Maternal, Newborn, and Women's Health Test #3 Study Guide PDF

**[Maternal, Newborn, and Women's Health Test \#3 V1 Study Guide ]** **Please note that this guide is meant to help but it is not all inclusive. Some items are not able to be prompted because they are evaluating critical thinking. You will need to review the PPTs and read your online text to have a...

**[Maternal, Newborn, and Women's Health Test \#3 V1 Study Guide ]** **Please note that this guide is meant to help but it is not all inclusive. Some items are not able to be prompted because they are evaluating critical thinking. You will need to review the PPTs and read your online text to have all the information needed for the exam.** **Unit 4 Labor** 1. **Review the nursing action when the fetus is found to be in a transverse (perpendicular) lie.** Perpendicular/transverse- contact provider 2. **Review progression of labor when the fetus is in a face presentation.** Face -- fetal neck extended- labor may progress slower than anticipated 3. **Review the 5 P's of labor.** - - - - - 4. Review fetal positioning and the labels and what they mean for each positioning. **Review fetal positioning and the labels and what they mean for each positioning.** +-----------------+-----------------+-----------------+-----------------+ | **Right | **Left | **Right | **Left Mentum** | | Occiput** | Occiput** | Mentum** | | +=================+=================+=================+=================+ | **Occiput | **Occiput | **R-Mentum | **L-MentumAnter | | Anterior** | Anterior** | Anterior** | ior** | | | | | | | **ROA** | **LOA** | **RMA** | **LMA** | +-----------------+-----------------+-----------------+-----------------+ | **Occiput | **Occiput | **R- Mentum | | | Posterior** | Posterior** | Posterior** | | | | | | | | **ROP** | **LOP** | **RAP** | | +-----------------+-----------------+-----------------+-----------------+ | **Occiput | **Occiput | | | | Transverse** | Transverse** | | | | | | | | | **ROT** | **LOT** | | | +-----------------+-----------------+-----------------+-----------------+ | | | | | +-----------------+-----------------+-----------------+-----------------+ | **Left Sacrum** | **Left Sacrum** | | | +-----------------+-----------------+-----------------+-----------------+ | **L-Sacrum | **L-Sacrum | | | | Anterior** | Posterior** | | | | | | | | | **LSA** | **LSP** | | | +-----------------+-----------------+-----------------+-----------------+ | | | | | +-----------------+-----------------+-----------------+-----------------+ 5. **Review when rupture of membranes happens in relation to labor contractions.** - 6. **Review maternal physiological adaptations that promote fetal oxygenation.** Increased cardiac output- promotes fetal oxygenation (Increased stroke volume, Increased heart rate) 7. **Review elevated WBC count during labor.** - 8. **Review nursing interventions for a client experiencing incontinence during labor.** - 9. Review the explanation of newborns who have elongated heads after birth. - 10. **Review dilation, effacement, and station when describing a client in the first stage of labor.** **Dilation:** Widening or opening of the cervix. **Effacement**:Thinning and shortening of the cervix. **Station:** Fetal **station:** is defined as the fetal position within the maternal pelvis related to the maternal ischial spines, bony prominences within the pelvis. ATI) 11. **Review troubleshooting for a tocodynamometer that is not recording accurately.** - 12. **Review nursing actions when the fetal monitor is recording late decelerations.** - - 13. **Review the nursing action for persistent fetal bradycardia.** - 14. **Review potential causes of fetal tachycardia.** - 15. **Review nursing actions for the presence of sinusoidal fetal heart pattern.** Intrauterine resuscitation (increase fetal oxygenation) 16. **Review the characteristics of a category II FHR tracing.** - - - 17. **Review the purpose of the tocodynamometer (TOCO) transducer.** - 18. **Review characteristics of uterine contractions used to assess fetal oxygenation.** Uterine relaxation between contractions is essential to ensure fetal oxygenation 19. Review the smooth muscle adaptations that promote expulsion of the fetus during labor. Stretching of pelvic smooth muscle: Facilitates cervical dilation 20. Review care for a client experiencing umbilical cord prolapse. Repositioning IV fluids Oxygen Discontinue uterotonic meds If persistent after interventions, notify provider Facilitate emergent birth **Unit 4 Pain Management** 21. Review the difference between somatic and visceral pain during labor. - - 22. Review cultural practices in factors influencing pain - - 23. Review ways to help anxiety as a factor influencing pain. - - 24. Review possible outcomes from a maternal client experiencing too much anxiety during labor. 25. Review client signs that indicate positive coping in perception of pain. - 26. Review non pharmacological techniques that could be used for back pain. - - 27. Review non pharmacological techniques for a client with a history of anxiety and psychosis. - - 28. Review the antagonist for opioid pain medication. - - 29. Review the best pain management option for repairing perineal lacerations. - - 30. Review potential complications of an epidural. - - 31. Review interventions for a client experiencing nausea from receiving an opioid. - 32. Review pain management used in a cesarean section. - - - - - - - - - 33. Review potential complications of general anesthesia. - 34. Review contraindications for an epidural. - - - - - - - - - - 35. Review epidural removal postpartum. - - - - 36. Review labor positioning that can help reduce client pain. - **Unit 4 Birth** 37. Review contraindications to a client having a home birth. - - 38. Review the reason for an episiotomy procedure. - 39. Review newborn risks for hypothermia. - - 40. Review newborn findings after delayed cord clamping. - - - 41. Review how to accurately measure lochia. - 42. Review signs of respiratory distress in a newborn. - - 43. Review eye prophylaxis for newborn care during the first 2 hours after birth. - **Unit 4 Complications of Labor and Birth** 44. Review the characteristics of an overt prolapsed cord. [ Obstetric emergency: Overt prolapse:] Cord slips through dilated cervix and becomes compressed by the fetal presenting part 45. Review what happens during a uterine rupture. [ Obstetric emergency] -- 3 muscular layers of uterus tear apart 46. Review Leopold's maneuvers and how to tell if a fetus is in a breech presentation. [Identified by using Leopold maneuvers:] Soft mass above symphysis pubis 47. Review manifestations that indicate shoulder dystocia during birth. "Turtle sign": Fetal head emerges and then retracts Turtle sign -- should prompt OB rapid response 48. Review priority actions for a client experiencing moderate acute placental abruption. [Nursing]: NPO Informed consent IV access FHR patterns and maternal VS Indwelling catheter 49. Review nursing care interventions for chorioamnionitis. [Nursing:] Educate the client about the treatment for chorioamnionitis Notify neonatology provider to attend the birth Monitor the FHR pattern Monitor maternal temperature Administer IV antibiotics Pain control 50. Review what the nurse will monitor for a client receiving magnesium sulfate. **[Nurse monitoring]**: FHR pattern, Patellar reflexes, Maternal respiratory rate, Urine output (kidney function:receiving oxygenated blood?) Uterine activity 51. Review nursing care for a client during an external cephalic version. [Nursing:] Determine client's understanding of procedure, Provide illustration Verify blood type and Rh factor Prescription for tocolytic Prep for emergency cesarean if indicated 52. Review factors that increase the risk for placental abruption. [Risk factors:] Gestational diabetes Artificial ROM Low hemoglobin Abdominal trauma Preeclampsia Eclampsia Multiples **Unit 5 Postpartum Period** 53. Review postpartum measurement of the fundus. [Fundal assessment:] Should be firm, nontender, globular, and located between symphysis pubis and umbilicus 12 hours postpartum- the fundus rises to at or below the umbilicus. The uterus decreases in size by about 1 cm per day to go back to between the symphysis pubis and the umbilicus by the end of the first week postpartum. 54. Review expected findings for lab values and blood volume following a vaginal birth. [Hematological systems]: hemodilution, Hemoglobin & hematocrit decrease first and then gradually increase, Clotting factors and fibrinogen, WBCs can increase to about 25,000 55. Review maternal cervical changes after birth. [Cervix:] Heals within a few weeks postpartum External os becomes a transverse slit 56. Review how to describe findings of lochia on a perineal pad. The amount of flow on the perineal pad after 1 hour is noted as: scant (less than 2.5 cm on pad), dark red/lochia rubra: 3-4 days PP, lochia serosa pink-brown 4-10 days PP, lochia alba/ white or yellow:10-14 days PP light (less than 10 cm on the pad), moderate (15 cm on the pad), heavy (pad saturated in 1 hour). 57. Review nursing interventions for a boggy uterus. [ If the fundus is not firm]: Perform fundal massage Assist client to empty bladder **Unit 3 Complications in the Postpartum Period** 58. Review risk factors for postpartum hemorrhage. [ Leading cause of maternal deaths in the U.S.:] Causes: uterine atony (boggy uterus), retained placenta, lacerations Uterine atony (boggy uterus) is the primary cause of PPH Failure of myometrium to contract, leading to bleeding Etiology/comorbidities History of PPH, BMI \> 40 (can lead to shock) 59. Review medication prescribed for excessive vaginal bleeding. Uterotonics- oxytocin, misoprostol, tranexamic, methylergonovine 60. Review complications of applying traction to the umbilical cord during the 3^rd^ stage of labor. 61. Review risk factors for placenta accreta. Risk factors Primigravida History of endometriosis Uterine atony Uterine fibroids Smoking Maternal age \> 35 years 62. Review risk factors for postpartum hemorrhage leading to shock. Comorbidities: History of hemorrhage following previous birth, BMI \> 40 63. Review risk factors for deep vein thrombosis in the postpartum period. Risk factors/comorbidities: BMI \> 35 (higher risk) Pre-existing diabetes 64. Review diagnostic testing for suspicion of deep vein thrombosis in the leg. 65. Review manifestations of postpartum infection turning into sepsis. Sepsis: Hypotension, hypoxia, hypothermia, tachycardia 66. Review nonpharmacological therapies for mastitis with pain in the breast. Mastitis- cold compresses 67. Review bleeding disorders that increase a client's risk for postpartum hemorrhage. Hemophilia, anticoagulation, Von Willebrand disease- hereditary bleeding disorder 68. Review expected physician orders for excessive bleeding and hypotension following birth in the maternal client. 69. Review the priority medication for a client with immune thrombocytopenia purpura. Medical management: Oral corticosteroids Tranexamic acid (for bleeding)