maternity exam 2 verified questions with answers all graded A+, Exams of Obstetrics

Download maternity exam 2 verified questions with answers all graded A+ and more Exams Obstetrics in PDF only on Docsity! 1 / 11 maternity exam 2 verified questions with answers all graded A+ 1.Occipital posterior vertex is a fetal presentation that causes: -Severe back pain in the mother - Feels contractions in the back -Difficult to labor (3-4 hrs) *sunny side up position* 2.How do we correct occipital bone vertex?: Reposition mother 3.What is a breech fetal lie presentation: A breech presentation occurs when the fetal buttocks or feet enter the maternal pelvis first and the fetal skull enters last. 4.Proper fetal presentation: Cephalic (vertex) "looking at mom's butt" 5.When palpating a mother's belly, you should feel , if a is felt it can indicate a breech presenation.: baby's butt, head which will feel soft and irregular 6.When feeling buttocks they should feel , which indicates vertex pre- sentation.: soft and irregular -Head will feel hard & round 7.When baby is facing correct way contractions are felt ?: in stomach 8.What are the labs needed for epidural?: Platelets (150k-450k) - Give one liter of fluid before epidural to combat maternal hypotension 9.After cm dilation, we do not give mother as pain medication, we should give in order to prevent respiratory depression of baby.: 6cm; morphine; epidural 2 / 11 10.When mother is suspected of suffering from , we never leave the newborn alone with the mother: postpartum psychosis 11.Babies born under 36 weeks gestation require a , where they are placed in the with a , to prevent the death of the baby after discharge.: car seat challenge; car seat; pulse oximeter 12.What is baby blues?: Mild depressive symptoms, anxiety, irritability, mood swing 13.When do symptoms of baby blues usually begin?: symptoms usually begin 2-4 days after birth & and resolve by the 8th day PEAK on day 4 and 5! RESOLVE BY DAY 8-10 14.What are Baby blues usually resolved with?: restorative sleep 15.symptoms of postpartum blues: irritability, anxiety, crying, loss of appetite, sadness, mood swings, fearfulness, fatigue, increased sensitivity. 16.After vaginal delivery when is a follow up required?: 6 weeks 17.Postpartum depression and psychosis may lead to...: 1. poor bonding 2.alienation from loved ones 3.daily dysfunction 4.violent thoughts and actions 18. In and symptoms last longer and present more severe: - Postpartum depression; postpartum psychosis 5 / 11 separation of abdominal walls?: hernias 35.How is engorgement relieved if breast feeding?: Frequent emptying, warm showers, and compresses BEFORE feeding, and cold compressions BETWEEN feeding 36.Engorgement: Process of swelling of the breast tissue due to an increase in blood and lymph supply as a precursor to lactation 37.How is engorgement relieved if not breast feeding?: Tight supportive bra, ice, & AVOIDANCE OF BREAST STIMULATION !! 38.What preventative measures would we teach non breast feeding mother who is suffering from engorgements?: GIVE BACK TO SHOWER & NO SEX - anything that stimulates breast= milk leakage 39.Non-lactating women return of menstruation is typically: 7-9 weeks after birth 40.Lactating women return of menstruation is typically: 2-18 months - depending on frequency and duration of breast feeding 41.Oral contraceptives that have should only be utilized for breast- feeding mothers.: progestrone 42.First Stage of Becoming A Mother (BAM): Commitment, attachment to unborn baby, preparation for delivery, and motherhood during pregnancy *figuring out birth plan* 43.Second Stage of Becoming A Mother (BAM): Acquaintance/attachment to the infant, learning to care for the infant, and physical restoration 2 6 / 11 to 6 weeks postbirth *bonding time with the baby* 44.Third Stage of Becoming A Mother (BAM): Moving toward a new normal - if first baby how do I go to run errands with my baby? - if third baby, how does baby fit in? 45.Fourth Stage of Becoming A Mother (BAM): Achievement of a maternal identity through redefining self to incorporate motherhood (around 4 months) 46.5 p's affecting labor: 1. Passageway (birth canal: pelvis and soft tissues) 2.Passenger (fetus and placenta) 3.Powers (contractions) 4.Position (maternal)- need to move, can't deliver laying down 5.Psychological response- scared labor wont be smooth 47.What determines success of vaginal delivery?: Shape of pelvis 48.Passageway for delivering baby: starts in false pelvis then goes to true 49.Pelvic shape favorable for vaginal delivery: gynecoid 50.Pelvic shape not favorable for vaginal delivery: Platypelloid 51.why is a platypelloid pelvis not favorable for vaginal birth: The shape of the platypelloid pelvis can make a vaginal birth difficult bc the baby may have trouble passing through the pelvic inlet. *may need C-section* 52.Most favorable fetal position/attitude: all joints flexed—the fetal back is 7 / 11 round- ed, the chin is on the chest, the thighs are flexed on the abdomen, and the legs are flexed at the knees 53.If we do not feel the we need to change ?: fontanelles; method of delivery 54.Cardinal movements of labor: 1. Engagement 2.Descent 3.Flexion 4.Internal Rotation 5.Extension 6.Restitution (External Rotation) 7.Expulsion 55.Fetal station: Against the ischial spine is what we want to see - labor down if the station is too high up (at 0) 56.Molding: The changed (elongated) shape of the fetal skull at birth as a result of overlapping of the cranial bones 57.What's a result of not achieving plus fetal positions and no cardinal move- ments of labor ?: shoulder dystocia 58.Signs of placental separation: 1. The uterus rises upward 2.The umbilical cord lengthens 3.A sudden trickle of blood is released from the vaginal opening 4.The uterus changes its shape to globular 59.With placenta separation what must nurse document?: Time the placenta comes out; the provider must look at it and make sure it is intact to know all pieces came out 60.Fetal physiologic responses to labor: -Periodic FHR accelerations and 10 / 80.Post mature week gestation:: After week 42 (with signs of placental aging) 81.Term weeks gestation:: 38-42 wks 82.post term or post dates weeks gestation:: After 42 wks 83.caput succedaneum: localized edema on the scalp that occurs from the pres- sure of the birth process. It is commonly observed after prolonged labor. Appears as a poorly demarcated soft tissue swelling that crosses suture lines 84.Cephalhematoma: a localized subperiosteal collection of blood of the skull which is always confined by one cranial bone. This condition is due to pressure on the head and disruption of the vessels during birth. 85.It occurs after prolonged labor and use of obstetric interventions such as low forceps or vacuum extraction: Cephalhematoma 86.Baby meds administered: 1. Vitamin K- For clotting 2. Erythromycin- abx to prevent eye infection 87.Cephalhematoma increases the risk for: Hyperbilirubinemia occurs following the breakdown of the red blood cells within the hematoma. *jaundice* 88.Circumcision care: 1. Must be at least 12 hrs old 2.Vitamin K must be given & baby must have voided 3.Use soapy watery over the area/pat dry 4.Petroleum jelly w/ each diaper change 5.Fasten diaper loosely, avoid putting on stomach to avoid friction 11 / 89.Sore nipples means: improper feeding 90.How do you ensure proper latch ?: Hearing audible swallowing 91.Why does insulin requirements drop after delivery of fetus?: There is no placenta 92.Lactation is the result of interaction of: estrogen, progesterone, prolactin, and oxytocin. 93.When does lactation begin?: 4-5 days after birth 94.Factors that influence attachment: -environmental circumstances -newborn health -quality of nursing care 95.Lochia: the postpartum vaginal discharge that typically continues for 4-6 weeks after childbirth 96.Rubra lochia: 3- 4 days postpartum color; dark red 97.Serosa lochia: birth to 3-10 days postpartum color; blood tinged pink/brown 98.Alba lochia: birth to 10-14 days postpartum color: yellow, cream 99.Thins through effacement to allow presenting part to descend into vagina- : Cervix 100. If pad is heavily saturated with lochia within the hr...: need to figure out what's going on 101. True pelvis: below linea terminalis 102. Linea terminalis: division of false and true pelvis 12 / 103. False pelvis: above linea terminalis 104. fontanelles: Intersections of sutures; help in identifying position of fetal head and in molding 105. After pains: It's a postpartum reproductive system adaptation where oxytocin suppresses uterus causing after pain (esp in breast feeding mothers) 106. Largest and least compressible structure: fetal skull 107. Allow for overlapping and changes in shape (molding); help identify position of fetal head: sutures 108. Feeling the fontanelle when baby is coming out, is ideal to ensure difficult free delivery.: posterior *feeling fontanelles determine where baby is going to be faced for delivery* - "face to mamis butt" 109. Boggy fundus could mean: Postpartum hemorrhage (PPH) 110. Attachment: Development of a strong affection between an infant and a sig- nificant other (mother, father, sibling, caregiver) 111. Bonding: Close emotional attraction to a newborn by the parents that 112. Develops the first 30 to 60 minutes after birth and unidirectional, from parent to infant: Bonding 113. First degree lacerations: Perineal skin and vaginal mucous membranes torn 114. Second degree laceration: Includes above plus the fascia and 15 / 130. during vaginal exam and 48 hrs after sex is normal: Bleeding 131. Guidelines for assessing FHR intermittently: 1. Initial 10-20 mins of contin- uous FHR assessment on admission 2.Completion of a prenatal and labor risk assessments on all clients 3.Intermittent auscultation every 30 minutes during active labor for low-risk women and every 15 minutes for high-risk women 4.During second stage of labor intermittent auscultation every 15 minutes for low-risk women and every 5 minutes for high-risk women 132. Uterine Resuscitation steps: C Change maternal position ex: if on her back turn to left side C Provide supplemental oxygen if indicated C Give IV bolus for late decelerations or Amnioinfusion for variable decelerations Correct maternal blood pressure: did she just get an epidural? C Reduce uterine activity C Alter second stage pushing efforts 133. How do you treat late decelerations?: give iv fluid to hydrate placenta 134. How do you treat variable decelerations?: amnioinfusion 135. What does a varible decel indicate: cord compression 136. What does a uterine contraction decel indicate: issue is placenta 137. FHR variability: 1. Absent=fluctuation range undetectable 2.Minimal= fluctuation range observed at <5bpm 16 / 3.Moderate= fluctuation range from 6-25bpm 4.Marked fluctuation range >25bpm 138. Marked fluctuation range >25bpm means: cord compression 139. Minimal= fluctuation range observed at <5bpm: Morphine to mommy= mor- phine to baby so possible IV pain med was given. Can mean 4 S's 1.Sleep 2.Sick 3.Sedate d 4. After 20-40 mins we will worry! 140. What is the worst FHR category?: Category III: abnormal 141. Nursing management third stage: 1. Interventions with birth 2.Cleansing of perineal area and vulva 3.Assisting with birth, suctioning of newborn, and umbilical cord clamping 4.Providing immediate care of newborn 5.Drying 6.Apgar score ~ Identification 142. Bladder needs to be empty for : Fundus to descend 143. At 20 weeks fundus should be: At the level of the umbilicus 144. Care for Newborn receiving phototherapy: 1. Monitor body temp 2.Document stools 3.Document wet diapers 17 / 4.Turn frequently 5.Observe skin integrity 5.Provide eye protection 6.Encourage parents to participate 145. 5's to consoling a baby: Swaddling Sitting stomach on mommy lap Shushing loudly/white noise Swinging Sucking (breast) no pacifier for breastfed baby until after 2 month 146. Baby needs to void: within 24 hrs of birth (meconium) *6-8 voids a day* 147. Breast feeding for= babies less likely to get sick: 6 months 148. Heat loss for newborns: 1. Thin skin; with the blood vessels close to the surface 2.Lack of shivering ability; limited reserve of metabolic substrates (glucose, glyco- gen, fat) 3.Limited use of voluntary muscle activity 4.Large body surface area relative to body weight 5.Lock of subcutaneous fat; little ability to conserve heat by changing position 6.No ability to adjust own clothing or blankets to get warm 7.Infants cannot communicate that they are too cold or too warm