RN Maternal Newborn Practice 2023 B

Questions and Answers

Which of the following prescriptions regarding the newborn should the nurse anticipate? (Select all that apply)

Initiate neonatal abstinence syndrome scoring (correct)

Perform routine immunizations

Administer scheduled doses of oral morphine

Maintain a low stimulus environment (correct)

What action should the nurse take for a client who is at 35 weeks of gestation and has a placenta previa?

Initiate continuous external fetal monitoring.

What suggestion should the nurse make to aid a 7-year-old child in accepting a newly adopted newborn?

Obtain a gift from the newborn to the sibling.

What action should the nurse take for a prenatal client who has parvovirus B19?

Schedule an ultrasound exam. Signup and view all the answers

What is the immediate action the nurse should take after observing a client with epilepsy having a seizure?

Administer oxygen via a non-rebreather mask. Signup and view all the answers

What statement indicates a client's understanding of terbutaline?

I will have a blood test because my potassium might decrease. Signup and view all the answers

What instruction should be included when teaching a client about misoprostol?

I can administer oxytocin 4 hours after the insertion of the medication. Signup and view all the answers

What should the nurse assess for indications of spina bifida occulta in a newborn?

Look for a small bruise-like mark on the bottom of the baby's spine. Signup and view all the answers

What non-pharmacological intervention should the nurse include for lactation suppression after a client’s discharge 3 days postpartum?

Place cabbage leaves to the breasts. Signup and view all the answers

What manifestation requires intervention by the nurse for a 12-hour-old newborn?

Substernal chest restrictions while sleeping. Signup and view all the answers

What manifestation should the nurse expect in a client with preeclampsia?

Blurred vision. Signup and view all the answers

What response should the nurse provide regarding the effects of tubal ligation on a client's sex life?

This procedure should have no effect on your sexual performance or adequacy. Signup and view all the answers

What finding should the nurse expect in a client with gestational diabetes experiencing hyperglycemia?

Reports increased urinary output. Signup and view all the answers

Where should the nurse place the Doppler ultrasound stethoscope to begin assessing fetal heart tones?

Just above the symphysis pubis. Signup and view all the answers

What should the nurse explain to a client regarding hyperpigmentation during pregnancy?

This is an expected occurrence. Signup and view all the answers

What finding should the nurse identify as a risk factor for developing preeclampsia?

Pre-gestational diabetes mellitus. Signup and view all the answers

What statement from a postpartum client indicates an understanding of newborn safety policy?

The person who comes to take my baby's pictures will be wearing a photo identification badge. Signup and view all the answers

What should the nurse teach the client about betamethasone?

This medication stimulates fetal lung maturity. Signup and view all the answers

What intervention should the nurse plan to implement during the taking-hold phase postpartum?

Demonstrate to the client how to perform a newborn bath. Signup and view all the answers

What diagnostic test should a nurse prepare a client for after a positive contraction stress test?

Biophysical profile. Signup and view all the answers

To where should the nurse apply the ultrasound transducer for left occiput anterior fetal position?

Left lower quadrant. Signup and view all the answers

What action should a nurse take upon observing an umbilical cord protruding from the vagina during labor?

Insert two gloved fingers into the vagina and apply upward pressure to the presenting part. Signup and view all the answers

What manifestations should a nurse instruct a postpartum client to monitor and report?

Unilateral breast pain. Signup and view all the answers

Which findings require immediate follow-up for a client who is 28 years old? (Select all that apply)

Vaginal spotting Signup and view all the answers

Which condition and client findings should be noted for a 28-year-old client? (Select one condition and one finding)

RLQ abdominal tenderness Signup and view all the answers

Which items should be included when preparing a client for surgery? (Select all that apply)

Insert an 18G IV Signup and view all the answers

Which findings indicate the client is experiencing a potential complication of surgery that requires immediate follow-up? (Select all that apply)

O2 saturation Signup and view all the answers

What statements should be included when teaching about the 1-hour glucose tolerance test?

If this test is positive, you will be scheduled for a 3-hour glucose tolerance test. Signup and view all the answers

What should be included when after performing universal newborn screening?

Ensure that the newborn has been receiving feedings for 24 hours prior to obtaining the specimen. Signup and view all the answers

In what order should the nurse perform actions while bathing a newborn?

<ol> <li>Wipe the newborn's eyes from the inner canthus outward; 2. Wash the newborn's neck by lifting the newborn's chin; 3. Cleanse the skin around the newborn's umbilical cord stump; 4. Wash the newborn's legs and feet; 5. Clean the newborn's diaper area.</li> </ol> Signup and view all the answers

What should the nurse do if a client in labor shows a respiratory rate of 10 while on magnesium sulfate?

Notify the provider. Signup and view all the answers

What lab test should be expected for suspected placental abruption?

Kleihauer-Betke test. Signup and view all the answers

What priority actions should be taken for a client experiencing postpartum hemorrhage due to uterine atony?

Massage the client's fundus. Signup and view all the answers

For what reason should a client undergoing amniocentesis receive an ultrasound?

To locate a pocket of fluid. Signup and view all the answers

What instruction should be given to a client using a diaphragm?

You should leave the diaphragm in place for at least 6 hours after intercourse. Signup and view all the answers

What nursing action should be included in a care plan for a postpartum client with preeclampsia?

Monitor the fetal heart rate continuously. Signup and view all the answers

What teaching should be provided about Rh(D) immunoglobulin?

I will need the medication if I have an amniocentesis. Signup and view all the answers

How should a nurse set the IV infusion pump for administering magnesium sulfate 3g/hr?

50 mL/hr. Signup and view all the answers

What is the expected date of birth for a client whose last menstrual cycle started on November 27th using Naegle's rule?

September 3rd. Signup and view all the answers

What is an adverse effect of carboprost administered for postpartum hemorrhage?

Hypertension. Signup and view all the answers

What complication should a nurse assess for in a client who admits to recent cocaine use during labor?

Abruption of placenta. Signup and view all the answers

What item should a nurse recommend for non-pharmacological pain management for a breastfeeding client with engorgement?

Cold cabbage leaves. Signup and view all the answers

What instruction should be included for caregivers about car seat safety?

Place the retainer clip at the level of the newborn's armpits. Signup and view all the answers

What finding during a prenatal visit should the nurse report?

Weight gain of 2.2 kg. Signup and view all the answers

What instruction should be provided for using a bulb syringe to suction a newborn's secretions?

Stop suctioning when the newborn cry sounds clear. Signup and view all the answers

What statement indicates an understanding of pregnancy's physiological changes at 10 weeks gestation?

I will likely need to use alternative positions for sexual intercourse. Signup and view all the answers

What finding in a 12-hour-old newborn should be reported to the provider?

Central cyanosis. Signup and view all the answers

Which findings should the nurse expect during a physical assessment of a newborn? (Select all that apply)

Heart rate 154 Signup and view all the answers

What technique should be used to minimize pain for a newborn during a heel stick procedure?

Place the newborn skin to skin on the caregiver's chest. Signup and view all the answers

What finding indicates a progression to preeclampsia with severe features?

Pulmonary edema. Signup and view all the answers

What finding should the nurse report for a client at 36 weeks of gestation?

Report of visual disturbances. Signup and view all the answers

What intervention should the nurse include in the care plan for a postpartum client receiving magnesium sulfate?

Monitor the fetal heart rate continuously. Signup and view all the answers

What cultural consideration should be included in a care plan for a postpartum client of Hispanic descent?

Protect the client's head from cold air. Signup and view all the answers

What actions should be taken for a client who is 3 days postpartum with endometritis?

Plan to administer IV antibiotics; obtain a culture of vaginal fluid using a sterile swab. Signup and view all the answers

Which symptoms should a nurse caring for a pregnant client report? (Select all that apply)

Burning upon urination Signup and view all the answers

What actions should a nurse take when assessing a client in labor with magnesium sulfate? (Select all that apply)

Administer calcium gluconate Signup and view all the answers

What findings could indicate a potential birth complication for a newborn? (Select all that apply)

Erb Duchenne paralysis - limp arm with absent spontaneous movement Signup and view all the answers

What should a nurse's priorities be when caring for a pregnant client? (Select all that apply)

Reposition to their side Signup and view all the answers

Study Notes

Newborn Care

Anticipate orders for oral morphine, low-stimulus environment, and neonatal abstinence syndrome scoring for a 72-hour-old newborn.
Maintain assessment for spina bifida occulta; look for signs like a small bruise at the spine's base.
Report central cyanosis and substernal chest restrictions in a 12-hour-old newborn as requiring intervention.
Use skin-to-skin contact to minimize pain during heel stick for blood collection in newborns.

Maternal Health

Continuous external fetal monitoring is crucial for clients at 35 weeks with placenta previa.
Schedule ultrasounds for pregnant clients with parvovirus B19.
For clients with gestational diabetes, expect signs of hyperglycemia, such as increased urinary output.
Monitor for blurred vision as a severe manifestation in clients with preeclampsia.

Client Education

For newly adopted families, suggest obtaining a gift from the newborn for older siblings to enhance bonding.
Teach preterm labor clients about terbutaline and potential blood tests due to potassium level concerns.
Educate about misoprostol timing and use oxytocin 4 hours post-administration.
Explain that tubal ligation will not affect sexual performance.

Obstetric Procedures and Interventions

Prepare for biophysical profiles after a positive contraction stress test at 36 weeks.
Administer magnesium sulfate and monitor for respiratory depression (RR < 12).
Prepare a client for amniocentesis using ultrasound to locate fluid pockets at 36 weeks.
Place Doppler ultrasound just above the symphysis pubis to assess fetal heart tones.

Postpartum Care

For lactation suppression, recommend applying cabbage leaves to the breasts.
Monitor for unilateral breast pain in postpartum clients, which may indicate complications.
Include practices that align with cultural beliefs in postpartum care, like guarding the head from cold air.

Signs and Symptoms Monitoring

Report findings like a weight gain of 2.2 kg at the 38-week visit to the provider.
Observe for potential adverse effects from medications, such as hypertension from carboprost.
Instruct clients to monitor for burning during urination, cramping, cervical dilation, and frequent contractions.

Family Planning and Contraception

Teach that diaphragms should be left in place for at least 6 hours after intercourse as part of birth control education.
Prepare to monitor the client for complications following suspected ectopic pregnancy, identifying symptoms like right lower quadrant tenderness.

Nursing Priorities

Prioritize actions like administering IV fluids and repositioning the client on their side to enhance comfort and circulation.
During labor, be prepared to discontinue magnesium sulfate and apply oxygen via a non-rebreather mask if necessary.
For clients at risk for abruptio placenta, assess for complications like bleeding and abdominal pain.

Newborn Screening

Ensure newborns have been fed for at least 24 hours prior to the universal screening.

Pain Management

Recommend non-pharmacological interventions, such as applying cold cabbage leaves for engorgement in breastfeeding mothers.

Emergency and Complication Management

In cases of uterine atony, prioritize massaging the fundus to control postpartum hemorrhage.
Prepare for immediate follow-ups such as repeat beta-hCG levels in cases of suspected ectopic pregnancy.

These notes encapsulate key information and practice guidelines for maternal and newborn care, ensuring a thorough understanding of nursing responsibilities and client education in various scenarios.

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Description

This quiz contains flashcards focused on maternal and newborn nursing care. It covers essential topics such as neonatal abstinence syndrome and appropriate care measures for newborns. Test your knowledge and readiness for real-world scenarios in maternal and newborn health.