1. During the first hour after birth (the period
of reactivity), the neonate is alert and awake.
2. When a pregnant patient has undiagnosed
vaginal bleeding, vaginal examination should be avoided until ultrasonography
rules out placenta previa.
3. After delivery, the first nursing action is to
establish the neonate’s airway.
4. Nursing interventions for a patient with
placenta previa include positioning the patient on her left side for maximum
fetal perfusion, monitoring fetal heart tones, and administering I.V. fluids
and oxygen, as ordered.
5. The specific gravity of a neonate’s urine is
1.003 to 1.030. A lower specific gravity suggests overhydration; a higher one
suggests dehydration.
6. The neonatal period extends from birth to day
28. It’s also called the first 4 weeks or first month of life.
7. A woman who is breast-feeding should rub a
mild emollient cream or a few drops of breast milk (or colostrum) on the
nipples after each feeding. She should let the breasts air-dry to prevent them
from cracking.
8. Breast-feeding mothers should increase their
fluid intake to 2½ to 3 qt (2,500 to 3,000 ml) daily.
9. After feeding an infant with a cleft lip or
palate, the nurse should rinse the infant’s mouth with sterile water.
10. The nurse instills erythromycin in a neonate’s
eyes primarily to prevent blindness caused by gonorrhea or chlamydia.
11. Human immunodeficiency virus (HIV) has been
cultured in breast milk and can be transmitted by an HIV-positive mother who
breast-feeds her infant.
12. A fever in the first 24 hours postpartum is
most likely caused by dehydration rather than infection.
13. Preterm neonates or neonates who can’t
maintain a skin temperature of at least 97.6° F (36.4° C) should receive care
in an incubator (Isolette) or a radiant warmer. In a radiant warmer, a
heat-sensitive probe taped to the neonate’s skin activates the heater unit
automatically to maintain the desired temperature.
14. During labor, the resting phase between
contractions is at least 30 seconds.
15. Lochia rubra is the vaginal discharge of
almost pure blood that occurs during the first few days after childbirth.
16. Lochia serosa is the serous vaginal discharge
that occurs 4 to 7 days after childbirth.
17. Lochia alba is the vaginal discharge of
decreased blood and increased leukocytes that’s the final stage of lochia. It
occurs 7 to 10 days after childbirth.
18. Colostrum, the precursor of milk, is the first
secretion from the breasts after delivery.
19. The length of the uterus increases from 2½”
(6.3 cm) before pregnancy to 12½” (32 cm) at term.
20. To estimate the true conjugate (the smallest
inlet measurement of the pelvis), deduct 1.5 cm from the diagonal conjugate
(usually 12 cm). A true conjugate of 10.5 cm enables the fetal head (usually 10
cm) to pass.
21. The smallest outlet measurement of the pelvis
is the intertuberous diameter, which is the transverse diameter between the
ischial tuberosities.
22. Electronic fetal monitoring is used to assess
fetal well-being during labor. If compromised fetal status is suspected, fetal
blood pH may be evaluated by obtaining a scalp sample.
23. In an emergency delivery, enough pressure
should be applied to the emerging fetus’s head to guide the descent and prevent
a rapid change in pressure within the molded fetal skull.
24. After delivery, a multiparous woman is more
susceptible to bleeding than a primiparous woman because her uterine muscles
may be overstretched and may not contract efficiently.
25. Neonates who are delivered by cesarean birth
have a higher incidence of respiratory distress syndrome.
26. The nurse should suggest ambulation to a
postpartum patient who has gas pain and flatulence.
27. Massaging the uterus helps to stimulate
contractions after the placenta is delivered.
28. When providing phototherapy to a neonate, the
nurse should cover the neonate’s eyes and genital area.
29. The narcotic antagonist naloxone (Narcan) may
be given to a neonate to correct respiratory depression caused by narcotic
administration to the mother during labor.
30. In a neonate, symptoms of respiratory distress
syndrome include expiratory grunting or whining, sandpaper breath sounds, and
seesaw retractions.
31. Cerebral palsy presents as asymmetrical
movement, irritability, and excessive, feeble crying in a long, thin infant.
32. The nurse should assess a breech-birth neonate
for hydrocephalus, hematomas, fractures, and other anomalies caused by birth
trauma.
33. When a patient is admitted to the unit in
active labor, the nurse’s first action is to listen for fetal heart tones.
34. In a neonate, long, brittle fingernails are a
sign of postmaturity.
35. Desquamation (skin peeling) is common in
postmature neonates.
36. A mother should allow her infant to
breast-feed until the infant is satisfied. The time may vary from 5 to 20
minutes.
37. Nitrazine paper is used to test the pH of
vaginal discharge to determine the presence of amniotic fluid.
38. A pregnant patient normally gains 2 to 5 lb (1
to 2.5 kg) during the first trimester and slightly less than 1 lb (0.5 kg) per
week during the last two trimesters.
39. Neonatal jaundice in the first 24 hours after
birth is known as pathological jaundice and is a sign of erythroblastosis
fetalis.
40. A classic difference between abruptio
placentae and placenta previa is the degree of pain. Abruptio placentae causes
pain, whereas placenta previa causes painless bleeding.
41. Because a major role of the placenta is to
function as a fetal lung, any condition that interrupts normal blood flow to or
from the placenta increases fetal partial pressure of arterial carbon dioxide
and decreases fetal pH.
42. Precipitate labor lasts for approximately 3
hours and ends with delivery of the neonate.
43. Methylergonovine (Methergine) is an oxytocic
agent used to prevent and treat postpartum hemorrhage caused by uterine atony
or subinvolution.
44. As emergency treatment for excessive uterine
bleeding, 0.2 mg of methylergonovine (Methergine) is injected I.V. over 1
minute while the patient’s blood pressure and uterine contractions are
monitored.
45. Braxton Hicks contractions are usually felt in
the abdomen and don’t cause cervical change. True labor contractions are felt
in the front of the abdomen and back and lead to progressive cervical dilation
and effacement.
46. The average birth weight of neonates born to
mothers who smoke is 6 oz (170 g) less than that of neonates born to nonsmoking
mothers.
47. Culdoscopy is visualization of the pelvic
organs through the posterior vaginal fornix.
48. The nurse should teach a pregnant vegetarian
to obtain protein from alternative sources, such as nuts, soybeans, and
legumes.
49. The nurse should instruct a pregnant patient
to take only prescribed prenatal vitamins because over-the-counter high-potency
vitamins may harm the fetus.
50. High-sodium foods can cause fluid retention,
especially in pregnant patients.
51. A pregnant patient can avoid constipation and
hemorrhoids by adding fiber to her diet.
52. If a fetus has late decelerations (a sign of
fetal hypoxia), the nurse should instruct the mother to lie on her left side
and then administer 8 to 10 L of oxygen per minute by mask or cannula. The
nurse should notify the physician. The side-lying position removes pressure on
the inferior vena cava.
53. Oxytocin (Pitocin) promotes lactation and
uterine contractions.
54. Lanugo covers the fetus’s body until about 20
weeks’ gestation. Then it begins to disappear from the face, trunk, arms, and
legs, in that order.
55. In a neonate, hypoglycemia causes temperature
instability, hypotonia, jitteriness, and seizures. Premature, postmature,
small-for-gestational-age, and large-for-gestational-age neonates are susceptible
to this disorder.
56. Neonates typically need to consume 50 to 55
cal per pound of body weight daily.
57. Because oxytocin (Pitocin) stimulates powerful
uterine contractions during labor, it must be administered under close
observation to help prevent maternal and fetal distress.
58. During fetal heart rate monitoring, variable
decelerations indicate compression or prolapse of the umbilical cord.
59. Cytomegalovirus is the leading cause of
congenital viral infection.
60. Tocolytic therapy is indicated in premature
labor, but contraindicated in fetal death, fetal distress, or severe
hemorrhage.
61. Through ultrasonography, the biophysical
profile assesses fetal well-being by measuring fetal breathing movements, gross
body movements, fetal tone, reactive fetal heart rate (nonstress test), and
qualitative amniotic fluid volume.
62. A neonate whose mother has diabetes should be
assessed for hyperinsulinism.
63. In a patient with preeclampsia, epigastric
pain is a late symptom and requires immediate medical intervention.
64. After a stillbirth, the mother should be
allowed to hold the neonate to help her come to terms with the death.
65. Molding is the process by which the fetal head
changes shape to facilitate movement through the birth canal.
66. If a woman receives a spinal block before
delivery, the nurse should monitor the patient’s blood pressure closely.
67. If a woman suddenly becomes hypotensive during
labor, the nurse should increase the infusion rate of I.V. fluids as
prescribed.
68. The best technique for assessing jaundice in a
neonate is to blanch the tip of the nose or the area just above the umbilicus.
69. During fetal heart monitoring, early
deceleration is caused by compression of the head during labor.
70. After the placenta is delivered, the nurse may
add oxytocin (Pitocin) to the patient’s I.V. solution, as prescribed, to
promote postpartum involution of the uterus and stimulate lactation.
71. Pica is a craving to eat nonfood items, such
as dirt, crayons, chalk, glue, starch, or hair. It may occur during pregnancy
and can endanger the fetus.
72. A pregnant patient should take folic acid
because this nutrient is required for rapid cell division.
73. A woman who is taking clomiphene (Clomid) to
induce ovulation should be informed of the possibility of multiple births with
this drug.
74. If needed, cervical suturing is usually done
between 14 and 18 weeks’ gestation to reinforce an incompetent cervix and
maintain pregnancy. The suturing is typically removed by 35 weeks’ gestation.
During the first trimester, a pregnant woman should avoid all drugs unless doing so would adversely affect her health.
During the first trimester, a pregnant woman should avoid all drugs unless doing so would adversely affect her health.
75. Most drugs that a breast-feeding mother takes
appear in breast milk.
76. The Food and Drug Administration has
established the following five categories of drugs based on their potential for
causing birth defects: A, no evidence of risk; B, no risk found in animals, but
no studies have been done in women; C, animal studies have shown an adverse
effect, but the drug may be beneficial to women despite the potential risk; D,
evidence of risk, but its benefits may outweigh its risks; and X, fetal
anomalies noted, and the risks clearly outweigh the potential benefits.
77. A patient with a ruptured ectopic pregnancy
commonly has sharp pain in the lower abdomen, with spotting and cramping. She
may have abdominal rigidity; rapid, shallow respirations; tachycardia; and
shock.
78. A patient with a ruptured ectopic pregnancy
commonly has sharp pain in the lower abdomen, with spotting and cramping. She
may have abdominal rigidity; rapid, shallow respirations; tachycardia; and
shock.
79. The mechanics of delivery are engagement,
descent and flexion, internal rotation, extension, external rotation, restitution,
and expulsion.
80. A probable sign of pregnancy, McDonald’s sign
is characterized by an ease in flexing the body of the uterus against the
cervix.
81. Amenorrhea is a probable sign of pregnancy.
82. A pregnant woman’s partner should avoid
introducing air into the vagina during oral sex because of the possibility of
air embolism.
83. The presence of human chorionic gonadotropin
in the blood or urine is a probable sign of pregnancy.
Radiography isn’t usually used in a pregnant woman because it may harm the developing fetus. If radiography is essential, it should be performed only after 36 weeks’ gestation.
Radiography isn’t usually used in a pregnant woman because it may harm the developing fetus. If radiography is essential, it should be performed only after 36 weeks’ gestation.
84. A pregnant patient who has had rupture of the
membranes or who is experiencing vaginal bleeding shouldn’t engage in sexual
intercourse.
85. Milia may occur as pinpoint spots over a
neonate’s nose.
86. The duration of a contraction is timed from
the moment that the uterine muscle begins to tense to the moment that it
reaches full relaxation. It’s measured in seconds.
87. The union of a male and a female gamete
produces a zygote, which divides into the fertilized ovum.
88. The first menstrual flow is called menarche
and may be anovulatory (infertile).
89. Spermatozoa (or their fragments) remain in the
vagina for 72 hours after sexual intercourse.
90. Prolactin stimulates and sustains milk production.
91. Strabismus is a normal finding in a neonate.
92. A postpartum patient may resume sexual
intercourse after the perineal or uterine wounds heal (usually within 4 weeks
after delivery).
93. A pregnant staff member shouldn’t be assigned
to work with a patient who has cytomegalovirus infection because the virus can
be transmitted to the fetus.
94. Fetal demise is death of the fetus after
viability.
95. Respiratory distress syndrome develops in
premature neonates because their alveoli lack surfactant.
96. The most common method of inducing labor after
artificial rupture of the membranes is oxytocin (Pitocin) infusion.
97. After the amniotic membranes rupture, the
initial nursing action is to assess the fetal heart rate.
98. The most common reasons for cesarean birth are
malpresentation, fetal distress, cephalopelvic disproportion, pregnancy-induced
hypertension, previous cesarean birth, and inadequate progress in labor.
99. Amniocentesis increases the risk of
spontaneous abortion, trauma to the fetus or placenta, premature labor,
infection, and Rh sensitization of the fetus.
100.
After amniocentesis,
abdominal cramping or spontaneous vaginal bleeding may indicate complications.
101.
To prevent her from
developing Rh antibodies, an Rh-negative primigravida should receive Rho(D)
immune globulin (RhoGAM) after delivering an Rh-positive neonate.
102.
If a pregnant
patient’s test results are negative for glucose but positive for acetone, the
nurse should assess the patient’s diet for inadequate caloric intake.
103.
If a pregnant
patient’s test results are negative for glucose but positive for acetone, the
nurse should assess the patient’s diet for inadequate caloric intake.
104.
Rubella infection in a
pregnant patient, especially during the first trimester, can lead to spontaneous
abortion or stillbirth as well as fetal cardiac and other birth defects.
105.
A pregnant patient
should take an iron supplement to help prevent anemia.
106.
Direct antiglobulin
(direct Coombs’) test is used to detect maternal antibodies attached to red blood
cells in the neonate.
107.
Nausea and vomiting
during the first trimester of pregnancy are caused by rising levels of the
hormone human chorionic gonadotropin.
108.
Before discharging a
patient who has had an abortion, the nurse should instruct her to report bright
red clots, bleeding that lasts longer than 7 days, or signs of infection, such
as a temperature of greater than 100° F (37.8° C), foul-smelling vaginal
discharge, severe uterine cramping, nausea, or vomiting.
109.
When informed that a
patient’s amniotic membrane has broken, the nurse should check fetal heart
tones and then maternal vital signs.
110.
The duration of
pregnancy averages 280 days, 40 weeks, 9 calendar months, or 10 lunar months.
111.
The initial weight
loss for a healthy neonate is 5% to 10% of birth weight.
112.
The normal hemoglobin
value in neonates is 17 to 20 g/dl.
113.
Crowning is the
appearance of the fetus’s head when its largest diameter is encircled by the
vulvovaginal ring.
114.
A multipara is a woman
who has had two or more pregnancies that progressed to viability, regardless of
whether the offspring were alive at birth.
115.
In a pregnant patient,
preeclampsia may progress to eclampsia, which is characterized by seizures and
may lead to coma.
116.
The Apgar score is
used to assess the neonate’s vital functions. It’s obtained at 1 minute and 5
minutes after delivery. The score is based on respiratory effort, heart rate,
muscle tone, reflex irritability, and color.
117.
Because of the
anti-insulin effects of placental hormones, insulin requirements increase
during the third trimester.
118.
Gestational age can be
estimated by ultrasound measurement of maternal abdominal circumference, fetal
femur length, and fetal head size. These measurements are most accurate between
12 and 18 weeks’ gestation.
119.
Skeletal system
abnormalities and ventricular septal defects are the most common disorders of
infants who are born to diabetic women. The incidence of congenital
malformation is three times higher in these infants than in those born to
nondiabetic women.
120.
Skeletal system
abnormalities and ventricular septal defects are the most common disorders of
infants who are born to diabetic women. The incidence of congenital
malformation is three times higher in these infants than in those born to
nondiabetic women.
121.
The patient with
preeclampsia usually has puffiness around the eyes or edema in the hands (for
example, “I can’t put my wedding ring on.”).
122.
Kegel exercises
require contraction and relaxation of the perineal muscles. These exercises
help strengthen pelvic muscles and improve urine control in postpartum
patients.
123.
Symptoms of postpartum
depression range from mild postpartum blues to intense, suicidal, depressive
psychosis.
124.
The preterm neonate
may require gavage feedings because of a weak sucking reflex, uncoordinated
sucking, or respiratory distress.
125.
Acrocyanosis (blueness
and coolness of the arms and legs) is normal in neonates because of their
immature peripheral circulatory system.
126.
To prevent ophthalmia
neonatorum (a severe eye infection caused by maternal gonorrhea), the nurse may
administer one of three drugs, as prescribed, in the neonate’s eyes:
tetracycline, silver nitrate, or erythromycin.
Neonatal testing for phenylketonuria is mandatory in most states.
Neonatal testing for phenylketonuria is mandatory in most states.
127.
The nurse should place
the neonate in a 30-degree Trendelenburg position to facilitate mucus drainage.
128.
The nurse may suction
the neonate’s nose and mouth as needed with a bulb syringe or suction trap.
129.
To prevent heat loss,
the nurse should place the neonate under a radiant warmer during suctioning and
initial delivery-room care, and then wrap the neonate in a warmed blanket for
transport to the nursery.
130.
The umbilical cord
normally has two arteries and one vein.
131.
When providing care,
the nurse should expose only one part of an infant’s body at a time.
132.
Lightening is settling
of the fetal head into the brim of the pelvis.
133.
If the neonate is
stable, the mother should be allowed to breast-feed within the neonate’s first
hour of life.
134.
The nurse should check
the neonate’s temperature every 1 to 2 hours until it’s maintained within
normal limits.
At birth, a neonate normally weighs 5 to 9 lb (2 to 4 kg), measures 18″ to 22″ (45.5 to 56 cm) in length, has a head circumference of 13½” to 14″ (34 to 35.5 cm), and has a chest circumference that’s 1″ (2.5 cm) less than the head circumference.
At birth, a neonate normally weighs 5 to 9 lb (2 to 4 kg), measures 18″ to 22″ (45.5 to 56 cm) in length, has a head circumference of 13½” to 14″ (34 to 35.5 cm), and has a chest circumference that’s 1″ (2.5 cm) less than the head circumference.
135.
In the neonate,
temperature normally ranges from 98° to 99° F (36.7° to 37.2° C), apical pulse
rate averages 120 to 160 beats/minute, and respirations are 40 to 60
breaths/minute.
136.
The diamond-shaped
anterior fontanel usually closes between ages 12 and 18 months. The triangular
posterior fontanel usually closes by age 2 months.
137.
In the neonate, a
straight spine is normal. A tuft of hair over the spine is an abnormal finding.
138.
Prostaglandin gel may
be applied to the vagina or cervix to ripen an unfavorable cervix before labor
induction with oxytocin (Pitocin).
139.
Supernumerary nipples
are occasionally seen on neonates. They usually appear along a line that runs
from each axilla, through the normal nipple area, and to the groin.
140.
Meconium is a material
that collects in the fetus’s intestines and forms the neonate’s first feces,
which are black and tarry.
141.
The presence of
meconium in the amniotic fluid during labor indicates possible fetal distress
and the need to evaluate the neonate for meconium aspiration.
142.
To assess a neonate’s
rooting reflex, the nurse touches a finger to the cheek or the corner of the
mouth. Normally, the neonate turns his head toward the stimulus, opens his
mouth, and searches for the stimulus.
143.
Harlequin sign is
present when a neonate who is lying on his side appears red on the dependent
side and pale on the upper side.
144.
Mongolian spots can
range from brown to blue. Their color depends on how close melanocytes are to
the surface of the skin. They most commonly appear as patches across the
sacrum, buttocks, and legs.
145.
Mongolian spots are
common in non-white infants and usually disappear by age 2 to 3 years.
146.
Vernix caseosa is a cheeselike
substance that covers and protects the fetus’s skin in utero. It may be rubbed
into the neonate’s skin or washed away in one or two baths.
147.
Caput succedaneum is
edema that develops in and under the fetal scalp during labor and delivery. It
resolves spontaneously and presents no danger to the neonate. The edema doesn’t
cross the suture line.
148.
Nevus flammeus, or
port-wine stain, is a diffuse pink to dark bluish red lesion on a neonate’s
face or neck.
149.
The Guthrie test (a
screening test for phenylketonuria) is most reliable if it’s done between the
second and sixth days after birth and is performed after the neonate has
ingested protein.
150.
To assess coordination
of sucking and swallowing, the nurse should observe the neonate’s first
breast-feeding or sterile water bottle-feeding.
151.
To establish a milk
supply pattern, the mother should breast-feed her infant at least every 4
hours. During the first month, she should breast-feed 8 to 12 times daily
(demand feeding).
152.
To avoid contact with
blood and other body fluids, the nurse should wear gloves when handling the
neonate until after the first bath is given.
153.
If a breast-fed infant
is content, has good skin turgor, an adequate number of wet diapers, and normal
weight gain, the mother’s milk supply is assumed to be adequate.
154.
In the supine
position, a pregnant patient’s enlarged uterus impairs venous return from the
lower half of the body to the heart, resulting in supine hypotensive syndrome,
or inferior vena cava syndrome.
155.
Tocolytic agents used
to treat preterm labor include terbutaline (Brethine), ritodrine (Yutopar), and
magnesium sulfate.
156.
A pregnant woman who
has hyperemesis gravidarum may require hospitalization to treat dehydration and
starvation.
157.
Diaphragmatic hernia
is one of the most urgent neonatal surgical emergencies. By compressing and
displacing the lungs and heart, this disorder can cause respiratory distress
shortly after birth.
158.
Common complications
of early pregnancy (up to 20 weeks’ gestation) include fetal loss and serious
threats to maternal health.
159.
Fetal embodiment is a
maternal developmental task that occurs in the second trimester. During this
stage, the mother may complain that she never gets to sleep because the fetus
always gives her a thump when she tries.
160.
Visualization in
pregnancy is a process in which the mother imagines what the child she’s
carrying is like and becomes acquainted with it.
161.
Hemodilution of
pregnancy is the increase in blood volume that occurs during pregnancy. The
increased volume consists of plasma and causes an imbalance between the ratio
of red blood cells to plasma and a resultant decrease in hematocrit.
162.
Mean arterial pressure
of greater than 100 mm Hg after 20 weeks of pregnancy is considered
hypertension.
163.
The treatment for
supine hypotension syndrome (a condition that sometimes occurs in pregnancy) is
to have the patient lie on her left side.
164.
A contributing factor
in dependent edema in the pregnant patient is the increase of femoral venous
pressure from 10 mm Hg (normal) to 18 mm Hg (high).
165.
Hyperpigmentation of
the pregnant patient’s face, formerly called chloasma and now referred to as
melasma, fades after delivery.
166.
The hormone relaxin,
which is secreted first by the corpus luteum and later by the placenta, relaxes
the connective tissue and cartilage of the symphysis pubis and the sacroiliac
joint to facilitate passage of the fetus during delivery.
167.
Progesterone maintains
the integrity of the pregnancy by inhibiting uterine motility.
168.
Ladin’s sign, an early
indication of pregnancy, causes softening of a spot on the anterior portion of
the uterus, just above the uterocervical juncture.
169.
During pregnancy, the
abdominal line from the symphysis pubis to the umbilicus changes from linea
alba to linea nigra.
170.
In neonates, cold
stress affects the circulatory, regulatory, and respiratory systems.
171.
Obstetric data can be
described by using the F/TPAL system:
F/T: Full-term delivery at 38 weeks or longer
P: Preterm delivery between 20 and 37 weeks
A: Abortion or loss of fetus before 20 weeks
L: Number of children living (if a child has died, further explanation is needed to clarify the discrepancy in numbers).
F/T: Full-term delivery at 38 weeks or longer
P: Preterm delivery between 20 and 37 weeks
A: Abortion or loss of fetus before 20 weeks
L: Number of children living (if a child has died, further explanation is needed to clarify the discrepancy in numbers).
172.
Parity doesn’t refer
to the number of infants delivered, only the number of deliveries.
173.
Women who are carrying
more than one fetus should be encouraged to gain 35 to 45 lb (15.5 to 20.5 kg)
during pregnancy.
174.
The recommended amount
of iron supplement for the pregnant patient is 30 to 60 mg daily.
175.
Drinking six alcoholic
beverages a day or a single episode of binge drinking in the first trimester
can cause fetal alcohol syndrome.
Chorionic villus sampling is performed at 8 to 12 weeks of pregnancy for early identification of genetic defects.
Chorionic villus sampling is performed at 8 to 12 weeks of pregnancy for early identification of genetic defects.
176.
In percutaneous
umbilical blood sampling, a blood sample is obtained from the umbilical cord to
detect anemia, genetic defects, and blood incompatibility as well as to assess
the need for blood transfusions.
177.
The period between
contractions is referred to as the interval, or resting phase. During this
phase, the uterus and placenta fill with blood and allow for the exchange of
oxygen, carbon dioxide, and nutrients.
178.
In a patient who has
hypertonic contractions, the uterus doesn’t have an opportunity to relax and
there is no interval between contractions. As a result, the fetus may
experience hypoxia or rapid delivery may occur.
179.
Two qualities of the
myometrium are elasticity, which allows it to stretch yet maintain its tone,
and contractility, which allows it to shorten and lengthen in a synchronized
pattern.
180.
During crowning, the
presenting part of the fetus remains visible during the interval between
contractions.
181.
Uterine atony is
failure of the uterus to remain firmly contracted.
182.
The major cause of
uterine atony is a full bladder.
183.
If the mother wishes
to breast-feed, the neonate should be nursed as soon as possible after
delivery.
184.
A smacking sound, milk
dripping from the side of the mouth, and sucking noises all indicate improper
placement of the infant’s mouth over the nipple.
185.
Before feeding is
initiated, an infant should be burped to expel air from the stomach.
186.
Most authorities
strongly encourage the continuation of breast-feeding on both the affected and
the unaffected breast of patients with mastitis.
187.
Neonates are
nearsighted and focus on items that are held 10″ to 12″ (25 to 30.5 cm) away.
188.
In a neonate, low-set
ears are associated with chromosomal abnormalities such as Down syndrome.
189.
Meconium is usually
passed in the first 24 hours; however, passage may take up to 72 hours.
190.
Boys who are born with
hypospadias shouldn’t be circumcised at birth because the foreskin may be
needed for constructive surgery.
191.
In the neonate, the
normal blood glucose level is 45 to 90 mg/dl.
192.
Hepatitis B vaccine is
usually given within 48 hours of birth.
193.
Hepatitis B immune
globulin is usually given within 12 hours of birth.
194.
HELLP (hemolysis,
elevated liver enzymes, and low platelets) syndrome is an unusual variation of
pregnancy-induced hypertension.
195.
Maternal serum
alpha-fetoprotein is detectable at 7 weeks of gestation and peaks in the third
trimester. High levels detected between the 16th and 18th weeks are associated
with neural tube defects. Low levels are associated with Down syndrome.
196.
An arrest of descent
occurs when the fetus doesn’t descend through the pelvic cavity during labor.
It’s commonly associated with cephalopelvic disproportion, and cesarean
delivery may be required.
197.
A late sign of
preeclampsia is epigastric pain as a result of severe liver edema.
198.
In the patient with
preeclampsia, blood pressure returns to normal during the puerperal period.
199.
To obtain an estriol
level, urine is collected for 24 hours.
200.
An estriol level is
used to assess fetal well-being and maternal renal functioning as well as to
monitor a pregnancy that’s complicated by diabetes.
201.
A pregnant patient
with vaginal bleeding shouldn’t have a pelvic examination.
202.
In the early stages of
pregnancy, the finding of glucose in the urine may be related to the increased
shunting of glucose to the developing placenta, without a corresponding increase
in the reabsorption capability of the kidneys.
203.
A patient who has
premature rupture of the membranes is at significant risk for infection if
labor doesn’t begin within 24 hours.
204.
Infants of diabetic
mothers are susceptible to macrosomia as a result of increased insulin
production in the fetus.
205.
To prevent heat loss
in the neonate, the nurse should bathe one part of his body at a time and keep
the rest of the body covered.
206.
A patient who has a
cesarean delivery is at greater risk for infection than the patient who gives
birth vaginally.
207.
The occurrence of
thrush in the neonate is probably caused by contact with the organism during
delivery through the birth canal.
208.
The nurse should keep
the sac of meningomyelocele moist with normal saline solution.
209.
If fundal height is at
least 2 cm less than expected, the cause may be growth retardation, missed
abortion, transverse lie, or false pregnancy.
210.
Fundal height that
exceeds expectations by more than 2 cm may be caused by multiple gestation,
polyhydramnios, uterine myomata, or a large baby.
211.
A major developmental
task for a woman during the first trimester of pregnancy is accepting the
pregnancy.
212.
Unlike formula, breast
milk offers the benefit of maternal antibodies.
213.
Spontaneous rupture of
the membranes increases the risk of a prolapsed umbilical cord.
214.
A clinical
manifestation of a prolapsed umbilical cord is variable decelerations.
215.
During labor, to relieve
supine hypotension manifested by nausea and vomiting and paleness, turn the
patient on her left side.
216.
If the ovum is
fertilized by a spermatozoon carrying a Y chromosome, a male zygote is formed.
217.
Implantation occurs
when the cellular walls of the blastocyte implants itself in the endometrium,
usually 7 to 9 days after fertilization.
218.
Implantation occurs
when the cellular walls of the blastocyte implants itself in the endometrium,
usually 7 to 9 days after fertilization.
219.
Heart development in
the embryo begins at 2 to 4 weeks and is complete by the end of the embryonic
stage.
220.
Methergine stimulates
uterine contractions.
221.
The administration of
folic acid during the early stages of gestation may prevent neural tube
defects.
222.
With advanced maternal
age, a common genetic problem is Down syndrome.
223.
With early maternal
age, cephalopelvic disproportion commonly occurs.
224.
In the early
postpartum period, the fundus should be midline at the umbilicus.
225.
A rubella vaccine
shouldn’t be given to a pregnant woman. The vaccine can be administered after
delivery, but the patient should be instructed to avoid becoming pregnant for 3
months.
226.
A 16-year-old girl who
is pregnant is at risk for having a low-birth-weight neonate.
227.
The mother’s Rh factor
should be determined before an amniocentesis is performed.
228.
Maternal hypotension
is a complication of spinal block.
229.
After delivery, if the
fundus is boggy and deviated to the right side, the patient should empty her
bladder.
230.
Before providing a
specimen for a sperm count, the patient should avoid ejaculation for 48 to 72
hours.
231.
The hormone human
chorionic gonadotropin is a marker for pregnancy.
232.
Painless vaginal
bleeding during the last trimester of pregnancy may indicate placenta previa.
233.
During the transition
phase of labor, the woman usually is irritable and restless.
234.
Because women with
diabetes have a higher incidence of birth anomalies than women without
diabetes, an alpha-fetoprotein level may be ordered at 15 to 17 weeks’
gestation.
235.
To avoid puncturing
the placenta, a vaginal examination shouldn’t be performed on a pregnant
patient who is bleeding.
236.
A patient who has
postpartum hemorrhage caused by uterine atony should be given oxytocin as
prescribed.
237.
Laceration of the
vagina, cervix, or perineum produces bright red bleeding that often comes in
spurts. The bleeding is continuous, even when the fundus is firm.
238.
Hot compresses can
help to relieve breast tenderness after breast-feeding.
239.
The fundus of a postpartum
patient is massaged to stimulate contraction of the uterus and prevent
hemorrhage.
240.
A mother who has a
positive human immunodeficiency virus test result shouldn’t breast-feed her
infant.
241.
Dinoprostone
(Cervidil) is used to ripen the cervix.
242.
Breast-feeding of a
premature neonate born at 32 weeks’ gestation can be accomplished if the mother
expresses milk and feeds the neonate by gavage.
243.
If a pregnant
patient’s rubella titer is less than 1:8, she should be immunized after
delivery.
244.
The administration of oxytocin
(Pitocin) is stopped if the contractions are 90 seconds or longer.
245.
For an extramural
delivery (one that takes place outside of a normal delivery center), the
priorities for care of the neonate include maintaining a patent airway,
supporting efforts to breathe, monitoring vital signs, and maintaining adequate
body temperature.
246.
Subinvolution may
occur if the bladder is distended after delivery.
247.
The nurse must place
identification bands on both the mother and the neonate before they leave the
delivery room.
248.
Erythromycin is given
at birth to prevent ophthalmia neonatorum.
249.
Pelvic-tilt exercises
can help to prevent or relieve backache during pregnancy.
250.
Before performing a
Leopold maneuver, the nurse should ask the patient to empty her bladder.
251.
According to the Unang
Yakap program (Essential Newborn Care), the cord should not be clamped until
pulsations have stopped (that’s about 1-3 minutes).
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