Obstetrics and Maternal Health Quiz
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Questions and Answers

A nurse is a provider office amniocenteses to determine the sex of the fetus

  • To assess fetal heart rate
  • To evaluate the mother's overall health
  • To determine the sex of the fetus
  • This procedure determines if your baby has genetic or congenital disorders (correct)

    • Which food source is most appropriate for a vegan client looking to increase vitamin B intake during pregnancy?

  • Charred beef
  • Eggs
  • Cheddar cheese
  • Fortified soy milk (correct)

    • What complication should a nurse be alert for following the forceps-assisted delivery of a newborn?

  • Caput Succedaneum
  • Facial Palsy (correct)
  • Brachial Plexus Injury
  • Cleft Lip

    • What statement by a parent indicates proper understanding of car seat safety for a newborn delivered at 38 weeks of gestation?

    <p>My baby will need a car seat challenge test before discharge.</p> Signup and view all the answers

    What key finding should a nurse expect when assessing a newborn with neonatal abstinence syndrome?

    <p>Excessive crying</p> Signup and view all the answers

    What should a nurse do before applying eyepatches for phototherapy in a newborn with jaundice?

    <p>Close the newborn’s eyes</p> Signup and view all the answers

    Which instruction is important for a postpartum client who wishes to continue using her diaphragm for contraception?

    <p>You should have your provider refit you for a new diaphragm.</p> Signup and view all the answers

    What question should a nurse ask a vegan client at 6 weeks of gestation to assess dietary intake?

    <p>How much protein do you eat in a day?</p> Signup and view all the answers

    What does leukocytosis indicate in a client?

    <p>Worsening condition</p> Signup and view all the answers

    What does decreased extremity edema suggest about a client's condition?

    <p>Indication of improving condition</p> Signup and view all the answers

    Which finding requires immediate follow-up in the postpartum client?

    <p>Lateral deviation of the uterus</p> Signup and view all the answers

    What is the significance of a blood pressure reading of 80/50 mm Hg in a client experiencing postpartum hemorrhage?

    <p>Indication of potential worsening condition</p> Signup and view all the answers

    How should a nurse interpret the presence of cloudy urine in a postpartum client?

    <p>Indication of potential worsening condition</p> Signup and view all the answers

    What does the presence of large amounts of lochia rubra signify in a postpartum assessment?

    <p>Indication of worsening condition</p> Signup and view all the answers

    What does the presence of proteinuria 2+ indicate in a pregnant client?

    <p>Sign of potential worsening condition</p> Signup and view all the answers

    What might be indicated by a continuous high-pitched cry in a newborn?

    <p>Indication of worsening condition</p> Signup and view all the answers

    How should a nurse interpret a respiratory rate of 70/min in a newborn?

    <p>Sign of potential worsening condition</p> Signup and view all the answers

    What does excessive sucking in a newborn potentially indicate?

    <p>Sign of potential improvement</p> Signup and view all the answers

    When caring for a client immediately following the delivery of a stillborn fetus, which action should the nurse take?

    <p>Provide the client with photos of the fetus</p> Signup and view all the answers

    What type of isolation precautions should be initiated for a client at 36 weeks of gestation with methicillin-resistant Staphylococcus aureus?

    <p>Contact precautions</p> Signup and view all the answers

    Which food item should the nurse recommend to a client on a vegan diet to increase their vitamin B intake?

    <p>Fortified soy milk</p> Signup and view all the answers

    To evaluate the effectiveness of the hands-and-knees position in active labor for a fetus in the occipitoposterior position, what should the nurse ask?

    <p>Has your back labor improved?</p> Signup and view all the answers

    Which food selection has the highest fiber content per cup for a client reporting constipation?

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

    What instruction should be included in discharge instructions for a client breastfeeding her newborn?

    <p>Allow the baby to feed at least every 3 hours</p> Signup and view all the answers

    Before administering a dinoprostone insert for labor induction, what action should the nurse take?

    <p>Verify that informed consent is obtained</p> Signup and view all the answers

    Which finding should a nurse expect when assessing a client with endometritis 6 hours postpartum?

    <p>Uterine tenderness</p> Signup and view all the answers

    What complication should a nurse monitor for in a client who is 80% effaced and 8 cm dilated?

    <p>Postpartum hemorrhage</p> Signup and view all the answers

    What should a nurse assess first for a client reporting significant vaginal bleeding 1 hour postpartum?

    <p>Fundal height</p> Signup and view all the answers

    Which clinical manifestation should a nurse identify as a potential complication after forceps-assisted delivery?

    <p>Facial palsy</p> Signup and view all the answers

    In evaluating medication adherence for a pregnant client taking digoxin, what is the best action for the nurse?

    <p>Ask the client if they are taking the medication as prescribed</p> Signup and view all the answers

    What indicates a contraindication for a contraction stress test in a pregnant client?

    <p>Previous classical incision</p> Signup and view all the answers

    Which of the following findings should the nurse identify as an adverse effect of medication?

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

    What is the most appropriate action for a nurse caring for a client who is 1 hour postpartum with peripartum cardiomyopathy?

    <p>Assess blood pressure twice daily</p> Signup and view all the answers

    Which laboratory finding warrants immediate reporting to the healthcare provider for a client at 20 weeks of gestation?

    <p>Fasting blood glucose 180 mg/dL</p> Signup and view all the answers

    In assessing a client at 30 weeks of gestation, what finding should the nurse identify as a symptom of pyelonephritis?

    <p>Flank pain</p> Signup and view all the answers

    What is the nursing priority after observing fetal bradycardia and a protruding umbilical cord?

    <p>Cover the umbilical cord with a sterile saline-saturated towel</p> Signup and view all the answers

    What action should the nurse take when caring for a newborn with a leaking myelomeningocele?

    <p>Cleanse the site with povidone-iodine</p> Signup and view all the answers

    Which oxygen saturation level indicates a decline in a newborn's status within the first 2 hours post-birth?

    <p>89%</p> Signup and view all the answers

    During discharge teaching for a newborn circumcision, what information should be included to ensure parental understanding?

    <p>Notify the provider if the end of the penis appears dark red</p> Signup and view all the answers

    What is the appropriate site for administering the hepatitis B vaccine in a newborn?

    <p>Vastus lateralis muscle</p> Signup and view all the answers

    What should the nurse do first when a client reports sore nipples while breastfeeding?

    <p>Assess the newborn's latch while breastfeeding</p> Signup and view all the answers

    After tubal ligation, which statement indicates the client's understanding of post-operative changes?

    <p>Ovulation will remain the same</p> Signup and view all the answers

    For home safety teaching, what should the nurse instruct a postpartum client regarding infant care?

    <p>Wash your baby's face with plain water</p> Signup and view all the answers

    What finding should a nurse report after assessing a client who is 3 days postpartum?

    <p>Cool clammy skin</p> Signup and view all the answers

    What is the correct nursing action when assisting a client with shoulder dystocia during labor?

    <p>Assist the client in pulling their knees toward their abdomen</p> Signup and view all the answers

    What does leukocytosis indicate regarding a client's condition?

    <p>Worsening condition</p> Signup and view all the answers

    How should a nurse interpret a finding of scant lochia rubra?

    <p>Condition is improving</p> Signup and view all the answers

    What should a nurse conclude if a client presents with a positive clonus?

    <p>Sign of potential worsening condition</p> Signup and view all the answers

    When considering the findings from a postpartum assessment, which of these requires immediate follow-up?

    <p>Lateral deviation of the uterus</p> Signup and view all the answers

    What does a finding of cloudy urine suggest in a postpartum client?

    <p>Potential worsening condition</p> Signup and view all the answers

    How should the nurse interpret increased warmth in an extremity?

    <p>Indication of worsening condition</p> Signup and view all the answers

    What is the significance of a finding of large amounts of lochia rubra?

    <p>Sign of potential worsening condition</p> Signup and view all the answers

    What does decreased extremity edema indicate?

    <p>Indication of improvement</p> Signup and view all the answers

    How should the nurse interpret a continuous high-pitched cry in a newborn?

    <p>Potential sign of worsening condition</p> Signup and view all the answers

    What do moderate lochia rubra and a blood pressure of 80/50 mm Hg in a postpartum client suggest?

    <p>Indications of worsening condition</p> Signup and view all the answers

    What should the nurse instruct a client who wishes to continue using her diaphragm for contraception within two days postpartum?

    <p>You should have your provider refit you for a new diaphragm.</p> Signup and view all the answers

    Which clinical manifestation should the nurse identify when assessing a newborn delivered using forceps?

    <p>Facial Palsy</p> Signup and view all the answers

    When preparing to administer phototherapy for a newborn with jaundice, which action should the nurse take first?

    <p>Apply eyepatches after closing the newborn's eyes.</p> Signup and view all the answers

    Which statement by a parent indicates an understanding of car seat safety for a newborn who was delivered at 38 weeks of gestation?

    <p>My baby will need a car seat challenge test before discharge.</p> Signup and view all the answers

    Which adverse effect should the nurse inform a client experiencing infertility about when discussing clomiphene citrate?

    <p>Breast tenderness</p> Signup and view all the answers

    What question can the nurse ask a vegan client at 6 weeks of gestation to assess her dietary intake?

    <p>How much protein do you eat in a day?</p> Signup and view all the answers

    What should the nurse communicate to a client about the purpose of amniocentesis at 12 weeks of gestation?

    <p>This procedure assesses for genetic or congenital disorders.</p> Signup and view all the answers

    What should the nurse expect to find when assessing a newborn who has neonatal abstinence syndrome?

    <p>Excessive crying</p> Signup and view all the answers

    Which finding should the nurse identify as a potential adverse effect of a medication?

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

    What is the most appropriate initial nursing action for a client exhibiting vaginal bleeding and uterine atony 1 hour postpartum?

    <p>Anticipate a prescription for misoprostol.</p> Signup and view all the answers

    Which laboratory finding during pregnancy warrants immediate reporting to the healthcare provider?

    <p>Fasting blood glucose 180 mg/dL</p> Signup and view all the answers

    When caring for a newborn with myelomeningocele, what is the priority nursing intervention?

    <p>Cover the defect with a sterile saline-soaked dressing.</p> Signup and view all the answers

    What indicates a significant decline in a newborn's respiratory status?

    <p>Oxygen saturation of 89%</p> Signup and view all the answers

    What instruction regarding newborn care should a nurse include in discharge teaching to new parents?

    <p>Use plain water to wash your baby's face.</p> Signup and view all the answers

    After performing Leopold maneuvers, what is the critical step the nurse must take?

    <p>Reassess fetal heart tones.</p> Signup and view all the answers

    What action should a nurse take when caring for a client who has excessive vaginal bleeding 1 hour postpartum?

    <p>Massage the client's fundus.</p> Signup and view all the answers

    Which assessment finding should prompt further evaluation in a client presenting 3 days postpartum?

    <p>Cool clammy skin</p> Signup and view all the answers

    Which dietary recommendation should a nurse provide for a client who is vegan and needs to increase vitamin B intake?

    <p>Fortified soy milk</p> Signup and view all the answers

    What symptom should a nurse recognize as a manifestation of pyelonephritis in a 30-week pregnant client?

    <p>Flank pain</p> Signup and view all the answers

    When assessing a client 6 hours postpartum with endometritis, which finding should the nurse expect?

    <p>Uterine tenderness</p> Signup and view all the answers

    What action should a nurse take for a client presenting with hypotension following epidural anesthesia?

    <p>Turn the client to a side-lying position.</p> Signup and view all the answers

    What does the nurse need to include in teaching parents about the Plastibell circumcision technique?

    <p>Contact the provider if the penis appears dark red.</p> Signup and view all the answers

    What is the best action for a nurse after discontinuing oxytocin in a client experiencing late decelerations in FHR?

    <p>Provide oxygen at 10 L/min via nonrebreather facemask.</p> Signup and view all the answers

    For a client who is experiencing shoulder dystocia, which maneuver should the nurse assist with?

    <p>Assist in pulling knees toward abdomen.</p> Signup and view all the answers

    Which intervention should a nurse implement for a client at 36 weeks of gestation diagnosed with methicillin-resistant Staphylococcus aureus?

    <p>Contact precautions.</p> Signup and view all the answers

    What is the recommended action for a client who is in labor and experiences fetal bradycardia with a protruding umbilical cord?

    <p>Cover the umbilical cord with sterile saline.</p> Signup and view all the answers

    What should a nurse assess first for a client who is 8 weeks of gestation and reports severe vomiting?

    <p>Assess hydration status.</p> Signup and view all the answers

    During discharge instructions for a breastfeeding client, what should the nurse emphasize?

    <p>Feed the baby at least every 3 hours.</p> Signup and view all the answers

    Which uterine condition increases the risk of postpartum hemorrhage?

    <p>History of uterine atony.</p> Signup and view all the answers

    For a client who has bladder distention following vaginal birth, what is the priority nursing action?

    <p>Assist the client to the bathroom.</p> Signup and view all the answers

    Which finding should a nurse recognize as contraindicating a contraction stress test?

    <p>Previous classical incision.</p> Signup and view all the answers

    What does the presence of malodorous discharge in a client with trichomoniasis indicate?

    <p>Potential complication requiring treatment.</p> Signup and view all the answers

    When reviewing a medical record for a client 2 days postpartum with constipation, which finding contraindicates the use of a suppository?

    <p>Third-degree perineal laceration.</p> Signup and view all the answers

    Which should a nurse do first for a newborn following a forceps-assisted birth?

    <p>Assess for facial symmetry.</p> Signup and view all the answers

    Study Notes

    Amniocentesis

    • 20-year-old client at 12 weeks of gestation
    • Amniocentesis can indicate genetic or congenital disorders, not just sex determination

    Vegan Diet During Pregnancy

    • Vegan client needs to supplement vitamin B
    • Fortified soy milk is a good source of vitamin B

    Forceps-Assisted Birth

    • Birth method can lead to facial palsy

    Car Seat Safety

    • Newborn at 38 weeks of gestation needs a car seat challenge test before discharge

    Neonatal Abstinence Syndrome (NAS)

    • Excessive crying is a common finding in newborns with NAS

    Phototherapy

    • For newborns with jaundice, close their eyes before applying eye patches

    Diaphragm Contraception Postpartum

    • New diaphragm fitting is required after giving birth

    Clomiphene Citrate for Infertility

    • Potential adverse effect is breast tenderness.

    Assessing a Vegan Diet During Pregnancy

    • Assess protein intake to ensure adequate nutrition during pregnancy

    Stillbirth Care

    • After stillbirth, instruct the client that an autopsy should be performed within 24 hours.
    • Provide the client with photos of the fetus.

    Isolation Precautions for MRSA in Pregnancy

    • Client at 36 weeks of gestation with MRSA requires contact isolation precautions.

    Constipation in Antepartum Client

    • Lentils are a high-fiber food to recommend for constipation

    Postpartum Breastfeeding

    • Allow the baby to feed at least every 3 hours.

    Dinoprostone Insert to Induce Labor

    • Ensure informed consent is obtained before administering dinoprostone

    Nonpharmacological Fertility Treatment

    • Maintaining a healthy weight is a nonpharmacological fertility treatment

    Assessing Labor Contractions

    • 80% effaced and 8 cm dilated can be a risk factor for postpartum hemorrhage.

    Full-Term Newborn Assessment

    • Subconjunctival hemorrhage in a full-term newborn should be reported to the provider

    Late Decelerations in FHR with Oxytocin Infusion

    • Discontinue oxytocin infusion and administer oxygen at 10 L/min via nonrebreather facemask

    Maternal Cytomegalovirus Info

    • Transmission can occur via saliva and urine of the newborn.

    Postpartum Hemorrhage

    • Massage the client's fundus to help control bleeding.

    Endometritis

    • Uterine tenderness is an expected symptom of endometritis

    Contraindication for Contraction Stress Test

    • A client who has had a previous classical incision has a contraindication for a contraction stress test

    Constipation and Third-Degree Perineal Laceration

    • Contraindication for using a suppository.

    Assessing Clients in Prenatal Clinic

    • Client at 8 weeks gestation reporting severe vomiting should be assessed first.

    Digoxin During Pregnancy

    • Ask the client if they are taking the medication as prescribed to assess medication adherence

    Nägele's Rule

    • Estimated date of delivery for a last menstrual period of August 10th is May 17th.

    Bladder Distention Postpartum

    • Assist the client to the bathroom to address bladder distention

    Delaying Antibiotic Ophthalmic Ointment in Newborn

    • Delay instillation to allow manifestations of infection to be identified.

    Cesarean Birth and Vaginal Bleeding

    • Evaluate urinary output when a client has steady vaginal bleeding after cesarean birth.

    Risk Factors for Postpartum Hemorrhage

    • Risk factors include vacuum-assisted delivery, history of uterine atony, and labor induction with oxytocin.

    Trichomoniasis in Pregnancy

    • Malodorous discharge is a common symptom of trichomoniasis

    Epidural Anesthesia and Opioid Analgesics

    • Hypotension is a potential adverse effect of opioid analgesics used for epidural anesthesia.

    Peripartum Cardiomyopathy

    • Assess blood pressure twice daily for a client with peripartum cardiomyopathy

    Laboratory Findings in Pregnancy – Fasting Blood Glucose

    • Report a fasting blood glucose of 180 mg/dL to the provider

    Pyelonephritis Symptoms

    • Flank pain is a manifestation of pyelonephritis

    Prolapsed Umbilical Cord

    • Cover the protruding umbilical cord with a sterile saline-saturated towel after calling for assistance and notifying the provider.

    Myelomeningocele Care

    • Cleanse the site with povidone-iodine for a newborn with a leaking myelomeningocele.

    Newborn Assessment with Respiratory Distress

    • Oxygen saturation of 89% indicates a decline in the newborn's status with respiratory distress

    Plastibell Circumcision

    • Notify the provider if the end of the baby's penis appears dark red after a Plastibell circumcision.

    Hepatitis B Vaccine for Newborns

    • Administer into the vastus lateralis muscle

    Breastfeeding Sore Nipples

    • Assess the newborn's latch while breastfeeding for sore nipples

    Tubal Ligation Understanding

    • Ovulation remains the same after tubal ligation

    Home Safety for Newborns

    • Wash the baby's face with plain water for home safety.

    Postpartum Assessment – Cool, Clammy Skin

    • Cool, clammy skin 3 days postpartum should be reported to the provider.

    McRoberts Maneuver

    • Assist the client in pulling their knees toward their abdomen for the McRoberts maneuver.

    Hypotension After Epidural Anesthesia

    • Turn the client to a side-lying position.

    Fourth-Degree Perineal Laceration Postpartum Care

    • Provide the client with a cool sitz bath.

    Uterine Atony and Postpartum Hemorrhage

    • Anticipate a prescription for misoprostol to address uterine atony and heavy bleeding.

    Neonatal Abstinence Syndrome (NAS) Treatment

    • Maintaining a low-stimulation environment
    • Instructing the parent to avoid breastfeeding
    • Performing Ballard newborn screening each shift
    • Weighing the newborn daily
    • Swaddling the newborn with flexed extremities

    Leopold’s Maneuvers

    • Instruct the client to empty their bladder.
    • Position the client supine with knees flexed and place a small rolled towel under one hip.
    • Palpate the fetal part in the fundus
    • Palpate the fetal parts along both sides of the uterus
    • Palpate the fetal part positioned above the symphysis pubis

    Interpreting Findings for Postpartum Deep Vein Thrombosis

    • Leukocytosis, redness in the extremity, increased warmth in the extremity, and tachycardia indicate a worsening condition
    • Scant lochia rubra and decreased extremity edema indicate improvement.

    Interpreting Findings for Preeclampsia

    • A platelet count of 90,000/mm3, hematuria, positive clonus, proteinuria 2+, and increased BUN indicate potential worsening of preeclampsia.
    • Leukorrhea is a sign of potential improvement

    Postpartum Client at Risk for Hemorrhage (8 Hours Postpartum)

    • Lateral deviation of the uterus
    • Large amount of lochia rubra
    • Uterine tone

    Interpreting Findings for Postpartum Hemorrhage

    • Blood pressure of 80/50 mm Hg, cloudy urine, and moderate lochia rubra indicate potential worsening of condition.
    • Fundus firm to palpation and fundus at the level of the umbilicus indicate that condition is potentially worsening.

    Interpreting Findings for NAS in Term Newborn (48 Hours Old)

    • Regurgitation, mottling, continuous high-pitched cry, respiratory rate of 70/min, and loose stools indicate potential worsening of condition.
    • Transient strabismus indicates potential improvement.

    Amniocentesis During Pregnancy

    • Amniocentesis is a procedure that involves obtaining amniotic fluid for testing.
    • It is typically performed to detect genetic or congenital disorders in the fetus.
    • It's not used to determine fetal sex.

    Vegan Diet and Vitamin B12 Intake

    • A vegan diet lacks vitamin B12 naturally found in animal products.
    • Fortified soy milk is a recommended food source to increase vitamin B12 intake for vegans.

    Forceps-Assisted Birth Complications

    • Facial palsy is a potential complication of forceps-assisted birth.
    • The nurse should assess the newborn for facial symmetry and movement.

    Car Seat Safety for Premature Infants

    • Premature infants require a car seat challenge test before discharge to ensure they can tolerate the position and safety of a car seat.
    • The nurse should teach parents about this required test.

    Neonatal Abstinence Syndrome (NAS)

    • NAS occurs when infants born to mothers who use opioids during pregnancy experience withdrawal symptoms.
    • Excessive crying is a common manifestation of NAS and should be reported to the provider.

    Phototherapy for Jaundice

    • Phototherapy uses light to break down bilirubin in the blood.
    • The nurse should close the infant's eyes before applying eyepatches to reduce the chance of light exposure.

    Diaphragm Contraception Postpartum

    • Diaphragms require refitting after pregnancy and before resuming use.
    • The nurse should advise the client to consult their healthcare provider for refitting.

    Clomiphene Citrate for Infertility

    • Clomiphene citrate is a medication used to induce ovulation in women with infertility.
    • Breast tenderness is a known adverse effect of clomiphene citrate.

    Vegan Diet During Pregnancy

    • Ensure protein intake is adequate during pregnancy.
    • Ask the client about their daily protein consumption to assess nutritional adequacy.

    Stillborn Delivery Care

    • If an autopsy is performed, it helps determine the cause of death and provide answers to the family.
    • Providing the client with photos of the fetus can help them process the loss and remember their baby.
    • Offer support and comfort to the grieving family.

    Methicillin-Resistant Staphylococcus Aureus (MRSA) in Pregnancy

    • Contact precautions are essential for pregnant clients with MRSA to prevent transmission.
    • The nurse should protect themselves and others by using appropriate personal protective equipment (PPE).

    Constipation During Pregnancy

    • Lentils are a good source of fiber and can alleviate constipation.
    • Encourage clients to consume high-fiber foods and fluids throughout pregnancy.

    Breastfeeding Frequency

    • Allow the baby to feed at least every 3 hours.
    • Encourage breastfeeding on demand whenever the infant displays signs of hunger.

    Dinoprostone Insert for Labor Induction

    • Always obtain informed consent from the client before administering any medication or procedure.
    • The nurse should ensure the client understands the risks and benefits of dinoprostone insertion.

    Fertility Treatment Options

    • Maintaining a healthy weight is crucial for fertility in both partners.
    • Encourage couples to discuss their weight and other lifestyle factors with a healthcare provider.

    Labor Initiation and Postpartum Hemorrhage Risk

    • A client at 80% effaced and 8 cm dilated is in advanced labor and at an increased risk for postpartum hemorrhage.
    • The nurse should monitor the client closely and be prepared for potential interventions.

    Newborn Assessment Following Full-Term Birth

    • Subconjunctival hemorrhage (bleeding in the white of the eye) is a benign finding in newborns, but it should be reported to the provider.
    • The nurse should document the finding and notify the provider for further evaluation.

    Late Decelerations in Fetal Heart Rate (FHR)

    • Late decelerations can indicate fetal distress.
    • Discontinue the oxytocin infusion, administer oxygen, and notify the provider.
    • Monitor the FHR closely and prepare for potential interventions.

    Maternal Cytomegalovirus (CMV)

    • CMV can be transmitted via saliva and urine of the newborn.
    • Educate nurses about the importance of handwashing and proper hygiene measures to prevent transmission.

    Postpartum Hemorrhage Assessment and Intervention

    • Massage the client's fundus to promote uterine contraction and reduce bleeding. If the bleeding persists, prompt intervention is necessary.
    • Notify the provider immediately and anticipate interventions such as IV fluids, uterotonics, and potentially surgical management.

    Endometritis - Postpartum Infection

    • Endometritis is an infection of the uterine lining.
    • Uterine tenderness is a classic symptom of endometritis and should be reported to the provider.

    Contraindication for Contraction Stress Test (CST)

    • A previous classical incision (C-section) is a contraindication for CST as it increases the risk of uterine rupture.
    • The nurse should perform a thorough assessment of the client's history and discuss alternative methods for fetal monitoring.

    Third-Degree Perineal Laceration and Suppositories

    • A third-degree perineal laceration involves damage to the anal sphincter, making it difficult to administer rectal suppositories.
    • The nurse should consult with the primary care provider about appropriate pain management options.

    Severe Vomiting in Early Pregnancy

    • Severe vomiting, especially during the first trimester, can indicate hyperemesis gravidarum. This requires urgent attention.
    • The nurse should assess the client's hydration status, weight, and electrolyte levels.

    Digoxin Management in Pregnancy

    • Ensure the client is taking the medication as prescribed.
    • Monitor the client's heart rate and potassium levels, as digoxin can affect both.

    Nägele's Rule for Estimating Due Date

    • To calculate the estimated due date, add 7 days to the first day of the last menstrual period (LMP) and subtract 3 months.
    • For a LMP of August 10th the due date is May 17th.

    Bladder Distention Postpartum

    • Assist the client to the bathroom as soon as possible to encourage bladder emptying.
    • Ensure adequate hydration.

    Delaying Antibiotic Ophthalmic Ointment

    • An antibiotic eye ointment is routinely given after birth to prevent eye infections.
    • Delaying the ointment allows the healthcare provider to assess the newborn's eyes for potential infections.

    Post Cesarean Vaginal Bleeding

    • Evaluate urinary output to rule out a full bladder, which can contribute to bleeding.
    • Monitor vital signs and notify the provider if bleeding persists.

    Postpartum Hemorrhage Risk Factors

    • Vacuum-assisted delivery, uterine atony, and labor induction with oxytocin all increase the risk of postpartum hemorrhage.
    • The nurse should monitor clients who have these factors closely.

    Trichomoniasis During Pregnancy

    • Trichomoniasis is a vaginal infection that can lead to a malodorous discharge.
    • The nurse should assess for symptoms, advise the client about treatment, and encourage partner notification.

    Epidural Anesthesia Adverse Effect

    • Hypotension is a potential adverse effect of epidural anesthesia that can occur due to vasodilation.
    • The nurse should monitor BP closely, administer fluids, and notify the provider if the client's BP is low.

    Peripartum Cardiomyopathy

    • Peripartum cardiomyopathy is a cardiac condition that can occur during pregnancy or up to 5 months postpartum.
    • Assess BP twice daily and monitor the client for signs of heart failure.

    Gestational Diabetes Assessment

    • A fasting blood glucose of 180 mg/dL is significantly higher than the normal range.
    • This finding warrants immediate reporting to the provider and further investigation.

    Pyelonephritis During Pregnancy

    • Flank pain is a common symptom of pyelonephritis.
    • The nurse should conduct a thorough assessment, including vital signs, pain level, and urinary symptoms.

    Protruding Umbilical Cord After Rupture of Membranes

    • A protruding umbilical cord is a medical emergency, as it can compromise fetal blood flow.
    • The nurse should immediately call for assistance, notify the provider, and cover the cord with a sterile saline-saturated towel to avoid drying.

    Myelomeningocele Care Immediately After Birth

    • Cleanse the site with povidone-iodine to prevent infection.
    • Ensure proper padding and positioning to prevent further injury or irritation to the site.

    Newborn Status Decline

    • Oxygen saturation of 89% is below the normal range for a newborn.
    • This finding indicates respiratory distress and warrants immediate attention. The nurse should notify the provider and monitor vital signs closely.

    PlastiBell Circumcision Technique

    • The nurse should educate parents about the potential complication of a dark red color at the end of the penis and advise them to contact the provider if this occurs.
    • The nurse should also instruct the parents on how to care for the circumcision site properly.

    Hepatitis B Vaccine Administration

    • Inject the hepatitis B vaccine into the vastus lateralis muscle, which is in the thigh, of the right thigh to avoid the sciatic nerve.

    Sore Nipples During Breastfeeding

    • Assessment of the newborn's latch is crucial because an improper latch can cause pain and discomfort for the mother.
    • Correct latch techniques should be taught to the client.

    Tubal Ligation

    • Although it is a permanent method of contraception, tubal ligation doesn't prevent ovulation.
    • Ovulation continues, but fertilized eggs can't reach the uterus.

    Home Safety for Newborns

    • Wash the newborn's face with plain water. Avoid soaps or lotions, as they can irritate the newborn's delicate skin.

    Postpartum Assessment - Report to Provider

    • Cool clammy skin is a sign of potential hypothermia and dehydration.
    • The nurse should report this finding to the provider for prompt management.

    McRoberts Maneuver for Shoulder Dystocia

    • Instruct the client to pull their knees toward their abdomen. This helps to rotate the pelvic inlet, allowing the anterior shoulder to deliver.

    Hypotension After Epidural Anesthesia

    • Turn the client to a side-lying position to improve venous return and increase blood pressure.
    • Monitor vital signs closely and notify the provider.

    Fourth-Degree Perineal Laceration

    • Providing a cool sitz bath can help to reduce pain and promote healing.
    • The nurse should also teach the client about proper perineal care and hygiene.

    Uterine Atony and Postpartum Hemorrhage

    • Anticipate a prescription for misoprostol, a uterotonic medication that helps contract the uterus.
    • Monitor the client closely for signs of continued bleeding and prepare for intervention.

    Neonatal Abstinence Syndrome (NAS) Care

    • Maintain a low-stimulation environment to minimize stress on the infant.
    • Instruct the parent to avoid breastfeeding until the infant is stable and the provider has approved.
    • Perform Ballard newborn screening each shift to assess the infant's neurodevelopmental status.
    • Weigh the newborn daily to monitor weight gain and hydration.
    • Swaddle the newborn with flexed extremities to provide comfort and reduce anxiety.

    Leopold Maneuvers Sequence

    • Instruct the client to empty their bladder.
    • Position the client supine with knees flexed and place a small rolled towel under one of their hips.
    • Palpate the fetal part positioned in the fundus.
    • Palpate the fetal parts along both sides of the uterus.
    • Palpate the fetal part positioned above the symphysis pubis.

    Postpartum Deep Vein Thrombosis (DVT) Assessment

    • Leukocytosis, redness in the extremity, increased warmth in the extremity, tachycardia, and decreased extremity edema are signs of potential worsening DVT.
    • Scant lochia rubra is a sign of improving DVT.

    Preeclampsia Assessment

    • A platelet count of 90,000/mm3, hematuria, positive clonus, proteinuria 2+, BUN 40 mg/dL are signs of potential worsening preeclampsia.
    • Leukorrhea is a sign of potential improvement.

    Postpartum Hemmorhage

    • Lateral deviation of the uterus, a large amount of lochia rubra, and uterine tone requiring follow-up in the next 30 minutes or sooner

    Misoprostol Administration Assessment

    • Blood pressure 80/50 mm Hg, Cloudy urine, Moderate lochia rubra, and Fundus at the level of the umbilicus, are findings that require immediate attention and may indicate a worsening postpartum hemorrhage.
    • A fundus firm to palpation is a positive sign that the medication is working.

    Neonatal Abstinence Syndrome Assessment

    • Regurgitation, mottling, continuous high-pitched cry, respiratory rate 70/min, loose stools, are all possible signs of potential worsening NAS.
    • Transient strabismus is a sign of potential improvement.

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    Test your knowledge on important topics in obstetrics and maternal health, including amniocentesis, dietary considerations during pregnancy, and neonatal care. This quiz covers various aspects such as forceps-assisted birth and safety protocols for newborns. Perfect for nursing students and healthcare professionals!

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