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NRS 322 - Final Exam Questions and Answers 100% Solved
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NRS 322 - Final Exam
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NRS 322 - Final Exampostpartum hemorrhage - answerdefined as a loss of greater than 500 mL for vaginal
birth or greater than 1000 mL for c-section
- life-threatening obstetric emergency with little warning
- cause - uterine atony (boggy), genital tract lacerations, hematoma, nonadherent
placenta, inversion, subinvolution
- management- firm fundal massage, asses uterine tone, weigh used per pads to
estimate blood loss, encourage urination, replace fluids, take labs, give meds, monitor
for shock
- medications- oxytocin, misoprostol, hemabate, methylergonovine
nonadherent placenta - answerpieces of placenta are left behind after delivery
inverion - answerturning inside out of the uterus
subinvolution - answerlate postpartum bleeding caused by thee failure of the uterus to
return to a non-pregnant state
- results in retained placental fragments and pelvic infection
amniotomy (AROM) - answerdefined as the artificial rupture of membranes via chemical
or mechanical methods
- labor usually begins within 12 hours of rupture
- indicated for slow labor when induction or augmentation is indicated
- considerations- monitor FHR and maternal vital signs, ensure presenting part of fetus
is engaged in the pelvis, document amniotic fluid characteristics
- take temperature every 2 hours after rupture (increased risk of infection with ruptured
membranes)
hyperemesis gravidarum - answerdefined as excessive vomiting accompanied by
dehydration, electrolyte imbalance, ketosis and weight loss
- interventions- possible IV fluid replacement, avoid having an empty stomach, eat small
and frequent meals , keep crackers at bedside
true labor - answer- cervical changes (effacement)
- regular contractions not relieved by anything
- presenting part of fetus engages
false labor - answer- no cervical change
- sporadic contractions (Braxton Hicks) relieved by walked and movement
, nonstress test - answer- assess FHR via doppler ultrasound. Mother pushes a. button
when she feels baby move. FHR should have accels during each movement
- if no movement is felts, might use a vibroacoustics or peristalsis to wake baby up
- may have reaction or nonreactive test results
reactive - answer2 or more accels with movement in 20 minutes
nonreaction - answerless than 2 accels in 20 minutes, refer patient to a biophysical
profile for further assessment
newborns first hour of life - answer- provide warmth (swaddle, skin to skin, hat)
- position and clear airway with a bulb syringe (mouth then nose)
- APGAR at 1 and 5 minutes
- dry stimulate and reposition
- evaluate critical signs (respiratory rate and effort, heart rate, color)
- vitamin K and hep B injections
placental abruption - answerdefined as a premature separation of the placenta from the
uterine wall
- s/s- sudden, intense pain (may mimic contraction), may bleed, rigid and tender
abdomen, late decels, absent variability
- most often caused by trauma or coccaine use
- management- immediately birth of baby
placenta previa - answerdefined as placenta implanting near of over the cervical os
- s/s - painless, bright red bleeding from vagina during the 2nd and 3rd trimester
- requires c-section when fetus is ready, no vaginal exams, do not want cervical dilation
to occur (no penetration)
intimate partner violence - answerdefined as behavior within an intimate relationship
that causes physical, sexual, or psychological harm
- assess at every visit ,get mother alone to ask questions
gestational hypertensionn - answerdefined as pregnancy induced hypertension
- BP greater than 140/90
- onset of HTN without proteinuria after 20 weeks of gestation
- BP should return to baseline by 12 weeks postpartum
- associated with placental abruption, kidney failure, hepatic rupture, preterm birth, and
maternal/fetal death
preeclampsia - answerdefined as generalized systemic vasospasm (all organ perfusion
reduced), gestational HTN with proteinuria greater than +1
- s/s - headache, visual disturbances, hyper reflexive, HTN, proteinuria
- sudden worsening- facial edema, oliguria, weight gain
- goal is to control preeclampsia before eclampsia (seizures) can occur, use MgS to
prevent potential seizures
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