Maternal/Newborn ATI Final REVIEW
Exam Questions with Full Solutions
What is the fourth stage of labor and when does it start? - -Postpartum
period- starts after the delivery of the placenta
-What are the greatest risks during the postpartum period? - -Hemorrhage
Shock
Infection
-When is RH immune globulin (RhoGAM) administered to post partum
women? - -Administered 72 hours for women who are Rh-negative and gave
birth to infants who are Rh-positive
This prevents sensitization to Rh in future pregnancies
-What is included in the postpartum nursing assessment? - -Monitoring vital
signs
Assessing uterine firmness & location in relation to umbilicus
Uterine position in relation to midline (if deviated, assist mom in emptying
bladder)
Amount of vaginal bleeding (lochia)
-How often should vitals be monitored after delivery? - -Every 15 min for the
first hour
Every 30 minutes for second hour
Every 4-8 hr depending on remaining medication regimen
-This occurs with contractions of the uterine smooth muscle, whereby the
uterus returns to its pre-pregnant state - -Involution
-Defined as blood flow from the uterus during postpartum period - -Lochia
-This type of lochia is bright red in color, bloody consistency, fleshy odor,
may contain small clots - -Lochia rubra
-This type of lochia is pinkish brown in color & serosanguineous consistency
- -Lochia serosa
-This type of lochia is yellowish, white creamy color, fleshy odor - -Lochia
alba
-When is colostrum present in the new mother's breasts? - -During
pregnancy and 2-3 days immediately after birth
, -Defined as an infection in a milk duct of the breast with concurrent flulike
symptoms - -Mastitis
-What are therapeutic and approved holding positions when breast feeding?
- -Cradle hold
Side-lying hold
Football hold
-What does breast feeding cause the release of? What does this prevent? - -
Breast feeding causes the release of oxytocin which stimulates uterine
contractions (will prevent hemorrhage)
-What are normal lab values in the post partum period? - -Increased Hct &
Hgb up to 72 hours
Leukocytosis (WBC count up to 20,000-25,000 for the first 10-14 days,
without presence of infection)
Increased coagulation factors
Increased fibrinogen
-A medical condition during pregnancy defined as excessive nausea and
vomiting that is prolonged past 12 weeks of gestation. Results in weight loss
& electrolyte imbalance - -Hyperemesis gravidarum
-What are nursing responsibilities when caring for a patient diagnosed with
hyperemesis gravidarum? - -Monitor client's I&O
Assess client's skin turgor/mucous membranes
Monitor vital signs
Monitor client's weight
Have client remain NPO for 24-48 hours
-This medical condition occurs during pregnancy due to inadequacy in
maternal iron stores and consuming insufficient amounts of dietary iron - -
Anemia
-This medical condition is defined as an impaired tolerance to glucose with
the first onset or recognition during pregnancy - -Gestational diabetes
mellitus
-What is the ideal blood glucose level during pregnancy? - -70-110mg/dL
-What are the clinical manifestations of hypoglycemia? - -Nervousness
Headache
Weakness
Irritability
Hunger
, Blurred vision
Tingling of mouth/extremities
-What are the clinical manifestations of hyperglycemia? - -Thirst
Nausea
Abdominal pain
Frequent urination (diuresis)
Flushed dry skin
Fruity breath
-What are the glucose levels that diagnostically, indicate gestational
diabetes mellitus? - -Blood glucose screening of 130-140mg/dL or greater,
indicating 3-hr oral glucose test is indicated
-This disorder begins after the 20th week of pregnancy where BP s elevated
at 140/90 mm Hg or greater recorded at least twice, 4-6 hours apart within a
1 week period - -Gestational hypertension (GH)
-This disorder is defined as gestational hypertension with the addition of
proteinuria greater than 1+ - -Mild preeclampsia
-This disorder is defined as maternal BP of 160/100 mm Hg or greater,
protenuria greater than 3+, oliguria, elevated Cr greater than 1.2mg/dLm
visual disturbances, hyperreflexia, pulmonary/cardiac involvement, extensive
peripheral edema, hepatic dysfunction & thrombocytopenia - -Severe
preeclampsia
-This disorder is defined as severe preeclampsia symptoms along with the
onset of seizure activity or coma - -Eclampsia
-This syndrome of pregnancy is a variant of gestational hypertension in
which hematologic conditions coexist with severe preeclampsia involving
hepatic dysfunction - -HELLP syndrome
H- hemolysis (anemia and jaundice)
EL- elevated liver enzymes (Elevated ALT/AST, nausea/vomiting)
LP- low platelets (thrombocytopenia, DIC)
-What are antihypertensive medications that are approved to be taken
during pregnancy? - -Methyldopa (Aldomet)
Nifedipine (Adalat, Procardia)
Hydralazine (Apresoline, Nesopresol)
Labetalol (Normodyne)
AVOID ACE INHIBITORS & ARBs
-What is an anticonvulsant medication used during pregnancy? - -
Magnesium sulfate
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