Podcast
Questions and Answers
Which of the following are risk factors for gestational diabetes mellitus? (Select all that apply)
Which of the following are risk factors for gestational diabetes mellitus? (Select all that apply)
- Maternal age older than 25 years (correct)
- Maternal age younger than 25 years
- Previous stillbirth (correct)
- Previous birth of an infant who was large (correct)
Which risk factors should the nurse include when teaching about gestational hypertension? (Select all that apply)
Which risk factors should the nurse include when teaching about gestational hypertension? (Select all that apply)
- Maternal age younger than 40 years
- Maternal age older than 40 years (correct)
- First pregnancy (correct)
- History of high blood pressure
What medication should be administered if magnesium sulfate toxicity is suspected?
What medication should be administered if magnesium sulfate toxicity is suspected?
Calcium gluconate
Which findings should the nurse identify and report as magnesium sulfate toxicity? (Select all that apply)
Which findings should the nurse identify and report as magnesium sulfate toxicity? (Select all that apply)
A prophylactic cervical cerclage is a surgical reinforcement of the cervix with a heavy ligature (suture) placed ______ around the cervix.
A prophylactic cervical cerclage is a surgical reinforcement of the cervix with a heavy ligature (suture) placed ______ around the cervix.
What client education should the nurse include regarding prophylactic cervical cerclage? (Select all that apply)
What client education should the nurse include regarding prophylactic cervical cerclage? (Select all that apply)
Which client should the nurse see first?
Which client should the nurse see first?
What should a client do when they feel their baby move during a nonstress test?
What should a client do when they feel their baby move during a nonstress test?
Which of the following findings indicate a need for administering oxytocin?
Which of the following findings indicate a need for administering oxytocin?
What should a nurse expect when assessing a newborn born at 26 weeks of gestation?
What should a nurse expect when assessing a newborn born at 26 weeks of gestation?
Identify the signs associated with hypoglycemia in a newborn.
Identify the signs associated with hypoglycemia in a newborn.
What should a nurse report for a 70-hour-old newborn showing CNS findings?
What should a nurse report for a 70-hour-old newborn showing CNS findings?
What is the priority action for a newborn undergoing phototherapy?
What is the priority action for a newborn undergoing phototherapy?
What indicates proper management for a client with type 1 diabetes during pregnancy?
What indicates proper management for a client with type 1 diabetes during pregnancy?
What condition might a newborn with a heart rate of 174/min and respiratory rate of 88/min be experiencing?
What condition might a newborn with a heart rate of 174/min and respiratory rate of 88/min be experiencing?
Can substernal retractions in a newborn indicate respiratory distress or infection?
Can substernal retractions in a newborn indicate respiratory distress or infection?
What finding post-amniocentesis should be reported?
What finding post-amniocentesis should be reported?
What should a nurse do for a postpartum client receiving heparin?
What should a nurse do for a postpartum client receiving heparin?
Identify risk factors for hyperemesis gravidarum.
Identify risk factors for hyperemesis gravidarum.
Which conditions should a nurse monitor in a client diagnosed with gestational diabetes?
Which conditions should a nurse monitor in a client diagnosed with gestational diabetes?
Is a headache that is unrelieved by analgesia a significant manifestation to report?
Is a headache that is unrelieved by analgesia a significant manifestation to report?
What is a common complication for a newborn who is 16 hours old?
What is a common complication for a newborn who is 16 hours old?
What are considered contraindicated actions in managing vaginal bleeding in a client?
What are considered contraindicated actions in managing vaginal bleeding in a client?
What are the expected findings during the initial assessment of a newborn in the first 24 hours?
What are the expected findings during the initial assessment of a newborn in the first 24 hours?
Which of the following findings should the nurse report to the provider for a client who is pregnant?
Which of the following findings should the nurse report to the provider for a client who is pregnant?
What action should the nurse take for a client who is at 22 weeks of gestation and is HIV positive?
What action should the nurse take for a client who is at 22 weeks of gestation and is HIV positive?
What finding should a nurse expect in a client who has idiopathic thrombocytopenia purpura (ITP)?
What finding should a nurse expect in a client who has idiopathic thrombocytopenia purpura (ITP)?
What does it indicate if a client states they are 'happy one minute and crying the next' during pregnancy?
What does it indicate if a client states they are 'happy one minute and crying the next' during pregnancy?
Which of the following is an indication of withdrawal from a selective serotonin reuptake inhibitor (SSRI) in a newborn?
Which of the following is an indication of withdrawal from a selective serotonin reuptake inhibitor (SSRI) in a newborn?
What finding should the nurse report for a newborn who is 18 hours old with an axillary temperature of 37.7° C (99.9° F)?
What finding should the nurse report for a newborn who is 18 hours old with an axillary temperature of 37.7° C (99.9° F)?
What fetal heart rate (FHR) should the nurse expect at 18 weeks of gestation?
What fetal heart rate (FHR) should the nurse expect at 18 weeks of gestation?
What positive parenting behavior should the nurse recognize when observing a guardian caring for their crying newborn?
What positive parenting behavior should the nurse recognize when observing a guardian caring for their crying newborn?
What should the nurse's first action be when caring for a newborn with mild respiratory distress?
What should the nurse's first action be when caring for a newborn with mild respiratory distress?
What is a common adverse effect that should be mentioned to a client starting combined oral contraceptives?
What is a common adverse effect that should be mentioned to a client starting combined oral contraceptives?
What assessment should the nurse prioritize after an amniotomy?
What assessment should the nurse prioritize after an amniotomy?
What is the priority intervention for a client whose water just broke?
What is the priority intervention for a client whose water just broke?
What should a client be instructed about taking levonorgestrel contraception?
What should a client be instructed about taking levonorgestrel contraception?
What condition indicates the need for fetal assessment using electronic fetal monitoring at 32 weeks of gestation?
What condition indicates the need for fetal assessment using electronic fetal monitoring at 32 weeks of gestation?
What should a nurse have ready for a client on magnesium sulfate IV?
What should a nurse have ready for a client on magnesium sulfate IV?
What phase of labor is indicated by a client in labor with a cervical dilation of 9 cm?
What phase of labor is indicated by a client in labor with a cervical dilation of 9 cm?
What finding in a fundal height measurement at 26 weeks of gestation should be reported?
What finding in a fundal height measurement at 26 weeks of gestation should be reported?
What should a nurse communicate about staff identification for the security of a newborn?
What should a nurse communicate about staff identification for the security of a newborn?
What should a client at 10 weeks of gestation do regarding folic acid intake?
What should a client at 10 weeks of gestation do regarding folic acid intake?
What finding should be reported for a client with hyperemesis gravidarum receiving IV fluid replacement?
What finding should be reported for a client with hyperemesis gravidarum receiving IV fluid replacement?
Match the steps of performing Leopold maneuvers:
Match the steps of performing Leopold maneuvers:
What should clients with hyperemesis gravidarum focus on regarding their diet?
What should clients with hyperemesis gravidarum focus on regarding their diet?
What should the nurse ensure before leaving a newborn with their parent?
What should the nurse ensure before leaving a newborn with their parent?
What manifestation should the nurse report for a newborn 12 hours after birth?
What manifestation should the nurse report for a newborn 12 hours after birth?
Which findings should the nurse report for the 16-year-old adolescent? (Select all that apply)
Which findings should the nurse report for the 16-year-old adolescent? (Select all that apply)
Which conditions are consistent with trichomoniasis, gonorrhea, or candidiasis? (Select all that apply)
Which conditions are consistent with trichomoniasis, gonorrhea, or candidiasis? (Select all that apply)
What condition is the client most likely developing if there is an elevated C-reactive protein?
What condition is the client most likely developing if there is an elevated C-reactive protein?
What medications should the nurse expect the provider to prescribe for pelvic inflammatory disease?
What medications should the nurse expect the provider to prescribe for pelvic inflammatory disease?
What should the nurse prioritize when reviewing the provider's prescriptions?
What should the nurse prioritize when reviewing the provider's prescriptions?
The adolescent should go to the emergency department if their urine turns dark.
The adolescent should go to the emergency department if their urine turns dark.
Which findings indicate a contraindication to oral contraceptives? (Select all that apply)
Which findings indicate a contraindication to oral contraceptives? (Select all that apply)
What intervention should the nurse perform if the uterus is palpated to the right above the umbilicus?
What intervention should the nurse perform if the uterus is palpated to the right above the umbilicus?
Which client should the nurse prioritize who is at 34 weeks of gestation and reports epigastric pain?
Which client should the nurse prioritize who is at 34 weeks of gestation and reports epigastric pain?
What is a manifestation of hypoglycemia in late preterm newborns?
What is a manifestation of hypoglycemia in late preterm newborns?
What indicates a possible hyperemesis gravidarum in a client at 10 weeks of gestation?
What indicates a possible hyperemesis gravidarum in a client at 10 weeks of gestation?
What diagnostic test should the nurse prepare for a client at 41 weeks of gestation with a positive contraction stress test?
What diagnostic test should the nurse prepare for a client at 41 weeks of gestation with a positive contraction stress test?
What action should the nurse include in the nonstress test plan of care?
What action should the nurse include in the nonstress test plan of care?
What maneuver should the nurse perform prior to applying an external transducer for fetal monitoring?
What maneuver should the nurse perform prior to applying an external transducer for fetal monitoring?
What finding contraindicates the initiation of an oxytocin infusion?
What finding contraindicates the initiation of an oxytocin infusion?
What is the priority nursing intervention following an amniocentesis for an Rh-negative client?
What is the priority nursing intervention following an amniocentesis for an Rh-negative client?
How many azithromycin tablets should be administered for a 1 g dose?
How many azithromycin tablets should be administered for a 1 g dose?
What finding indicates that a newborn is experiencing pain following a circumcision?
What finding indicates that a newborn is experiencing pain following a circumcision?
What is the expected action a nurse should take regarding the client's blood pressure after administering epidural anesthesia?
What is the expected action a nurse should take regarding the client's blood pressure after administering epidural anesthesia?
What indicates gestational hypertension or preeclampsia during a prenatal visit?
What indicates gestational hypertension or preeclampsia during a prenatal visit?
Flashcards
Preterm labor indicators
Preterm labor indicators
Regular uterine contractions, cervical dilation, gestational age at 32 weeks.
HIV-positive pregnant client (22 weeks)
HIV-positive pregnant client (22 weeks)
Report to the health department and ensure antiretroviral treatment to reduce newborn infection risk.
ITP (Idiopathic Thrombocytopenic Purpura) postpartum
ITP (Idiopathic Thrombocytopenic Purpura) postpartum
Expect decreased platelet counts due to autoimmune responses.
Emotional lability in pregnancy
Emotional lability in pregnancy
Signup and view all the flashcards
Newborn SSRI withdrawal
Newborn SSRI withdrawal
Signup and view all the flashcards
Concerning newborn temperature
Concerning newborn temperature
Signup and view all the flashcards
18-week fetal heart rate (FHR)
18-week fetal heart rate (FHR)
Signup and view all the flashcards
Positive parenting behavior
Positive parenting behavior
Signup and view all the flashcards
Calcium gluconate administration (preeclampsia)
Calcium gluconate administration (preeclampsia)
Signup and view all the flashcards
Fetal heart rate assessment (water breaks)
Fetal heart rate assessment (water breaks)
Signup and view all the flashcards
Post-rupture of membranes
Post-rupture of membranes
Signup and view all the flashcards
Daily folic acid intake
Daily folic acid intake
Signup and view all the flashcards
Combined oral contraceptives (COCs)
Combined oral contraceptives (COCs)
Signup and view all the flashcards
Oligohydramnios monitoring
Oligohydramnios monitoring
Signup and view all the flashcards
Hyperemesis gravidarum (hydration)
Hyperemesis gravidarum (hydration)
Signup and view all the flashcards
Newborn identification
Newborn identification
Signup and view all the flashcards
Jaundice in newborns (first 24 hours)
Jaundice in newborns (first 24 hours)
Signup and view all the flashcards
Adolescent health reporting
Adolescent health reporting
Signup and view all the flashcards
Gonorrhea symptoms
Gonorrhea symptoms
Signup and view all the flashcards
Candidiasis discharge
Candidiasis discharge
Signup and view all the flashcards
Study Notes
Antepartum Care
- Report findings indicative of preterm labor such as regular uterine contractions, cervical dilation, and gestational age at 32 weeks.
- For HIV-positive clients at 22 weeks, report to local health department and ensure antiretroviral treatment to reduce infection transmission risk to the newborn.
Postpartum Assessments
- In cases of idiopathic thrombocytopenia purpura (ITP), expect decreased platelet counts indicative of autoimmune responses.
- Emotional lability in pregnant clients can manifest as rapid mood swings due to intense hormonal changes.
Newborn Assessments
- Withdrawal symptoms from SSRIs in newborns include irritability, agitation, diarrhea, and vomiting, usually lasting up to 2 days.
- An axillary temperature of 37.7°C (99.9°F) in a newborn is concerning and can indicate sepsis.
- Expected findings at 18 weeks of gestation include a fetal heart rate (FHR) around 152 bpm.
Parenting and Infant Care
- Positive parenting behavior includes gentle tactile stimulation techniques to soothe newborns.
- Before administering medications such as calcium gluconate, ensure it is readily available when managing magnesium sulfate for preeclampsia.
Labor and Delivery Care
- Assess fetal heart rate (FHR) first when a client’s water breaks to check for umbilical cord prolapse risk.
- Following a rupture of membranes, document fluid characteristics and check cervical dilation.
Nutrition and Medication in Pregnancy
- Pregnant clients should ingest 600 mcg of folic acid daily to prevent neural tube defects.
- Be aware that combined oral contraceptives can cause depression and other side effects; educate clients accordingly.
Monitoring During Pregnancy Complications
- Oligohydramnios necessitates electronic fetal monitoring for thorough assessment.
- For hyperemesis gravidarum, observe urine for ketones as an indicator of hydration status; report any decreased blood pressure.
Identity and Safety Measures for Newborns
- Always verify matching identification bands between parents and newborns before release.
- Jaundice in a newborn within the first 24 hours post-birth should prompt immediate reporting due to possible serious underlying issues.
Adolescent Health Considerations
- Report abnormal findings in adolescents such as abdominal tenderness, greenish vaginal discharge (indicating infection), and elevated temperature (potential infection or inflammation).
Differential Diagnosis in STIs
- Gonorrhea often presents with abdominal pain, while greenish discharge is characteristic of both gonorrhea and trichomoniasis.### Candidiasis and Related Conditions
- Candidiasis leads to thick, white, lumpy vaginal discharge.
- Diabetes predisposes individuals to candidiasis due to high glucose levels facilitating yeast growth.
- Dysuria, or pain on urination, can occur in candidiasis, trichomoniasis, and gonorrhea.
- Lack of condom use increases the risk for trichomoniasis and gonorrhea; candidiasis is not sexually transmitted.
Pelvic Inflammatory Disease (PID)
- PID results from untreated infections, often caused by Neisseria gonorrhoeae and Chlamydia trachomatis, affecting the pelvic reproductive organs.
- Symptoms include fever, nausea, vomiting, and increased C-reactive protein (CRP).
- A nurse suspects PID when CRP levels are elevated.
Treatment of PID
- Anticipated treatment includes ceftriaxone as a single IM dose and doxycycline for 14 days orally.
Education on Medications
- Clients must be educated about medications to understand their purpose and potential side effects.
- Ceftriaxone must be administered as a NOW prescription within 90 minutes, following patient education.
Discharge Understanding
- Patients should continue medication even if asymptomatic to prevent recurrence.
- Frequent PID can impact fertility.
- Doxycycline can increase sun sensitivity, requiring protective measures.
- Dark urine may result from metronidazole; patients shouldn't be alarmed.
- IUDs prevent pregnancy but do not protect against STIs; condoms should still be used.
Contraindications for Oral Contraceptives
- Contraindicated conditions include:
- Cholecystitis
- Hypertension
- Migraines
Postpartum Assessment
- If a uterus is palpated above the umbilicus, assist the client in emptying their bladder to prevent increased bleeding.
Priority Assessments in Antepartum Care
- A client at 34 weeks with epigastric pain may indicate preeclampsia and should be prioritized.
- Nonurgent conditions include elevated fasting blood glucose (gestational diabetes) and anemia in pregnancy.
Newborn Assessments
- Respiratory distress in late preterm newborns may indicate hypoglycemia.
- Monitor for signs like lethargy, jitteriness, and abnormal crying.
Monitoring During Pregnancy
- Frequent vomiting with weight loss may suggest hyperemesis gravidarum, requiring reporting.
- A positive contraction stress test suggests potential uteroplacental insufficiency, warranting preparation for a biophysical profile (BPP).
Nonstress Test Procedure
- Clients should press a button during fetal movements to aid in interpreting results.
- Proper positioning enhances fetal monitoring, and hydration is encouraged.
Labor and Delivery Considerations
- Monitor blood pressure closely after administering epidural anesthesia to detect hypotension.
- Indications for oxytocin postpartum include a flaccid uterus and excess vaginal bleeding.
Assessment of Newborns
- Newborns at 26 weeks of gestation may show minimal arm recoil, indicating immature muscular tone. Other maturity indicators include breast bud development and creases on the soles of the feet.### Newborn Care and Conditions
- Hypoglycemia in newborns is characterized by decreased temperature, poor feeding, respiratory distress, and lethargy.
- Hyperbilirubinemia presents with yellow sclera and oral mucosa, poor feeding, and an increased risk in newborns with ecchymotic caput succedaneum.
- Sepsis shows similar symptoms to hypoglycemia but includes yellow sclera and oral mucosa.
Newborn Assessment and Intervention
- Inconsolable newborns with high-pitched cries and increased muscle tone may indicate Neonatal Abstinence Syndrome (NAS), requiring prompt reporting.
- Newborns typically have oxygen saturation above 94%, respiratory rates of 30-60/min, and temperatures between 36.5° and 37.5° C.
- The Moro reflex is a normal defensive reaction in infants; its absence may indicate injury.
Phototherapy Protocols
- During phototherapy for hyperbilirubinemia, only the diaper should be left on the newborn to maximize skin exposure to UV light.
- Do not apply lotions or creams on newborns undergoing phototherapy as they can retain heat and cause burns.
- Hydration should be maintained through breastfeeding or formula; water and glucose water do not aid bilirubin excretion.
Diabetes Management in Pregnancy
- Clients with type 1 diabetes must continue insulin during illness to prevent severe blood sugar fluctuations.
- It's crucial to avoid foods high in refined sugars, emphasizing a low-carbohydrate and high-protein diet.
- Blood glucose control may require less insulin during the first trimester due to enhanced insulin response.
Cold Stress in Newborns
- Symptoms indicating cold stress include low temperature, elevated respiratory rate, and hypoglycemia.
- Immediate actions involve skin-to-skin contact and encouraging breastfeeding, while monitoring temperature and glucose levels is crucial for assessing recovery.
Erb's Palsy Management
- Range of motion exercises for the affected arm should begin after about one week post-injury, along with assessing for a grasp reflex to evaluate function.
- Passive ROM exercises are essential to restore movement after Erb's palsy caused by brachial plexus injury.
Antepartum Care
- For a client with vaginal bleeding in the third trimester, insert a large bore IV catheter for potential fluid resuscitation and monitor blood loss accurately by weighing perineal pads.
- Avoid assessing cervical dilation in cases of vaginal bleeding, as this could pose risks to both mother and fetus.
Complications to Report
- Unrelieved headache during pregnancy may indicate preeclampsia and should be reported.
- For potential complications after amniocentesis, report vaginal fluid leakage, as it may suggest premature membrane rupture.
Magnesium Sulfate Considerations
- Monitor clients on magnesium sulfate for signs of toxicity, including absence of patellar reflexes, decreased urine output, and respiratory depression.
- Calcium gluconate should be readily available to counteract magnesium sulfate toxicity.
Cervical Cerclage Education
- Prophylactic cervical cerclage involves surgically reinforcing the cervix to prevent premature dilation, requiring strict activity restrictions and hydration post-procedure.
- Report contractions, membrane rupture, or other signs of preterm labor or infection immediately after the procedure.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
