RN MATERNAL FETAL STUDY GUIDE 2021|Vanderbilt University

RN MATERNAL FETAL STUDY GUIDE 2021|Vanderbilt University A nurse is providing care for an uncircumcised male newborn and his mother. What information should be provided during discharge regarding bathing of the penile area of the newborn male? -Wash the penis with soap and water and rinse. -The foreskin should not be forced back or constriction may result. A nurse is providing discharge teaching to a new parent regarding cord care. What information should be provided? 1. Wash your hands. Use soap and water. Wash your hands before and after you clean his stump. 2. Clean the cord stump. Gently wash the cord stump and the skin around it with mild soap and warm water during every bath. Gently pat the stump dry after your baby's bath. 3. Use rubbing alcohol or water. Your baby's healthcare provider may suggest you use rubbing alcohol or water and a cotton swab to clean the stump. Gently wipe from the base to the top of the stump with a cotton swab dampened with rubbing alcohol or water. Clean the stump with each diaper change. 4. Clean urine or bowel movement off the stump. If your baby's stump gets dirty from urine or bowel movement, wash it off right away with water. Gently pat the stump dry after you clean it. 5. Let the cord air dry. After diaper changes or stump cleaning, fold the front of the diaper down below the cord stump to let it air dry. 6. Dress your baby in loose clothing. Loose-fitting clothes will help the stump dry out faster. 7. Do not pull or tug at the cord stump. The stump will fall off on its own. 8. Do not cover the cord stump. If you want to use a bellyband on your baby, use only clean, dry gauze. A nurse is caring for a client in the third stage of labor. What nursing interventions should be taken during this stage? 1. -Palpate the uterus to determine the risk upward as well as characteristic change in shape 2. -If 30 minutes passes and there is no placental discharge, it is considered "retained". 3. -Oxytocic medication is administered to deliver placenta. 4. -Monitor for signs of placental separation (globular shaped uterus, uterine volume shrinks, protrusion umbilical cord) A nurse is caring for a client in the transition stage of labor. What interventions should the nurse include when caring for this client? 1. -Continue to encourage voiding every 2 hr. 2. -Continue to monitor and support the client and fetus. 3. -Encourage a rapid pant-pant-blow breathing pattern if the client has not learned a particular breathing pattern prenatally. 4. -Discourage pushing efforts until the cervix is fully dilated. 5. -Listen for client statements expressing the need to have a bowel movement. This sensation is a sign of complete dilation and fetal descent. 6. -Prepare the client for the birth. 7. -Observe for perineal bulging or crowning (appearance of the fetal head at the perineum). 8. -Encourage the client to begin bearing down with contractions once the cervix is fully dilated A nurse is administering oxytocin to a client in labor. What are symptoms of uterine hyperstimulation that would cause the nurse to discontinue this medication? Oxytocin is discontinued if uterine hyperstimulation occurs with contraction duration longer than 90 seconds. Uterine hyperstimulation is defined as either a series of single contractions lasting 2 minutes or more OR a contraction frequency of five or more in 10 minutes. Uterine hyperstimulation may result in fetal heart rate abnormalities, uterine rupture, or placental abruption. It is usually treated by administering terbutaline. A complication of a newborn after birth is hypoglycemia. What is the cause of hypoglycemia in a newborn? Which newborns are at greater risk of this complication? Identify nursing assessments and interventions to address this newborn complication. ● Poor nutrition for the mother during pregnancy ● Making too much insulin because the mother has poorly controlled diabetes ● Incompatible blood types of mother and baby (severe hemolytic disease of the newborn) ● Birth defects ● Congenital metabolic diseases ● Not enough oxygen at birth (birth asphyxia) ● Liver disease ● Infection ● Babies who are small for gestational age or growth-restricted ● Preterm babies, especially those with low birth weights ● Babies born under significant stress ● Babies with mothers treated with certain medicines such as terbutaline ● Babies who are large for their gestational age ...