2-18 months).

Know About Postpartum Depression

Risk factors for postpartum mood disorders include decreased social support, anxiety about parenting, low self-esteem, history of prior depressive disorders, and unintended pregnancies.

Pregnancy and Different Drugs

Alcohol: growth restriction, craniofacial deformities, CNS dysfunction.
Nicotine: impaired oxygenation, low birth weight, pre-term birth.
Marijuana: small for gestational age, fetal growth restriction.
Methamphetamine: preterm birth and low birth weight.
Cocaine: preterm/low birth-weight, learning impairments, GU, cardiac, CNS defects.

Know About HIV + Pregnancy

HIV can be transmitted to the baby before birth, during birth, or through breastfeeding.
Antiretroviral medications help prevent transmission.

Fetal Demise

Therapeutic communication and empathy are essential.
Avoid the euphemism "miscarriage," instead use direct language like "died."

Umbilical Cord Prolapse

Umbilical cord protrudes through the cervix ahead of the baby, a critical and potentially fatal complication.

Different Birthing Positions

Standing, walking, all fours, side-lying, and squatting.
Each position offers advantages for the mother's comfort, safety, and overall well-being.

Newborn Dehydration

Sunken eyes, fewer tears, fewer wet diapers, sunken fontanelles, dry/sticky mouth, tachycardia, irritability are some signs of newborn dehydration.

Symptoms of Necrotizing Enterocolitis (NEC)

Abdominal distention and tenderness.
Bloody stools.
Feeding intolerance.
Diarrhea and vomiting.
Lethargy.
Sepsis, apnea.

Risk Factors for Small-for-Gestational-Age (SGA)

Advanced maternal age.
History of hypertension, preeclampsia, and/or diabetes.
Smoking.
Low socioeconomic status.
Substance abuse.
Nutritional deficiencies.

Neurologic Impairment

Brachial plexus injury, Erb palsy, Klumpke palsy.
Facial nerve injury.
Intraventricular/periventricular hemorrhage.

Risks for Large for Gestational Age Babies

Maternal obesity/diabetes.
Prior LGA birth.
Postdate pregnancies.

Jaundice

Promotion of breastfeeding and frequent stooling can help prevent jaundice.
Phototherapy is used for severe cases.

Meconium Aspiration Syndrome (MAS)

Meconium aspiration is the risk that meconium present in the amniotic fluid can cause neonatal respiratory failure.
Immediate and aggressive care is required to prevent potential risks like respiratory distress, and need for surfactant administration.

Respiratory Distress Syndrome (RDS)

Surfactant deficiency causes RDS.
Shallow, rapid respirations, retractions, grunting, cyanosis are signs of RDS.

Cephalohematoma

Hematoma that does not cross suture lines.

Caput Succedaneum

Swelling that crosses suture lines.

Cervical Cerclage

Surgical reinforcement of the cervix to prevent premature dilation and/or rupture.

Herpes in Newborns

The most common risk is transmission from an infected mom around the time of delivery.

HELLP Syndrome

This is a variant of gestational hypertension that has a high risk of complications.
HELLP symptoms range from hemolysis, elevated liver enzymes, and low platelets.

Newborn Vital Signs

Temperature: 97.7-99.5°F (36.5-37.5°C)
Heart rate: 110-160 beats per minute (bpm); increased rate with crying.
Respirations: 30-60 breaths per minute (bpm); increased rate with crying.
Blood pressure: 50-75 systolic; 30-45 diastolic.

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Description

Test your knowledge on nursing care associated with deep vein thrombosis, hypovolemic shock, and newborn care. This quiz covers symptoms, recommended interventions, and understanding bonding. Enhance your expertise in providing effective nursing support during childbirth and postpartum care.