Nursing Care During Pregnancy & Labor
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Questions and Answers

What is a known contraindication for administering magnesium sulfate during labor?

  • Active vaginal bleeding (correct)
  • Increased heart rate
  • First trimester pregnancy
  • Hypotension in the mother

What is the primary purpose of administering betamethasone during pregnancy?

  • To induce labor
  • To prevent hypotension
  • To enhance fetal lung maturity (correct)
  • To manage chorioamnionitis

During which trimester does significant maternal tissue growth occur?

  • First trimester
  • Third trimester
  • All trimesters equally
  • Second trimester (correct)

Which medication may be used cautiously alongside nifedipine due to potential interference?

<p>Magnesium sulfate (C)</p> Signup and view all the answers

Which change in vital signs is expected during the third trimester?

<p>Slightly increased respiratory rate (A)</p> Signup and view all the answers

What is the primary purpose of performing a Bishop score during labor?

<p>To assess cervical readiness for induction (B)</p> Signup and view all the answers

When is cervical ripening indicated?

<p>When Bishop score is less than 8 (B)</p> Signup and view all the answers

What is a significant risk associated with continuous internal fetal monitoring?

<p>Cord compression from electrode placement (A)</p> Signup and view all the answers

Which of the following describes the term 'prolapsed umbilical cord'?

<p>The cord is displaced through the cervix and is compressing fetal circulation (B)</p> Signup and view all the answers

What is the primary advantage of performing an amnioinfusion during labor?

<p>Relieves cord compression due to oligohydramnios (C)</p> Signup and view all the answers

Which statement best describes the term 'labor dystocia'?

<p>Abnormal labor characterized by difficulties related to the five Ps (B)</p> Signup and view all the answers

What is the primary purpose of the Leopold maneuvers?

<p>To determine the fetal position and presentation (A)</p> Signup and view all the answers

In what situation would a c-section be indicated due to breech presentation?

<p>When the fetus is transverse lie (D)</p> Signup and view all the answers

What type of fetal presentation can require a cesarean section?

<p>Breech presentation (B), Transverse lie (C)</p> Signup and view all the answers

Which is NOT considered a typical nursing intervention during labor?

<p>Positioning the mother supine for comfort (B)</p> Signup and view all the answers

What characterizes hypertonic uterine contractions?

<p>Consistent, strong contractions with inadequate relaxation (B)</p> Signup and view all the answers

What does continuous external fetal monitoring involve?

<p>Placing sensors on the maternal abdomen (D)</p> Signup and view all the answers

Which method is typically used to artificially initiate uterine contractions?

<p>Administration of Pitocin (A)</p> Signup and view all the answers

Which screening test is mandated by law during pregnancy to check for syphilis?

<p>VDRL/RPR (C)</p> Signup and view all the answers

What is the primary purpose of a glucose challenge test during pregnancy?

<p>To screen for gestational diabetes (D)</p> Signup and view all the answers

Which of the following is NOT considered a danger sign of pregnancy?

<p>Increase in fetal movements (C)</p> Signup and view all the answers

During which trimester should a pregnant woman aim for a weight gain of approximately 2-4 lbs?

<p>First trimester (B)</p> Signup and view all the answers

What dietary recommendation is advised to enhance iron absorption during pregnancy?

<p>Consume iron with vitamin C (D)</p> Signup and view all the answers

Which complications can be alleviated by increasing fiber intake and physical activity?

<p>Constipation (D)</p> Signup and view all the answers

What should a pregnant woman limit regarding caffeine intake to maintain health?

<p>200 mg per day (D)</p> Signup and view all the answers

What is the recommended treatment for a pregnant woman who actively has genital herpes to prevent transmission to the newborn?

<p>C-section delivery (D)</p> Signup and view all the answers

Which of the following infections is screened for at 35-37 weeks of pregnancy?

<p>Group B Streptococcus (GBS) (B)</p> Signup and view all the answers

What is an indicated sign of hyperglycemia during pregnancy?

<p>Increased urination (C)</p> Signup and view all the answers

Which risk factor is associated with placental abruption?

<p>Increased age (D)</p> Signup and view all the answers

What is the primary focus of nursing care in cases of PROM?

<p>Monitor for signs of infection (D)</p> Signup and view all the answers

Which symptom would most likely indicate uterine contractions during preterm labor?

<p>Dull lower abdominal pain (C)</p> Signup and view all the answers

What indicates a need for immediate delivery in a patient experiencing symptoms of placental abruption?

<p>Dark red vaginal bleeding with fetal distress (D)</p> Signup and view all the answers

Which of the following is NOT a common complication associated with PPROM?

<p>Increased fetal driving (C)</p> Signup and view all the answers

Which medication is used to enhance fetal lung maturity?

<p>Betamethasone (D)</p> Signup and view all the answers

What is a common assessment finding in PROM?

<p>Gush or leakage of clear fluid (C)</p> Signup and view all the answers

How can nurses best support a patient experiencing preterm labor?

<p>Educate on labor progression (C)</p> Signup and view all the answers

What change indicates the presence of Chadwick's sign during pregnancy?

<p>Dark blue color of cervix and vagina (A)</p> Signup and view all the answers

What symptom is indicative of fetal distress?

<p>Abrupt FHR variable or prolonged deceleration (A)</p> Signup and view all the answers

What should a pregnant woman do to avoid supine hypotensive syndrome?

<p>Lie on her left lateral side (B)</p> Signup and view all the answers

What is an effective nonpharmacological method for pain management during labor?

<p>Breathing techniques (B)</p> Signup and view all the answers

Which risk factor increases the likelihood of preterm labor?

<p>Low pre-pregnancy weight (A)</p> Signup and view all the answers

Which condition is characterized by the relaxation of muscles in the ureters and bladder, increasing the risk for urinary stasis during pregnancy?

<p>Increased progesterone levels (D)</p> Signup and view all the answers

What common complaint in the gastrointestinal system during pregnancy can interfere with the quality of life for many women?

<p>Heartburn and acid reflux (D)</p> Signup and view all the answers

What does the nitrazine paper test for?

<p>Confirmation of amniotic fluid (D)</p> Signup and view all the answers

What is a key consideration when managing pain during childbirth?

<p>Patients should remain fully aware of contractions (A)</p> Signup and view all the answers

What is the term for the stretch marks that appear on the abdomen and thighs during pregnancy?

<p>Striae gravidarum (C)</p> Signup and view all the answers

What defines a positive sign of pregnancy?

<p>Fetal heart sounds detectable by a professional (C)</p> Signup and view all the answers

Which of the following is an expected finding in placental abruption?

<p>Dark red vaginal bleeding (A)</p> Signup and view all the answers

Which of the following hormonal changes helps maintain pregnancy and prepares the body for delivery?

<p>Relaxin (C)</p> Signup and view all the answers

What is the purpose of performing a complete blood count (CBC) during antepartum assessment?

<p>Determine maternal health and check for anemia (B)</p> Signup and view all the answers

What is a likely risk associated with the increased blood volume in pregnant women?

<p>Increased blood clots and DVT (B)</p> Signup and view all the answers

What factor is involved in the assessment of gestational age during prenatal visits?

<p>Estimated delivery date calculation (C)</p> Signup and view all the answers

Which of the following is a sign that may lead to the examination suspecting pregnancy?

<p>Cervical consistency changes (D)</p> Signup and view all the answers

During which trimester do increased respiratory rates commonly occur due to pressure from the growing fetus?

<p>Third trimester (C)</p> Signup and view all the answers

What helps relieve pressure on major blood vessels during pregnancy?

<p>Using the side-lying position (A)</p> Signup and view all the answers

What should be included in education for pregnant patients to prevent weight-related complications?

<p>Emphasize importance of hydration and physical activity (C)</p> Signup and view all the answers

What is a common complication of untreated chlamydia during pregnancy?

<p>Preterm labor (D)</p> Signup and view all the answers

What should a patient be educated about prior to chorionic villus sampling?

<p>Empty bladder (C)</p> Signup and view all the answers

Which infection is NOT recommended to be treated with antibiotics during the first trimester due to teratogenic effects?

<p>Trichomoniasis (B)</p> Signup and view all the answers

What is the expected finding in ectopic pregnancy?

<p>Missed menstrual period (A)</p> Signup and view all the answers

What is the primary purpose of a nonstress test during pregnancy?

<p>Monitor fetal heart rate in response to fetal movements (C)</p> Signup and view all the answers

What condition may present with bright red painless bleeding after 20 weeks of pregnancy?

<p>Placenta previa (A)</p> Signup and view all the answers

What is the recommended treatment for gonorrhea during pregnancy?

<p>Oral antibiotics (A)</p> Signup and view all the answers

What pregnancy complication is associated with vaginal cramping and bleeding?

<p>Ectopic pregnancy (C)</p> Signup and view all the answers

What is a possible complication of amniocentesis?

<p>Ruptured membranes (D)</p> Signup and view all the answers

Which of the following should be avoided while taking methotrexate for an ectopic pregnancy?

<p>Folic acid (B)</p> Signup and view all the answers

What is the function of the biophysical profile during pregnancy?

<p>Visualizing fetal physical and physiological characteristics (B)</p> Signup and view all the answers

What symptom is most notable for trichomoniasis in women?

<p>Yellow-green foul-smelling vaginal discharge (D)</p> Signup and view all the answers

What is an expected finding in spontaneous abortion?

<p>Heavy bright red vaginal bleeding (B)</p> Signup and view all the answers

What is NOT a risk factor for placenta previa?

<p>History of ectopic pregnancy (B)</p> Signup and view all the answers

Flashcards

Nifedipine

A medication used to suppress uterine contractions and prevent preterm labor. It can cause hypotension, so the patient should be closely monitored and educated about the risks. It is not given with magnesium sulfate.

Magnesium Sulfate

A medication used to prevent and treat seizures in pregnant women with preeclampsia or eclampsia. It must have no contraindications, and the antidote is calcium gluconate.

Betamethasone

A corticosteroid medication given to pregnant women to accelerate fetal lung development. It takes about 3 days to take full effect and can cause hyperglycemia in the mother.

Ampicillin

A medication that is commonly used to treat chorioamnionitis, an infection of the amniotic sac and surrounding membranes.

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Epidural

A type of spinal anesthesia that can cause hypotension. Ephedrine is used to treat hypotension caused by epidural anesthesia.

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Fundal Height at 36 Weeks

The fundus of the uterus reaches the level of the xiphoid process (the bony tip of the sternum) at around 36 weeks of pregnancy.

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Chadwick's Sign

A bluish discoloration of the cervix and vagina during pregnancy.

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Goodell's Sign

Softening of the cervix during pregnancy.

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Diastasis Recti

The separation of the abdominal muscles (rectus abdominis) that often occurs during and after pregnancy.

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Hormonal Changes in Pregnancy

Hormones play a crucial role in maintaining pregnancy, preparing the body for labor, and supporting fetal development.

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Cardiovascular Changes in Pregnancy

An increase in blood volume and cardiac output occurs during pregnancy to support the growing fetus and placenta.

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Supine Hypotensitive Syndrome

A condition where a pregnant woman experiences low blood pressure when lying on her back.

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Epidural Anesthesia

A type of spinal anesthesia that can cause hypotension.

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Ephedrine

A medication used to treat hypotension caused by epidural anesthesia.

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Physiological Changes in Pregnancy

Changes in the body systems that occur during pregnancy, often due to hormonal influences and adaptations to accommodate the growing fetus.

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Amenorrhea

A presumptive sign of pregnancy, indicating the absence of a menstrual period.

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Auscultation of Fetal Heart Sounds

A positive sign of pregnancy, indicating the presence of fetal heart sounds.

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Chlamydia

A sexually transmitted infection (STI) that can be treated with antibiotics during pregnancy. If left untreated, it can cause preterm labor, premature rupture of membranes (PROM), and postpartum endometritis. It can also lead to conjunctivitis and pneumonia in newborns.

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Gonorrhea

A sexually transmitted infection (STI) that can be treated with antibiotics during pregnancy. If left untreated, it can cause preterm labor, premature rupture of membranes (PROM), and postpartum endometritis. It can also lead to neonatal sepsis and blindness.

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Trichomoniasis

A sexually transmitted infection (STI) that can be treated with antibiotics during pregnancy. If left untreated, it can lead to pelvic inflammatory disease and fallopian tube blockage.

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HPV

A sexually transmitted infection (STI) that can cause genital warts and cervical cancer. The vaccine is not recommended during pregnancy.

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Biophysical Profile

A prenatal test used to assess fetal well-being. It combines a non-stress test (NST) with an ultrasound.

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Nonstress Test (NST)

A prenatal test used to assess fetal well-being by monitoring the fetal heart rate response to fetal movement. It also measures the mother's contractions.

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Chorionic Villus Sampling (CVS)

A prenatal test done in the first trimester to diagnose fetal chromosomal, metabolic, and DNA abnormalities. It involves a catheter inserted into the cervix.

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Amniocentesis

A prenatal test done in the second and third trimesters to assess for neural tube defects or chromosomal disorders. It involves a needle inserted into the amniotic sac using ultrasound.

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Spontaneous Abortion

A pregnancy that ends before 20 weeks gestation due to natural causes.

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Ectopic Pregnancy

A pregnancy where the fertilized egg implants outside the uterus, most commonly in the fallopian tube.

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Placenta Previa

A condition where the placenta attaches low in the uterus, covering the cervix, preventing vaginal delivery.

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Placenta Abruption

A condition where the placenta partially or completely detaches from the uterine wall, with potential bleeding.

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VDRL/RPR

A blood test that screens for syphilis in pregnant women. It is mandated by law to protect the mother and baby.

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Rubella Titer

A blood test that determines immunity to Rubella (German Measles) in a pregnant woman. Non-immune pregnant women require vaccination after delivery.

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Hepatitis B

A blood test that detects Hepatitis B carriers. Pregnant women with Hepatitis B should be treated to prevent transmission to the baby.

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Urinalysis

A urine test that confirms pregnancy and screens for gestational diabetes, gestational hypertension, infections, or renal disease in pregnant women.

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Vaginal/Rectal Cultures

Samples are taken from the vagina and rectum to detect Chlamydia & Gonorrhea (tested early pregnancy) and Group B Streptococci (GBS, tested late pregnancy -- 35-37 weeks). These infections can be harmful to the baby during labor.

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Multiple Marker Screen

A blood test that screens for fetal anomalies. This test can determine the risk of chromosomal abnormalities like Down Syndrome or Spina Bifida.

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Glucose Challenge Test

A blood test that screens for gestational diabetes (GDM, occurs only during pregnancy). This test is done at two different times.

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Signs of Hyperglycemia

An increase in thirst, urination, and hunger.

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Nausea

A common symptom of pregnancy that typically occurs in the first trimester due to hormonal changes.

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Leopold Maneuvers

A systematic palpation of the gravid uterus to determine fetal position, presentation, and engagement

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Cephalic Presentation

The baby's head is positioned down towards the birth canal, the optimal fetal presentation for vaginal delivery

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Longitudinal Fetal Lie

The fetal spine is parallel to the mother's spine

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Transverse Fetal Lie

The fetal spine is perpendicular to the mother's spine - Cannot deliver vaginally, requires C-section

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Fetal Attitude

The baby's fetal posture, including flexion and extension of body parts

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Fetal Position

The presenting fetal part in relation to the mother's pelvis, important for understanding the baby's position and how it's moving through the birth canal

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Fetal Station

The measurement of fetal descent in relation to the maternal ischial spines, used to track the baby's progress during labor

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Primary Powers

Involuntary contractions of the uterus that cause cervical effacement and dilation

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Secondary Powers

Voluntary pushing efforts made by the mother during labor

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Bishop Score

A score for labor that measures cervical dilation, effacement, station, cervical consistency, and position - A score of 8 or higher typically indicates successful induction of labor.

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Cervical Ripening

A method used to ripen the cervix by promoting softening and dilation, increases the chances of successful induction

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Augmentation of Labor

Interventions to stimulate hypotonic contractions once labor has started but is progressing slowly

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Amniotomy

The artificial rupture of the amniotic sac (water breaking) which can be used to induce labor or speed up a slow labor

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Amnioinfusion

The infusion of saline into the amniotic sac to increase amniotic fluid volume, often used to manage oligohydramnios (low amniotic fluid) or cord compression

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Prolapsed Umbilical Cord

A complication of labor where the umbilical cord is compressed, causing fetal distress

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Chorioamnionitis

A type of infection of the amniotic sac and surrounding membranes, often associated with preterm premature rupture of membranes (PPROM). It can lead to serious complications for both the mother and baby.

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Preterm Premature Rupture of Membranes (PPROM)

A condition where the amniotic sac breaks before the onset of labor before 37 weeks of pregnancy. It increases the risk of infection and can lead to complications like premature birth or fetal distress.

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Premature Rupture of Membranes (PROM)

A condition where the amniotic sac breaks before the onset of labor after 37 weeks of pregnancy. It typically doesn't pose the same risks as PPROM.

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Tocolytics

A type of medication used to stop labor contractions in women who are at risk of delivering prematurely. It can help to buy some critical time for the baby's lungs to mature.

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Effleurage

Pain management technique where light, circular strokes are applied to the abdomen in rhythm with breathing during contractions. It can help reduce pain and anxiety.

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Sacral Counterpressure

A pain management technique where pressure is applied to the sacral area of the back during contractions. It can provide relief from low back pain.

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Preterm Labor

A condition where labor initiates before 37 weeks of pregnancy. It can be caused by various factors like infections, prior preterm births, and smoking.

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Antihypertensive Medications

A set of medications that can help control blood pressure in pregnant women with preeclampsia or eclampsia. They often include magnesium sulfate, nifedipine, and hydralazine.

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Preeclampsia

A condition that affects pregnant women, usually in the third trimester. It can be characterized by high blood pressure, protein in the urine, and swelling in the extremities.

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Eclampsia

A severe complication of preeclampsia that can cause seizures in pregnant women. It can be life-threatening for both the mother and baby.

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Study Notes

Antepartum & Intrapartum Nursing Care (100 points)

  • Dosage Calculation: assessed with 3 items
  • Gynecologic Exam: assessed with 1 item
  • Contraception: assessed with 2 items
  • Pregnancy & Antepartum Nursing Care: assessed with 7 items
  • Nutrition for Childbearing: assessed with 4 items
  • Infections During Pregnancy: assessed with 2 items
  • Fetal Assessment: assessed with 2 items
  • Hemorrhagic Conditions: assessed with 4 items
  • Preterm Labor & PROM/PPROM: assessed with 6 items
  • Process of Birth/ Factors Affecting Labor: assessed with 7 items
  • Pain Management During Childbirth: assessed with 3 items
  • Intrapartum Fetal Surveillance: assessed with 4 items
  • Nursing Care During Labor: assessed with 4 items
  • Labor Complications: assessed with 1 item

Medications

  • Rhogam: Blood product, 2 RN CHECK
    • Injection given after baby is born
    • Mother receives another dose
  • Methotrexate: Suppresses contractions, but may cause hypotension
    • Give education about hypotension; do not give with magnesium sulfate
  • Magnesium Sulfate: Must have no contraindications
    • Calcium gluconate is the antidote
    • Active vaginal Bleeding
    • Dilation of cervix >6 cm
    • Greater than 34 weeks
    • Acute fetal distress
    • Chorioamnionitis
  • Nifedipine: Suppresses contractions, but may cause hypotension.
    • Give education about hypotension; do not give with magnesium sulfate

Gyne Exam

  • Contraception: assessed with 2 items
  • Pregnancy and Antepartum:
    • 1st trimester (week 1-13): no obvious changes, pregnancy more noticeable later
    • 2nd trimester (week 14-27): rapid physical changes in abdomen and breasts, possible discomfort in mobility, skin, balance, back or legs
    • 3rd trimester (week 28-42): fetal tissue growth, increase in vital signs (HR, RR) and slight decrease in BP

Other notable topics from the document include:

  • Assessment, Analysis, Planning, Intervention, Evaluation: Nursing process steps to critical thinking/clinical judgement. Multiple systems assessed.
  • Management of Care: Multifaceted, broad aspect of care management.
  • Safety and Infection Control: A key element of care management
  • Health Promotion and Maintenance: Essential in any aspect of care
  • Psychosocial Integrity: Assessing emotional well-being within childbirth
  • Basic Care and Comfort: Fundamental in patient care.
  • Pharmacological: assessment and therapy.
  • Reduction of Risk Potential: Assessment and mitigation of risks to maternal and fetal well-being.
  • Physiological Adaptation: Assessing and supporting ongoing physical changes.
  • Risk factors, complications, and expected findings: relevant to specific conditions during pregnancy

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Description

This quiz assesses your knowledge in antepartum and intrapartum nursing care. It covers various topics including dosage calculations, gynecologic exams, fetal assessments, and pain management during childbirth. Prepare to test your understanding of the essential nursing practices necessary for effective maternal care.

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