Exam (elaborations)
NR 348 Peds & OB Exam 1 Questions With Complete Solutions
- Course
- NR 348
- Institution
- Chamberlain College Of Nursing
NR 348 Peds & OB Exam 1 Questions With Complete Solutions
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NR 348 Peds & OB Exam 1 Questions With CompleteSolutions
"VEAL CHOP" Correct Answers
1st trimester warning signs Correct Answers -Bleeding
-Abdominal cramping (both can indicate miscarriage/ectopic
pregnancy)
-Throwing up (hyperemesis gravidarium)
2nd trimester warning signs Correct Answers -bleeding &
cramping (miscarriage/preterm birth-baby's born after 24-26
weeks may survive in NICU)
-vision changes
-test for gestational diabetes (1-hour glucose check, do 3-hour if
sugar>140mg/dL at 1st test)-symptoms in 3 P's, flushed dry
skin, fuity breath, headache
-preeclamspia symptoms
-Rhogam shot for Rh negative moms, give again within 24hrs
after delivery to prevent mom's body cells from attacking baby's
cells.
3 phases of maternal role attainment Correct Answers "Taking
In" (first 24-48 hours)
-Focused on personal needs
-Rely on others for assistance
-Talkative, excited, need to review birth process
,"Taking Hold" (Day 2-3 to Day 10 or several weeks)
-Focus on baby care/caregiving competency
-Want to take charge, learn and practice
-Dealing with physical and emotional discomforts (baby blues)
"Letting Go"
-Focus on family as a unit
-Resumption of role (partner, individual)
3rd timester warning signs Correct Answers -Preeclampsia:
Hypertension, proteinuria,vision changes, edema, epigastric pain
(glomerulus impaired, not reabsorbing proteins)
-Leaking of amniotic fluid: Could be Placenta Previa,
implantation of placenta low in uterus, can completely/partially
cover cervix/cause premature rupture of memranes. Need
emergency delivery, mom& baby are at risk for infection if she
doesn't come in
-Look for GBS by swabbing vagina: If positive, give two doses
of ABX (usually penicillin) during and after labor to prevent
giving it to baby
4 Stages of labor Correct Answers 1st stage: dilation of
cervix/contractions
-early labor:0-3cm dilated, contractions every 5-20min, mom
talkative, excited, nervous, can last 6-12 hours
-active labor:4-7cm dilated, contractions every 3-5min, mom
focused on pushing, can last 3-5 hours
-transition phase: 8-10cm dilated, contractions every 2-3min,
mom tried, frustrated from pushing.can last 30min-2hours
,2nd stage: pushing and delivery of the baby
3rd stage: delivery of the placenta
4th stage: initial postpartum recovery (~2hrs)
5 P's that affect labor and delivery Correct Answers -
Passenger (fetus & placenta):size of head, presentation, is baby
facing spine (occiput anterior, ideal) or is baby facing moms
belly (occiput posterior/stargazer, harder to deliver with head
against spine)
-Passageway (birth canal): head position, hip size/structure
-Powers (contractions): contractions 5 min apart, 1 min in
duration, 1 hour period is ideal. Need effacement
(shortnening/thinning or cervix) and dilation (enlargement/
widening of cervical opening)
-Position (maternal): different kinds, traditional, hands and
knees, squatting, etc
-Psychological Response: anxiety can interfere with progress
and make pain worse, patient may have increased psychological
need fot analgesia, anesthesia.
Abnormal lochia findings Correct Answers -excessive
bleeding/heavier pad instead of lighter & large/numerous clots
(hemorrhage), foul odor (infection), discharge lasting longer
than expected.
, amniocentesis Correct Answers Aspiration of amniotic fluid
via ultrasound guidance
Assess for:
-Fetal abnormalities (AFP) & neural tube defects
-Chromosomal, genetic, or congenital anomalies
-Fetal hemolytic disease
-fetal Lung maturity
Risk of complications are low, but include:
-Amniotic fluid emboli
-Maternal/fetal hemorrhage
-Maternal/fetal infection
-Fetal damage/death
-Maternal intestinal or bladder damage
-Miscarriage/preterm labor
-Leakage of amniotic fluid or PROM
APGAR scoring system Correct Answers Activity:(muscle
tone floppy/some flexion/ well flexed and resisting extension) 0-
2pts
Pulse:(absent/less than 100/100-160) 0-2pts
-Grimace(reflex irritability either absent/ baby grimaces or weak
cry/ cries when stimulated): 0-2pts
-Appearance(skin color cyanotic or pale/only peripheral
cyanosis/pink): 0-2pts
Respiration:(apnea/slow or irregular respirations/strong cry) 0-
2pts
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