MATURNITY OB/ HESI EXAM REVIEW
QUESTIONS AND ANSWERS
For PKU what foods /supplements should be avoided? - Answer-all natural protein, diet
cola containing nutra sweet, dairy products
What could the result be if PKU levels are below 2mg/dl? - Answer-growth retardation
What could the result be if PKU levels are above 10mg/dl? - Answer-significant brain
damage
What could the result be if PKU levels are greater then 6mg/dl in a pregnant women? -
Answer-can affect development of embryo
How does the newborn head measurement compare to the chest measurement? -
Answer-the head circumference should be equal to and no more than 2 cm greater than
the chest circumference until the age of 2.
developmental hip dysplasia? - Answer-1-1000 births has this. subluxation or
dislocation either partial or complete. The head of the femur is partly or completely
displaced as a result of swallow hip socket
signs and symptoms of developmental hip dysplasia? - Answer--when infant is prone
the nurse observes the buttocks for variation of size
- the legs of infant should be equal in length
-should be kicking with both legs not just one
-the depth and number of skin folds of infant upper thighs should be symmetrical
-well baby clinic nurse notes the posture and gait of older children and records
observations
What causes milia? - Answer-obstruction of sebaceous glands, looks like pimples, teach
parents nor to try to pop them, its normal and it will go away in a few weeks
priority ssessment after surgery for spinea bifida? - Answer-prevent infection, good skin
care, adequate nutrition, the size/area of sac are checked doe tears and leakage. Don't
lay baby on sac, dont put dressing on sac, extremities are observed for deformalities,
head circumference is measured to determine hydrocephalus. fontanels are observed to
provide a baseline. lack of anal sphincter control and drippling urine differential
diagnosis.
What are signs of cold stress? - Answer-decrease skin temp. increase respiratory rate
with periods of apnea, bradycardia, mottling of the skin and lethargy
,necessary assessments for NEC (Narcotizing enterocolits)? - Answer-source of bacteria
growth is formula milk or hypertonic gavage feedings signs are abdominal distention,
bloddy stools, diarrhea and bilious vomiting. give the baby breast milk
NEC (Narcotizing enterocolits)? - Answer-this diminishs blood supply to the lining of the
bowel wall because of hypoxia and sepsis that causes a decrease in protective mucus
and results in bacterial invasion
What is the posterm baby at risk for in pp period? - Answer-Asphyxia caused by
hypoxia, meconium aspiration, poor nutrition status, depleted glycogen which causes
hypoglycemia, increase in RBC's production, birth defects, and seizures
What are the signs and symptoms to observe for with Meconium aspiration syndrome? -
Answer-Nasal flaring, retractions, cyanosis, grunting, rales and rhonchi, tachypnea
Know what to report to dr. with newborn vital signs ? - Answer-Respirations greater than
60 less than 30
Temp above 37.7 (99.8f) or below 36.2 (97.1 F)
Pulse rate greater than 160 less than 110
Noisy respirations and nasal flaring or chest retention
What is Bronchopulmonary dysplasia? - Answer-is the toxic response of lung to O2
therapy
what cases Bronchopulmonary dysplasia? - Answer-O2 toxicity is high risk for infants
receiving prolonged treatment with high concentrations of O2.
causes of vaginal hematoma? - Answer-birth trauma
symptoms of vaginal hematoma ? - Answer-severe pain that analgesics don't relieve,
pressure in vulva, pelvis or rectum, Maybe unable to urinate because of the pressure.
May develop signs of concealed blood loss pulse and respiration rate rises and bp falls.
Treatment of small vaginal hematoma ? - Answer-small hematoma nothing you can
apply ice packs
treament of large hematoma? - Answer-Larger ones may require incision and drainage
of the clots and you can apply ice packs to this too
nursing care and pt. instrucation for Post-partum infections? - Answer-handwashing,
peri care, promote rest and nutrient, take all meds don't stop them when you are feeling
better
Post-partum infections? - Answer-Uti- cystitis (bladder), low grade fever, burning
urgency, and frequency, pyelonephritis (kidneys), high fever with pattern of spikes,
chills, and pain in costovertebral angle or flank, nausea and vomiting.
, what are the test that can be done to predict/ diagnose down syndrome? - Answer-
Ultrasound assessment of thickness of fetal nuchal fold and absence of the nasal bone.
Quad test involves testing blood for levels of AFP. A low AFP or High HCG and inhibin
A with a low Ue may indicate a high risk for Down syndrome. Chromosomal analysis is
another way
signs of intracranial hemorrhage? - Answer-Poor muscle tone, lethargy, poor sucking
reflex, respiratory destress, cyanosis, twitching, forceful vomiting , a high pitch shrill cry,
the pupil of one eye may be constricted and the other eye may be dilated.
When can surfactant be given to a preterm baby? - Answer-You can give the mother a
injection of corticosteroids such as bethamethasone 1-2 days before delivery, it can also
be administered through the endotracheal tube at birth
What are all the TX for pp hemorrhage? - Answer-Administration of oxytocin,
methylergonovine or prostaglandin such as carboprost to contract the uterus, firm
uterine contractions often expels the retain fragments and no other treatment is needed.
Ultrasound is used to identify remaining fragments and if still bleeding a D &C or D&E is
preformed to remove blood clots and placenta fragments. Antibiotics are prescribed if
infection is suspected
Meconium? - Answer-the first stool mixture of amniotic and secretions of the intestal
glands. Dark greenish black thick and tarry. 8-24 hours after birth until the 1st week
progression of stooling pattern for breastfed babies? - Answer-bright yellow soft and
pasty last 3-6 days, then goes to 2 nd transition to normal breast fed stool to cow's milk
stool
Transition stools? - Answer-loose greenish yellow with mucus
progression of stooling pattern for bottled babies? - Answer-more solid they vary from
yellow to brown
Why are preterm babies more prone to bleeding? - Answer-Their blood is deficient in
prothrombin a factor of blood clotting mechanism. Fragile capillaries of the head are
susceptible for injury during birth causing intracranial hemorrhage
Is drooling normal in newborns? - Answer-The salivary glands do not secrete saliva until
the infant is 2-3 months old. Drooling in newborns is considered a sign of pathological
disturbance and needs to be reported
nursing care for Hydrocephalus/ VP shunt? - Answer-Observe for signs of increased
intracranial pressure (ICP) and of infection. Pain control management
Bacterial infection is life threatening. position infant on opposite side of operation