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NURS 225 EXAM 1 LATEST 2025|QUESTIONS WITH
CORRECT ANSWERS|A+ VERIFIED
Preeclampsia Hypertensive multisystem disorder in pregnancy caused by Abnormal placentation leading to abnormal modeling vessels. Preeclampsia diagnostics criteria SBP 140 or higher / DBP 90 or higher at least twice (4hrs apart) post 20 wk gestation w/ previously normal readings. AND/OR Proteinuria possible. Platelet count <100,000, creatinine >1.1, AST/ALT twice normal, pulmonary edema, new-sxset visual or cerebral sx Preeclampsia management Birth only "cure", monitor BP, RR, P, O2, lung sounds, LOC, edema, headache, visual disturbances, epigastric pain, fetal status, uterine activity, temp, I&O. Seizure precautions (pads, suction, cart, min stim) Meds for HTN pregnancy Labetalol
Hydralazine Nifedipine Eclampsia Preeclampsia plus seizure activity from lack of perfusion to brain Eclampsia management Emergency response team, patient on side, airway, IV access, magnesium sulfate, prepare for delivery, emergency seizure meds possible Eclampsia meds Magnesium sulfate: Seizure meds: Post seizure management O2 10 L/min non-rebreather, suction, BP, P, RR Q5 min, continuous FHR, O2, LOC Q15 min for 1 hour post
Progesterone Establishes placenta, maintains uterine health, prevents contractions Estrogen Hormone promotes blood vessel, maintains uterine lining, fetal organ development Prolactin Hormone for breast growth and milk prod Relaxin Hormone for uterine relaxation, cervical softening, maternal vasodilation Oxytocin (Pitocin) Hormone, stimulates uterine contractions release of prostaglandin
Foods to avoid in pregnancy Alcohol, fish/high mercury, raw or unpasteurized products Physical changes during pregnancy: CV and blood Increased blood volume, increased HR, increased clotting factor and clot risk. Decreased per vascular resistance, BP, hematocrit values, blood viscosity Physical changes in pregnancy: Uterus Increased blood flow, hyperplasia and hypertrophy, change size, shape, position, Braxton hicks contractions may start around 16 wks Fundal height Measured in cm from top of pubis to top of fundus, should approximately correlate to gestational age (20 cm=20wks) More than 2 cm discrepancy warrants further investigation Changes in pregnancy: Cervix and vagina
Positive: Fetal HR, movement, ultrasound. Confirms presence without doubt. Initial Prenatal Assessment Full PMH and Obstetrics, GTPAL, full head to toe, possible pap, fetal assessment depending on gestation, psychosocial check in, prenatal labs, UA, Rh test, educate on trimesters, how often to schedule. Prenatal care counseling, folic acid Naegele's Rule Calculates birth, take first day last menstrual cycle, add one year, minus three months, plus one week. Not exact science, guesstimate preeclampsia risk factors family hx, nulliparity, multiple gestation, >35 y/o, BMI >30, pre-existing HTN, DM, CKD, IVF How long to monitor for s/s HELLP and eclampsia PP if preeclampsia present
at least 72 hours Cervical Insufficiency (Incompetent Cervix) Premature dilation of cervix. Can lead to preterm birth and fetal death. Cervical Insufficiency (Incompetent Cervix) S&S Increased pelvic pressure, bleeding, pink tinged discharge, gush of fluid (very bad), cervical dilation cervical insufficiency diagnosis Transvaginal ultrasound cervical insufficiency treatment Cerclage at 12-14wks, removed 36-38wks Bedrest, pelvic rest, no sex Possible hospitalization
Placenta previa treatment IV fluids, blood products PRN, possible corticosteroids for infant lung maturation Placental abruption (Abruptio placenta) Separation of placenta from uterine wall prematurely post 20 wks HIGH RISK MATERNAL FETAL MORTALITY, fetal ischemia, maternal hemorrhage and shock leading to death Placental abruption S&S Dark red vaginal bleeding, severe abdominal pain, rigid/boardlike abdomen s/s hypovolemic shock (tachypnea, pallor, low BP) placental abruption risk factors Smoking, maternal HTN, trauma (MVA), multiparity, stimulant use
Placental abruption treatment Emergency C Section, hemmorhagic shock treatment (IV fluids, blood products) Avoid vaginal exams HELLP syndrome hemolysis, elevated liver enzymes, low platelets Very serious, HELLP S&S epigastric, RUQ pain, elevated ALT, AST, thrombocytopenia, low platelet HELLP treatment Antihypertensives: Hydralazine, Labetalol OK in pregnancy. ACE inhibitors and ARBs contraindicated pregnancy. Magnesium sulfate: Assess resp status Magnesium sulfate antidote
Infant: meningitis, pneumonia, sepsis Amniotic fluid abnormalities polyhydramnios, oligohydramnios, chorioamnioitis polyhydramnios Excessive amniotic fluid polyhydramnios risk factors gestational DM, fetal congenital abnormalities, polyhydramnios treatment amniocentisis oligohydramnios decreased amniotic fluid
oligohydramnios risk factors PROM, placental insufficiency, GU fetal abnormality chorioamnionitis infection of chorion and amnion chorioamnioitis risk factors UTI, STI, chorioamnioitis S&S malodorous, fever, unusual discharge, uterine pain chorioamnionitis treatment antibiotics Oxytocin (Pitocin) Med Information
Marked: amplitude range >25 BPM FHR accelerations increase in FHR onset to peak under 30 sec. Can be periodic or episodic. Nonstress Test (NST) Looks for FHR acceleration. Considered reactive when at least 2 accelerations in 20 min period w/ moderate variability and no decelerations. Early deceleration Temporary/periodic, correspond to contraction, Benign, caused by vasovagal response from fetal head compression. Typically resolves as contraction ends/pressure resolves Occurs usually in active labor Late decelerations
Appear later, after onset and nadir of contraction. Reflex or nonreflex. Reflex= FHR variability nonreflex= diminished or absent variability. Typically caused by Uteroplacental Insufficiency, MAY LEAD TO IMPAIRED OXYGEN TRANSFER Causes of uteroplacental insufficiency (UPI) uterine hyperactivity, parental hypotension, parental HTN, placental abruption, placenta previa, IUGR, parental DM, chorioamnionitis, postterm gestation, parental anemia, parental cardiac disease, parental smoking Fetal tachycardia causes parental fever, chorioamnioitis, fetal sepsis, stimulants or other drugs, fetal hypoxemia, tachyarrythmia, fetal heart failure, severe fetal anemia, parental hyperthyroidism Prolonged deceleration Deceleration 15 or more BPM lasting between 2 and 10 mins associated w hypoxia
Stage 1 3 Phases Onset labor to full dilation Latent : excited, talkative, minimal pain, 0-3cm dilation Active: 4-7cm dilation, stronger contractions, anxiety, apprehensive Transition: 8-10cm dilation, strong urge to push/BM, verbalized fear "I can't do this/take this" Almost there Stage 2 Full dilation to baby birth Stage 3 Baby to placenta Stage 4 Placenta birth to stabilized
Effacement Thinning of cervix, 0-100% Dilation Widening of open to cervix, 0-10cm Intrapartum onset of labor to newborn delivery Main force for delivery caused by uterine contraction three layers of uterus perimetrium, myometrium, endometrium myometrium can do what contract due to oxytocin
