Download Maternal and Child Health: Nursing Exam Notes and more Exams Nursing in PDF only on Docsity!
Final Exam.
Maternal Child Health Final Exam Exam 1
- Toxoplasmosis: o Associated with the consumption of infested undercooked meat and poor hand washing after handling cat litter ▪ Educate on having someone else change the cat’s litter pan and to avoid consuming uncooked meat
- Blood Volume: o Because of the increase in plasma the hematocrit will appear low, especially at 32-34 weeks gestation. A hemoglobin of 11.2 and hematocrit of 38% would be considered normal - Natural Family Planning: o Identifying the fertile time during the cycle and using abstinence or other contraceptive methods during the fertile period requires motivation and considerable counseling - IPV (Intimate Partner Violence) o Nurse should routinely screen all of their patients. Using words such as, “do you feel safe in your current environment and relationships?” - Recreational Drugs o The use of these drugs can harm the fetus, causing miscarriage/spontaneous abortion and low birth weight
Final Exam.
- First Prenatal Visit (3) o The patient has appropriate questions for her potential provider that include: ▪ The opportunity to use complementary and alternative methods during labor and birth ▪ And opportunity to meet other providers in the practice ▪ The health care provider’s beliefs and practices concerning epidural anesthesia the routine use of episiotomy
Final Exam.
- Side-Lying Position: o Side-lying in the lateral position decreases pressure on the vena cava and is common instruction given to increase venous return and increases fetal circulation, circulatory volume and placental and renal perfusion - Fundal Height: o 14 weeks is slightly above the symphysis pubis - Urgent Reportable Signs in Pregnancy: o Vaginal bleeding
Final Exam.
o Rupture of membranes o Headaches that do not respond to usual therapy
- GTPAL o GRAVIDA- pregnant woman o Term- carried to term o P- number of preterm deliveries o A- number of abortions/spontaneous or induced o L- number of living children
- Cardiac Output: o Increases and peaks around 20-24th^ week (second trimester) o Frequently it is 10-15 beats higher to facilitate the extra volume
- EDD or EDB o Naegele’s Rule: ▪ Subtract 3 FULL months + 7 days
- Nutritional Counseling: o Essential nutritional elements are protein, iron, folic acid, calcium and water
- Breast Self-Exam: o Step 1 : exam with arms down o Step 2 : exam with arms up o Step 3 : signs of fluid discharge o Step 4 : feel while lying down o Step 5 : feel while sitting or standing
Final Exam.
- Newborns Addicted to Drugs: o INCESSANT CRYING - Fractures Can Occur from Birth: o Large babies can become lodged in the birth canal, and the CLAVICLE can fracture during the process of birth - Spinal Anesthesia- Epidural (4): o Intake and Output o Blood Pressure o Respiratory Rate o Fetal Heart Rate - Preeclampsia : o Nursing care would include administering magnesium sulfate according to the agency policy - Assessment of Postpartum Woman (3): o Assessment of pain and provide pain medication o Ongoing physical assessment o Notification to the provider if the RR is still elevated an hour after med admin - Mental Health Questions: o Ask to hear about how things are going in their own words. o Use words like, “tell me about…” - Erythromycin Ointment and Vitamin K:
Final Exam.
o Start at the inner cannulas and move to the outer cannulas o Dab excess on the skin, but DO NOT wash it away
- Symptoms of Early Labor: o Excited or irritable related to answering multiple questions about contractions o Her pulse rate will be 100 beats per minute o Her pulse rate will be 100 beats per minute - Headache and the Postpartum Patient:
Final Exam.
o the single thing that will save the mother’s life: ▪ massage the uterine fundus with continual lower segment support
- Preterm Labor: o Corticosteroid therapy is presently the only treatment shown to improve fetal survival when given to a woman in preterm labor between 24-33 weeks - Betamethasone : o Corticosteroid o Given to mom to help baby’s lungs mature - Mother does not want to really touch her infant:
Final Exam.
o Do not correct her or tell her how to act or feel o We would SUPPORT the mother in her reaction to the newborn
- Discharge instructions for a C-Section: o Only lift the weight of the baby for 2 weeks o Abdominal exercises are not recommended until 6 weeks post-op - Preterm Rupture of Membranes: o The nurse will: ▪ Monitor fetal heart rate ▪ Administer antibiotics ▪ Monitor vital signs ▪ And do a SPECULUM EXAM - Not a vaginal exam - Jaundice (HYPERBILIRUBEMIA): o Inadequate intake may lead to jaundice ▪ Encourage the frequent feeding of breastmilk to avoid this - Blood pressure and Pregnancy: o High blood pressure: ▪ Hypertension o Chronic Hypertension: ▪ Hypertension that was present before becoming pregnant o Gestational Hypertension: ▪ High blood pressure that first occurs in the second half (after 20 weeks) of pregnancy o Problems that occur due to hypertension:
Final Exam.
o Due to high blood pressure o Signs: ▪ Proteinuria ▪ Low platelet count o Usually occurs after 20 weeks pregnancy ▪ During the 3 rd^ trimester ▪ If before 32 weeks it is called early-onset preeclampsia o Causes: ▪ First pregnancy ▪ Hx of preeclampsia ▪ Hx of chronic HTN ▪ Over 40 ▪ Carrying more than one baby ▪ Certain medical conditions such as:
- Diabetes, thrombophilia, lupus ▪ Obesity ▪ In vitro fertilization o Risks for baby: ▪ May need immediate delivery ▪ Preterm = complications o Risks for mother: ▪ Increased risk of cardiovascular disease and kidney disease ▪ Can lead to seizures, also known as eclampsia ▪ Can also lead to HELLP Syndrome o Management: ▪ Corticosteroids ▪ Meds may also be given to lower blood pressure and to help prevent seizures
Final Exam.
- HELLP Syndrome: o Hemolysis, Elevated Liver enzymes, and Low Platelet count - Reason to not give an epidural: o Decreased platelet count ▪ Platelets less than 90,000 (100,000 is considered low normal) - What to administer before an epidural:
Final Exam.
▪ Toddlers play with the same materials but do not play together- two children playing with trucks next to each other o Associated play: ▪ Preschoolers- loosely organized with our organization, division of labor, or mutual goal- helps children learn to share, simple rules and concepts
- Airway: o Stridor or frog-like noises can occur when the airway is compromised o It is important to maintain the airway - Cystic Fibrosis:
Final Exam.
o Describing to a parent would include: ▪ Thick mucus that affects exocrine glands and several body systems ▪ Increased mucous production causes obstruction and stasis of fluid, providing a rich habitat for growth ▪ In later childhood, the reproductive system is affected as ovarian ducts and vas deferens may be occluded, leading to infertility
- Infantile Colic: o Irritability and fussiness about the same time every day, usually during the late afternoon of evening. o Infant pulls both legs and arms into a flexed position. - Food Fads: o Are normal and this tendency will pass - Contraindications to vaccinations: o A previous severe allergic reaction to the vaccine - Health teaching for immunosuppressed children: o Teaching the parents the benefit of hand washing is an important measure - Teaching for children with diabetes (3): o Diet o Insulin o Exercise - Glascow Coma Scale: o A pediatric scale to assess neurological status
Final Exam.
o Use a doll or toy as a transition object
- Minimizing separation anxiety in a hospitalized toddler? o Encourage the parents to room in - Best drug to use immediately post-op: o Morphine - Debridement of burn wounds: o Fentanyl and Midazolam can be given for pain relief - Burn Injury: o Primary complication is infection - Anemia: o Nursing diagnosis: ▪ Activity intolerance related to generalized weakness - Children with Renal Failure: o At risk for water and sodium retention - Sickle Cell Disease: o Chronic lifelong illness o Nursing interventions (2): ▪ Hydration ▪ Pain management - Nursing care in cardiac catheterization:
Final Exam.
o Direct pressure above the catheterization site
- Urinary tract infection: o Predisposition: ▪ Short urethra in young girls - Hydrocephalus: o Recognition: ▪ Bulging fontanel and dilated scalp veins - Discipline (3):
