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Nursing Guide for Pregnancy and Childbirth, Study notes of Nursing

Comprehensive information on various aspects of pregnancy, childbirth, and postpartum care. It covers topics such as diaper usage, chorioamnionitis, lacerations, transition phase of labor, diet during pregnancy, preterm labor, gestational hypertension, breastfeeding, cervical effacement, menarche, intercourse during pregnancy, obstetric history, postpartum hemorrhage, labor induction, group b streptococcus infection, discomforts of pregnancy, physical assessment of newborns, risk factors for postpartum hemorrhage, comfort measures for labor, discomforts during the first trimester, assessment of pregnant women, emergency contraceptives, contraceptives, abruption placenta, postpartum infection, labor experience, cesarean birth, preterm premature rupture of membranes, high infant mortality rate, and factors placing a woman at high risk for preterm premature rupture of membranes.

Typology: Study notes

2021/2022

Uploaded on 03/14/2024

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When integrating the principles of family-centered care, the nurse would
include which of the following? Childbirth results in changes in relationships
The parents of a newborn become concerned when they notice that their
baby seems to stop breathing for a few seconds. After confirming the
parents’ findings by observing the newborn, which of the following actions
would be most appropriate? Assess the newborn for signs of respiratory
distress.
During a routine prenatal visit, a client, 36 weeks pregnant, states she has
difficulty breathing and feels like her pulse rate is really fast. The nurse
finds her pulse to be 100 beats per minute (increased from baseline
readings of 70 to 74 beats per minute. and irregular, with bilateral crackles
in the lower lung bases. Which nursing diagnosis would be the priority for
this client? Gas Exchange
A new mother who is breast-feeding her newborn asks the nurse, “How will
I know if my baby is drinking enough?” Which response by the nurse would
be most appropriate? He should wet between 6 to 12 diapers each day
The nurse is presenting a class at a local community health center on
violence during pregnancy. Which of the following would the nurse include
as a possible complication? Chorioamnionitis
A nurse is assessing a woman after birth and notes a second-degree
laceration. The nurse interprets this as indicating that the tear extends
through which of the following? Muscles of perineal body
The partner of a woman who has given birth to a healthy newborn says to
the nurse, “I want to be involved, but I’m not sure that I’m able to care for
such a little baby.” The nurse interprets this as indicating which of the
following stages? Reality
A nurse is making a home visit to a postpartum woman who delivered a
healthy newborn 4 days ago. The woman’s breasts are swollen, hard, and
tender to the touch. The nurse documents this finding as which of the
following? engorgement
A postpartum client has a fourth-degree perineal laceration. The nurse
would expect which of the following medications to be ordered? Docusate
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When integrating the principles of family-centered care, the nurse would include which of the following? Childbirth results in changes in relationships The parents of a newborn become concerned when they notice that their baby seems to stop breathing for a few seconds. After confirming the parents’ findings by observing the newborn, which of the following actions would be most appropriate? Assess the newborn for signs of respiratory distress. During a routine prenatal visit, a client, 36 weeks pregnant, states she has difficulty breathing and feels like her pulse rate is really fast. The nurse finds her pulse to be 100 beats per minute (increased from baseline readings of 70 to 74 beats per minute. and irregular, with bilateral crackles in the lower lung bases. Which nursing diagnosis would be the priority for this client? Gas Exchange A new mother who is breast-feeding her newborn asks the nurse, “How will I know if my baby is drinking enough?” Which response by the nurse would be most appropriate? He should wet between 6 to 12 diapers each day The nurse is presenting a class at a local community health center on violence during pregnancy. Which of the following would the nurse include as a possible complication? Chorioamnionitis A nurse is assessing a woman after birth and notes a second-degree laceration. The nurse interprets this as indicating that the tear extends through which of the following? Muscles of perineal body The partner of a woman who has given birth to a healthy newborn says to the nurse, “I want to be involved, but I’m not sure that I’m able to care for such a little baby.” The nurse interprets this as indicating which of the following stages? Reality A nurse is making a home visit to a postpartum woman who delivered a healthy newborn 4 days ago. The woman’s breasts are swollen, hard, and tender to the touch. The nurse documents this finding as which of the following? engorgement A postpartum client has a fourth-degree perineal laceration. The nurse would expect which of the following medications to be ordered? Docusate

The nurse is developing a teaching plan for a client who has decided to bottle feed her newborn. Which of the following would the nurse include in the teaching plan to facilitate suppression of lactation? Instructing her to apply ice packs to both breasts every other hour The nurse notes persistent early decelerations on the fetal monitoring strip. Which of the following would the nurse do next? Continue to monitor the FHR because this pattern is benign. When explaining how a newborn adapts to extrauterine life, the nurse would describe which body systems as undergoing the most rapid changes? Respiratory and cardiovascular A client has not received any medication during her labor. She is having frequent contractions every 1 to 2 minutes and has become irritable with her coach and no longer will allow the nurse to palpate her fundus during contractions. Her cervix is 8 cm dilated and 90% effaced. The nurse interprets these findings as indicating: Transition phase of the first stage of labor The nurse is teaching a pregnant woman with type 1 diabetes about her diet during pregnancy. Which client statement indicates that the nurse’s teaching was successful? Pregnancy affects insulin production, so I’ll need to make adjustments in my diet. It is determined that a client’s blood Rh is negative and her partner’s is positive. To help prevent Rh isoimmunization, the nurse anticipates that the client will receive RhoGAM at which time? At 28 weeks' gestation and again within 72 hours after delivery A nurse is assessing a pregnant woman who has come to the clinic. The woman reports that she feels some heaviness in her thighs since yesterday. The nurse suspects that the woman may be experiencing preterm labor based on which additional assessment findings? Dysuria… QUIZLET HAS IT AS AN SATA (Answers: malodorous vaginal discharge, dull low backache.) After reviewing a client’s history, which factor would the nurse identify as placing her at risk for gestational hypertension? Mother had gestational hypertension during pregnancy.

A woman is admitted to the labor and birthing suite. Vaginal examination reveals that the presenting part is approximately 2 cm above the ischial spines. The nurse documents this finding as: NEGATIVE (-2) Station A client who is 4 months pregnant is at the prenatal clinic for her initial visit. Her history reveals she has 7-year-old twins who were born at 34 weeks gestation, a 2-year old son born at 39 weeks gestation, and a spontaneous abortion 1 year ago at 6 weeks gestation. Using the GTPAL method, the nurse would document her obstetric history as: 4 1 1 1 3 Which of the following factors in a client’s history would alert the nurse to an increased risk for postpartum hemorrhage? Uterine atony, placenta previa, operative procedures. (it’s not a SATA lol). A pregnant client undergoing labor induction is receiving an oxytocin infusion. Which of the following findings would require immediate intervention? Urine output of 20 mL/hour Assessment of a postpartum client reveals a firm uterus with bright-red bleeding and a localized bluish bulging area just under the skin at the perineum. The woman also is complaining of significant pelvic pain and is experiencing problems with voiding. The nurse suspects which of the following? hematoma When palpating the fundus during a contraction, the nurse notes that it feels like a chin. The nurse interprets this finding as indicating which type of contraction? moderate The nurse is providing care to several pregnant women who may be scheduled for labor induction. The nurse identifies the woman with which Bishop score as having the best chance for a successful induction and vaginal birth? 11 A nurse is providing care to several pregnant women at the clinic. The nurse would screen for group B streptococcus infection in a client at: 36 weeks’ gestation A nurse is describing how the fetus moves through the birth canal. Which of the following would the nurse identify as being most important in allowing the fetal head to move through the pelvis? Sutures

A nurse is caring for a newborn and calculating the Apgar score. At 1 minute after delivery, the following findings are noted: heart rate of 110/min; slow, weak cry; some flexion of extremities; grimace in response to suctioning of the nares; body pink in color with blue extremities. Calculate the newborn's Apgar score. 6 A nurse is teaching a pregnant client in her first trimester about discomforts that she may experience. The nurse determines that the teaching was successful when the woman identifies which discomfort as common during the first trimester? (Select all that apply.) breast tenderness…urinary frequency…cravings A nurse is conducting an in-service program for a group of nurses on the health of women and their families, incorporating information from Healthy People 2020. The nurse determines that additional discussion and clarification is needed when the group makes which statement? Immunizations may be the cause of some illnesses being seen currently At prenatal classes a client asks the nurse how long it takes to actually become pregnant after having sexual intercourse. What is the nurse's best response? Conception happens about 72 hours after fertilization of the ovum. A nurse measures woman’s fundal height to be 28cm, nurse determines this to indicate client is at how many weeks gestation? 28 weeks gestation. Which of the following would alert the nurse to the possibility of respiratory distress in a newborn? Sternal retractions The nurse is teaching a pregnant woman about recommended weight gain. The woman has a prepregnancy body mass index (BMI) of 21. The nurse determines that the teaching was successful when the woman states that she should gain no more than which amount during pregnancy? 25-35 lbs. When discussing contraceptive options, which method would the nurse recommend as being the most reliable? Intrauterine system A woman with gestational hypertension experiences a seizure. Which intervention would the nurse identify as the priority? Oxygenation

successful when the students identify which of the following as a risk factor? (Select all that apply.) Placenta previa…Hydramnios…Labor augmentation A nurse is providing teaching to a new mother about her newborn’s nutritional needs. Which of the following would the nurse be most likely to include in the teaching? (Select all that apply). Feeding the newborn every 2 to 4 hours during the day…Burping the newborns frequently throughout each feeding…Using feeding time for promoting closeness A client's recent prenatal ultrasound assessment reveals a normal placenta. Which outcomes would the nurse expect? Select all that apply.The hormones made by the placenta support fetal growth…The placenta protects the fetus from an immune attack created by the mother…The placenta produces hormones that ready the fetus for extrauterine life. A nurse is preparing to visit the home of a two day postpartum client and her infant. which assessments would the nurse expect to prioritizes during the home visit? select all that apply. Palpate the breasts…Check vaginal discharge…Assess the extremities…Inspect the perineum. Which position would be most appropriate for the nurse to suggest as a comfort measure to a woman who is in the first stage of labor? (Select all that apply. straddling with forward leaning over a chair… rocking back and forth with foot on chair…walking with partner support. A nurse is completing the assessment of a woman admitted to the labor and birth suite. Which of the following would the nurse expect to include as part of the physical assessment? (Select all that apply). contraction pattern…membrane status…Current pregnancy history After teaching a group of students about the discomforts of pregnancy, the students demonstrate understanding of the information when they identify which as common during the first trimester? Urinary frequency…Breast tenderness…Cravings A nurse is assessing a pregnant woman on a routine checkup. When assessing the woman’s gastrointestinal tract, which of the following would the nurse expect to find? (Select all that apply.) Hyperemic gums… Complaints of bloating…Heartburn…Nausea

A nurse is preparing a class for a group of young adult women about emergency contraceptives (ECs). Which of the following would the nurse need to stress to the group? (Select all that apply) ECs are birth control pills in higher, more frequent doses…ECs are not to be used in place of regular birth control…ECs provide little protection for future pregnancies. A nurse is preparing a class for a group of women at a family planning clinic about contraceptives. When describing the health benefits of oral contraceptives, which of the following would the nurse most likely include? (Select all that apply.) Protection against pelvic inflammatory disease… Reduced risk for endometrial cancer…Improvement in acne A nurse providing care to a women in labor. The nurse determines that the client is in the active phase based on which assessment finding? Select all that apply). cervical dilation (dilatation) of 6 cm…Contractions lasting up to 60 seconds A nurse suspects that a pregnant client may be experiencing abruption placenta based on assessment of which of the following? (Select all that apply.) Dark red vaginal bleeding…Rigid uterus…Absent fetal heart tones A nurse is reviewing the medical record of a postpartum client. The nurse identifies that the woman is at risk for a postpartum infection based on which of the following? Select all that apply.) History of diabetes… Hemoglobin level 10 mg/dL…Placenta requiring manual extraction A nurse is preparing a presentation for a group of pregnant women about the labor experience. Which of the following would the nurse most likely include when discussing measures to promote coping for a positive labor experience? (Select all that apply.) Presence of a support partner…Low anxiety level…Participation in a pregnancy exercise program 42-year-old woman is 26 weeks’ pregnant. She lives at a shelter for abused women. Her blood pressure is 170/90, FHR is 140, TORCH studies are positive, and she is bleeding vaginally. What finding put her at risk of delivering a small-for-gestational-age infant? (Select all that apply.) Clients age…Positive TORCH test…Living in an abuse shelter…Vaginal Bleeding…Blood Pressure A client expresses concerns that her grandmothers had complicated pregnancies. What principles of the Healthy People 2020 initiative should the nurse enact in order to allay the fears of the client? (Select all that

A public health nurse is developing programs to assist in improving infant mortality rates. Which factors would need to be addressed? (Select All that apply.) Prematurity…Congenital anomalies…Low birth weights Which factors are main causes of high infant mortality rate? (Select All that Apply.) Low birth weight…Necrotizing Enterocolitis…Viral infections … Infectious disease A nurse is reviewing an article about preterm premature rupture of membranes. Which factors would the nurse expect to find placing a woman at high risk for this condition? (Select all that apply.) Low socioeconomic status…Urinary tract infection…Smoking Benefits of oral contraceptives? (reduced acne is one answer) reduced risk of endometrial & ovarian cancer: improved regulation of menstruation… relief of benign breast disease…prevention of ovarian cysts…reduction of risk of symptomatic PID A nurse is providing preoperative instructions to a client undergoing an emergency cesarean birth. which actions follow appropriate communication guidelines select all that apply. NO ANSWER ON QUIZLET/GOOGLE CHECKS A nurse is conducting a class for pregnant women who are in the third trimester. The nurse is reviewing information about emotional changes that occur in the postpartum period, including postpartum blues and postpartum depression. After reviewing information about postpartum blues, the group demonstrates understanding when they make which statement about this condition. Post-Partum Depression??? NOT FOUND ON QUIZLET OR GOOGLE. Postpartum depression vs. Blues: At the 6-week visit following delivery of her infant, a postpartum client reports extreme fatigue, feelings of sadness and anxiety, and insomnia. Based on these assessment findings, the nurse documents that the client is exhibiting characteristics of: Correct response: postpartum depression. Explanation: Extreme fatigue, feelings of sadness and anxiety, and insomnia are consistent with a diagnosis of postpartum depression. Postpartum blues occurs in the first week after birth. Postpartum psychosis is a psychiatric emergency in which symptoms

of high mood and racing thoughts (mania), depression, severe confusion, loss of inhibition, paranoia, hallucinations, and delusions present following a birth. Postpartum adjustment is a positive coping experience in which the woman transitions to the role of mother. Emergency Contraceptives: Emergency contraception (EC) reduces the risk of pregnancy after unprotected intercourse or contraceptive failure such as condom breakage. It is used within 72 to 120 hours of unprotected intercourse to prevent pregnancy. The sooner ECs are taken, the more effective they are. They reduce the risk of pregnancy for a single act of unprotected sex by almost 90% The placenta protects the fetus from immune attack by the mother, removes waste products from the fetus, induces the mother to bring more food to the placenta and, near the time of birth, and produces hormones that mature fetal organs in preparation for life outside the uterus. When the lowermost portion of the presenting part is 1 cm above the ischial spine, it is noted as being minus (-)1. When positioned 2 cm above the ischial spine, it is -2 station. At the level of the spines the station is referred to as 0 (zero). When the presenting part is 1 cm below the spines, the station is said to be plus (+)1. Most accurate fetal heart measurement: Internal fetal heart monitoring: Contractions: Duration 45-60 seconds, frequency 2-5 minutes Neagle (estimation of delivery date): Add 7 days, subtract 3 months, make sure you have the right year http://www.learningaboutelectronics.com/Articles/Naegeles-rule- calculator.php#answer

APGAR

Parameter 0 Point 1 Point 2 Points

extremities with the appropriate color for ethnicity appearing within minutes after birth) (acrocyanosis) both trunk and extremities)