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70 Cards in this Set
- Front
- Back
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The fetal monitoring tracing is showing late decelerations. The nurse is aware that this is a sign of?
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uteroplacental insufficiency
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Why does the blood volume increase during pregnancy?
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to increase for maternal and fetal oxygen demands as well as preparing for potential blood loss during labor.
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What does the triple screen test for?
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neural tube defects
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What is the normal fetal heart rate?
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110-160 bpm
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If the pt. presents with supine hypotension, what is the best intervention to correct it?
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turn the pt. to either side
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If an adolescent becomes pregnant and her and the boyfriend are inquiring about childbirth classes...what is the best response by the RN?
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The childbirth class is good for you and your boyfriend to prepare for the childbirth and parenting.
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If a pregnant woman has a history of heroine abuse, what pharmacologic agents should never be given to the pt?
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narcan and stadol
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Is it ok for mom to have an alcoholic beverage while she is pregnant? Even if it is only one beer?
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the pregnant mother should not have any alcohol consumption at all. Even the smallest amt. can be harmful.
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The use of tobacco and smoking has what effect?
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peripheral and uterine Vasoconstriction and decrease carrying capacity for oxygen. reduces uteroplacental blood flow.
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If a pt. has chlamydia, what will be required of the patient?
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The partner needs to be tested and the pt. needs to follow-up in 2-3 weeks.
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What is the biggest sign of a baby that is withdrawing from opiates?
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high pitched cry, hypertonus, increased RR
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What is one of the most important assessments to do with a pt. who has herpes?
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inspect the genital area for active lesions
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A patient who becomes pregnant and is diabetic will be more susceptible to:
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infection and preeclampsia
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Pregnancies that are complicated by type 2 diabetes can lead to what kind of effects on the fetus? select all that apply:
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shoulder dystocia, polyhydramnios, and congenital anomalies
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A pregnant woman with asthma can lead to what kind of risk for the fetus?
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decreased oxygen supply due to bronchoconstriction and mucosal edema
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A woman with class II heart disease who is pregnant should be advised what?
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Physical activity can cause SOB and angina, plus bedrest is highly suggested.
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If a pregnant woman has a pregnancy that results in a hydatiform mole, what is important for the nurse to advise the pt?
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Don't get pregant for 1 year and take oral contraceptives. These 2 implementations reduce the risk of forming choriocarcinoma. It is also important to not have an IUD put in as well.
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If a pregnant woman presents to the ER with persistent pain down lower and it won't go away, what is the most likely complication that has occurred?
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placental abruption, most likely due to cocaine use.
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The signs and symptoms of placental previa include:
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bright red blood, clotted blood, absence of pain or tenderness
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What are the three types of placenta previa?
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marginal, partial, and complete
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If a pregnant woman has amniotic fluid embolism during delivery, the nurse would expect that:
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it may require perimortem c-section delivery to improve the chances of neonate survival.
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A woman that has a Hx of marginal placenta previa, the nurse recognizes immediate intervention for:
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hemorrhage
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The nurse caring for a patient in labor, knows that the measurement for frequency of contractions is:
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from the beginning of one contraction to the beginning of the next contraction.
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The best indicator to be monitored for a diabetic patient is:
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hemoglobin A1c. Result should be <6.1.
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A pt. with herpes asks the nurse when she is contagious. The best response by the nurse is:
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you are contagious when vesicles rupture and express exudate.
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When the cervix becomes purple or bluish in color, this is a sign of:
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Chadwick's sign
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A pt. that is considered most susceptible for toxoplasmosis is:
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one that has cats for pets. the litter where the cats urinate is considered toxic.
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A normal finding on a nonstress test (NST) is considered:
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reactive
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Variable decelerations is considered a sign of:
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cord compression
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Late decelerations is a sign of:
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uteroplacental insufficiency
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A FHR pattern that is considered bad is one that has:
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absence of variability
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What are some things to assess for in an adolescent pregnancy?
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iron-deficiency anemia, STD's, and substance abuse
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If a maternal pt. has a history of drug abuse, what can be done on the neonate without her permission?
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meconium drug screen
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Tobacco smoking also causes what in pregnancy?
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premature placental calcification
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The most common teratogen in pregnancy is?
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alcohol
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what is goodell's sign?
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the tip of the cervix becomes softened at about the 6th week of pregnancy due to increased vascularity, hypertrophy, and hyperplasia.
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What Hegar's sign?
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6th week of pregnancy, compressability and softening of lower uterine segment.
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Why is blood loss so deceiving during delivery?
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A woman can lose lots of blood before signs and symptoms of shock appear.
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what is the main type of care for a pregnant woman who has had a trauma?
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k-b assay
also remember: cpr for 5 minutes and then possible c-sec. |
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The ABC's of domestic violence are:
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A-acknowledge that she is not the only one.
B-Believe the woman and acknowledge her grief & pain. C-confidentiality is mandatory. D-document everything E-educate about abuse and safety |
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What are some of the labs drawn on the inital prenatal visit?
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CBC (check for Hct & Hgb), rubella titer, Chlamydia/GC screen, type and cross, irregular Rh, antibody screen, U/A and urine culture.
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What does GTPAL stand for?
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G-gravida (# of pregnancies carried past 20 weeks)
T-term (# of preg. carried to term) P-preterm (# of preg. delivered before 37 weeks) A-abortion (# of preg. terminated before 20 weeks) L-living (# of children currently living) |
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How much does the HR increase when a woman becomes pregnant?
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10-15 bpm by the 14th week.
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How much does the cardiac output increase?
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30-50% by 8-10 weeks
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What happens to vascular resistance during pregnancy?
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systemic (left afterload) and pulmonary(right afterload) vascular resistance decreases during pregnancy.
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What kind of blood pressure changes will be seen in pregnancy?
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1st trimester: no change
2nd trimester: slight decrease in systolic and diastolic. 3rd trimester: return to 1st trimester levels. |
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If mom experiences a drop in systolic BP of 30 mmHg or more. After 4 -5 Minutes, they experience reflex bradycardia. Cardiac output is reduced by half and the mom will feel faint and dizzy. What is this called and how can it be treated
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supine hypotension syndrome. pt. needs to be turned to either side.
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How much does blood volume increased during pregnancy?
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40-50%
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During pregnancy, the plasma increased more than the RBC's. What is this called?
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physiologic anemia (hemodilution)
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At what point will the mother be considered anemic?
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Hgb is less than 10 or Hct is less than 35%
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Postpartum diuresis causes concentration of clotting factors and an increased risk for:
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deep vein thrombosis (DVT)
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A pregnant woman has a decreased threshold for CO2. This puts the pregnant woman more at risk than a nonpregnant woman for:
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respiratory alkalosis, which is then compensated with metabolic acidosis
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Glycosuria predisposes a pregnanct woman to what?
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urinary tract infections (UTI)
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The most accurate and best time to do an ultrasound is:
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17th week
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The normal amniotic fluid index is:
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9-18cm
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An amniotic fluid index of 0-5cm is a sign of:
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oligohydramnios
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An amniotic fluid index of >25cm is a sign of:
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polyhydramnios
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Normal amount of fetal movement should be:
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4-6 times per hour
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Persistent and repetitive late decelerations indicates:
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fetal hypoxemia stemming from insufficient placental perfusion
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The follow-up care for a pregnant woman who has just had a hydatiform mole is:
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biweekly serum Hcg until normal; then can go every 3 weeks, monthly for 6 months, and Q2 months per year
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Special considerations for mom with heart dz, while she is in labor:
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position for optimal cardiac output, recommend vag birth, pt. is at risk for CHF after birth.
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If a pregnant pt. has thrombembolic dz, what precautions should be taken?
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do not wear constrictive leg weaer, avoid crossing legs, and no standing for long periods of time. DO NOT give pregnant woman coumadin.
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What is a concern during the post partum period for a pregnant woman with HELLP syndrome?
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post partum diuresis can cause Mg levels to be subtherapeutic, causing potential risk for more seizures
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What is the most common prostaglandin inhibitor used in pregnant women?
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indocin
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Terbutaline is a________, with how much of a dose?
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tocolytic: betamimetic; 0.25mg q15min for 5 doses, then 2.5-5.0mg q4-6hrs
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Terbutaline has what effect?
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relaxation of the smooth muscles, specifically the uterus
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Magnesium sulfate has what effect?
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suppresses nerve transmission to the uterine smooth muscle, again relaxing the uterus.
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What is the dose of MgSO4?
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4-6gm IV bolus
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What are some s/sx of too much magnesium sulfate?
What is the antidote? |
extreme muscle relaxation with suppressed respiratory rate (<12 breaths/min).
10% calcium gluconate |
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Acute and chronic fetal hypoxia can cause blood flow to decrease from the:
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lungs, gut, and kidneys
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