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NSG222/ NSG 222 Exam 3: (New 2024/ 2025
Update) Family Nursing Review| Questions
and Verified Answers| 100% Correct| A
Grade– Herzing
QUESTION
premature rupture of membranes (PROM) Answer:
37 weeks gestation
QUESTION
pre-term premature rupture of membranes (PPROM) Answer: < 37 weeks gestation
QUESTION
management of premature rupture of membranes Answer:
- antibiotics
- STERILE cervical exams
- activity restriction
- monitor for signs of labor
- monitor for infection (temp >100.4)
- discharge home if no labor within 48 hours
QUESTION
How long should lupus be stable or in remission before getting pregnant?-
Answer: 6 months
QUESTION
treatment for HIV positive mother Answer:
- oral antiretroviral drugs bid from 14 weeks to birth
- IV antiretroviral meds during labor
- oral syrup for newborn (6 hours through 6 weeks)
- more likely to have C-section
- avoid anything that will expose fetus to maternal blood (episiotomy)
QUESTION
risk factors for dystocia Answer:
- epidural
- macrosomia
41 weeks gestation
- maternal exhaustion
- abnormal fetal position
- multiple fetuses
- ineffective pushing techniques
- nulliparity
QUESTION
dystocia Answer: slow, abnormal progression of labor (failure to progress)
QUESTION
McRoberts Maneuver
QUESTION
indications for induction or augmentation Answer:
- prolonged gestation
- prolonged PROM
- gestational hypertension
- dystocia
- intrauterine fetal demise
QUESTION
What is used for labor induction? Answer:
- cervical ripening agent (cervidil, cytotec)
- Oxytocin/Pitocin
QUESTION
signs of umbilical cord prolapse Answer:
- visualization of cord in vagina
- sudden fetal bradycardia
- recurrent variable decelerations
QUESTION
management of umbilical cord prolapse*** Answer:
- call for help
- relieve cord compression (continuously push fetus back up, DO NOT TOUCH umbilical cord)
- position change (elevate hips - trendelenberg, Sims, knee-chest)
- administer oxygen (non-rebreather mask)
- delivery
- support
QUESTION
indications for C-section Answer:
- HIV positive
- shoulder dystocia
- active genital herpes
- gestational hypertension (sometimes)
- macrosomia
- fetal distress
QUESTION
When is Penicillin given to a mother who tests positive for Group B strep? Answer:
4 hours before delivery
QUESTION
postpartum hemorrhage Answer:
- leading cause of maternal death
500mL blood loss in vaginal birth
1000mL blood loss in C-section
QUESTION
symptoms of postpartum hemorrhage Answer:
- hypotension
- tachycardia (heart beats faster to try to get more blood to the body)
- boggy uterine fundus
QUESTION
newborn weight variations Answer:
- appropriate for gestational age (AGA)
- small for gestational age (SGA): <2500g, <10th percentile
- large for gestational age (LGA): >4000g, >90th percentile
- low birth weight (LBW): <2500g
- very low birth weight (VLBW): <1500g
- extremely low birth weight (ELBW): <1000g
QUESTION
small for gestational age causes Answer:
- fetal growth restriction (intrauterine growth restriction - IUGR)
- placental insufficiency (undersupply of O2 and nutrients)**
- hypertension
- smoking
- drug use
- alcohol use
- chronic maternal illness
- intrauterine infection
QUESTION
common problems for SGA newborns Answer:
- perinatal asphyxia
- difficulty with thermoregulation
- hypoglycemia
- polycythemia
- meconium aspiration
- hyperbilirubinemia
- birth trauma
QUESTION
common problems for LGA newborns Answer:
- birth trauma
- hypoglycemia
- polycythemia
- hyperbilirubinemia
QUESTION
placenta previa Answer: a placenta that is implanted in the lower portion of the uterus, partially or completely blocking cervical opening
QUESTION
risk factors for placenta previa Answer:
- prior C-section
- maternal age >
- smoking
- diabetes
- short interval between pregnancies
QUESTION
nursing management for placenta previa Answer:
- avoid vaginal exams
- monitor FHR
- have patient lie on left side
- insert IV to restore fluids
gestational hypertension Answer:
- elevated BP >140/
- more than 20 weeks gestation through 12 weeks postpartum
- no previous history of hypertension
- no protein in urine
QUESTION
preeclampsia Answer:
- elevated BP >140/
- protein in urine and/or organ dysfunction
QUESTION
treatment for severe preeclampsia Answer:
- magnesium sulfate
- hospitalization
- monitor BP
- prepare for birth
- prevent seizures (assess neurologic function, DTRs)
QUESTION
chronic hypertension timeline Answer:
- before pregnancy
- before 20 weeks gestation
- continues after 12 weeks postpartum
QUESTION
treatment for chronic hypertension Answer:
- anti-hypertensives
- exercise
- low salt diet
QUESTION
gestational diabetes Answer: diabetes that develops during pregnancy
QUESTION
risk factors for gestational diabetes Answer:
- advanced maternal age
- family hx of diabetes
- lack of activity
- obesity
- hypertension/cardiac disease
QUESTION
neonatal complications related to gestational diabetes Answer:
- macrosomia
- shoulder dystocia due to large size, trauma during birth
- hypoglycemia (excessive insulin produced by baby to offset mother's hyper- glycemia)
QUESTION
treatment for gestational diabetes Answer:
- thermal regulation (delay bathing)
- nutrition (vital signs may decline b/c they cannot suck and swallow)
- infection prevention (wash hands)
- decrease stimulation (cluster care, dim light)
QUESTION
pain management of newborn Answer:
- non-nutritive sucking (pacifier)
- breast feeding
- heat (warm blanket)
- skin-to-skin contact
- reduced noise
- sweetened solutions
QUESTION
Which newborns more frequently suffer hypoxic-ischemic encephalopa- thy? Answer: home births or birthing center newborns
QUESTION
equipment needed for HIE newborns Answer:
- wall suction
- oxygen
- ventilation bag
- infant warmer
- towels
- laryngoscope
QUESTION
transient tachypnea Answer:
- usually resolves within 72 hours after birth
- caused by delayed clearance of fluid from lungs
QUESTION
signs of transient tachypnea and respiratory distress syndrome Answer:
- tachyp- nea
- retractions
- grunting
- nasal flaring
- cyanosis
QUESTION
respiratory distress syndrome Answer:
- tachypnea that lasts more than 72 hours
- caused by lung immaturity or decreased surfactant
- treated with surfactant, mechanical ventilation
- ground glass pattern on chest x-ray
QUESTION
signs of meconium aspiration syndrome Answer:
- tachypnea
- cyanosis
- grunting
- retractions
- nasal flaring
- barrel-shaped chest
- staining of amniotic fluid, nails, skin, umbilical cord
QUESTION
periventricular/intraventricular hemorrhage Answer:
- bleeding in the brain caused by weak cerebral vessels
- typically seen in preterm newborns
- most common in first 72 hours
- no treatment
QUESTION
signs of necrotizing enterocolitis Answer:
- abdominal distention
- bloody stools
- feeding intolerance
- lethargy
QUESTION
treatment for necrotizing enterocolitis Answer:
- NPO
- antibiotics
- IV fluids
- orogastric tube to prevent gastric distention
- surgical removal of necrotic or perforated bowel
QUESTION
neonatal abstinence syndrome (NAS) Answer:
- drug dependency acquired in utero manifested by neurologic and physical behaviors
- symptoms may last from 1 week to 6 months
QUESTION
management of NAS Answer:
- dim lights
- cluster care
- frequent feedings
- low noise
- frequent diaper changes
- tight swaddle
- pacifier
- morphine/methadone
QUESTION
signs of NAS Answer: Wakefulness (sleeping less than 3 hours after feeding) Irritability Temperature variation (hyperthermia) Hyperactivity (hypertonic) Diarrhea, disorganized suck Respiratory distress Apneic Weight loss Alkalosis Lacrimation
QUESTION
signs of neonatal sepsis Answer:
- poor feeding
- respiratory distress
- lethargy (later symptom)
- persistent crying
QUESTION
treatment for neonatal sepsis
Answer: herniation of intestines through abdominal wall (no peritoneal sac)
QUESTION
imperforate anus Answer: absence or abnormal location of anal opening
QUESTION
5 A's when working with substance abuse mothers Answer: Ask Assess Assist Advise Arrange
QUESTION
causes of ectopic pregnancy Answer:
- tubal scarring related to PID (most cases)
- chlamydia
- IUD
- prior tubal surgery
- smoking
- douching
QUESTION
places where ectopic pregnancy can occur Answer:
- abdominal cavity
- fallopian tube
- cervix
QUESTION
management of ectopic pregnancy Answer:
- if not ruptured, drug therapy (methotrex- ate)
- if ruptured, surgery
- Rh immunoglobin if woman is Rh-
- monitor HCG levels until undetectable
QUESTION
hallmark sign of ectopic pregnancy Answer: abdominal pain with bleeding within 6 to 8 weeks after missed menses
QUESTION
causes of miscarriage (spontaneous abortion) Answer:
- unknown & highly variable
- genetic abnormalities - 1st trimester
- maternal conditions - 2nd trimester
QUESTION
nursing assessment of miscarriage Answer:
- vaginal bleeding
- cramping or contractions
- vital signs
- pain level
- weeks gestation
