NURS 330 Exam #2 Study Guide || Questions & Answers (Graded A+)
NURS 330 Exam #2 Study Guide || Questions & Answers (Graded A+)
Labs before epidural - ANSWER - -CBC to look at H&H, platelets, WBC
-Infection and coagulopathy are contraindications
Concerns after insertion of an epidural - A...
, NURS 330 Exam #2 Study Guide ||
Questions & Answers (Graded A+)
Labs before epidural - ANSWER - -CBC to look at H&H, platelets, WBC
-Infection and coagulopathy are contraindications
Concerns after insertion of an epidural - ANSWER - -Marked hypotension:
-Can slow the progress of labor
-Ineffective breathing pattern
-Inability to effectively push
-Headache (fixed with autologous blood patch)
-Safety/Falls as patient unable to get up and walk
If your patient has marked hypotension after an epidural is placed, what should you
do? - ANSWER - -Monitor for impaired placental perfusion on FHM
-Place side pillow
-IV fluid
-Supplemental O2
-Ephedrine
What is the most common endocrine disorder in pregnancy? - ANSWER - -Diabetes
Mellitus
-Due to the hormones of pregnancy, any form of DM is hard to control even if pt is
compliant with multidisciplinary care plan
When and how are patients screened for Gestational Diabetes Mellitus? - ANSWER
- -GDM is screened for between 24-28 weeks
-Glucose Tolerance Test (GTT)
-If blood glucose more than 140, 3 hour GTT is ordered.
-If two out of 3 values are elevated, pt is considered gestational diabetic.
How is DM (GDM, Type I, and Type II) managed during pregnancy? - ANSWER - -
GDM can often be managed with ADA diet
-Regular and NPH insulin (not long acting as thats hard to titrate)
-Oral DM medications not usually used
Is sugar a teratogen? - ANSWER - Yes
Fetal risks with maternal diabetes - ANSWER - -Macrosomia (big baby)
-Hydramnios (too much amniotic fluid)
-Ketoacidosis
-Hyperglycemia
-Hypoglycemia
-Dystocia
-Sudden and unexplained stillbirth
-Congenital malformations in CVS (atrial or ventral septal defect more common),
CNS, and Skeletal system
, How are fetuses monitoring in GDMs as they at risk for sudden, unexplained death?
- ANSWER - -NST (fetal monitoring) twice a week starting at 32 weeks
-Kick counts (come in for decreased fetal movement)
What is an ectopic pregnancy? - ANSWER - -Fertilized ovum outside of the uterus
that proliferates
What is the priority nursing diagnosis for ectopic pregnancy? - ANSWER - -If the
fallopian tube were to rupture, there is a risk for hemorrhage. NANDA would be
about shock not pain.
What medications are given for ectopic pregnancy? - ANSWER - -Methotrexate
stops the fetal cells from proliferating if unruptured
-Salpingostomy vs salpingectomy is surgical treatment.
How is the progress off labor measured? - ANSWER - Dilation, effacement, and
station
What is dilation? - ANSWER - Cervix become wider.
-Latent phase is 0-3 cm
-Active phase is 4-7 cm
-Transition phase is 8-10 cm
-10 cm is full dilated
What is effacement? - ANSWER - Cervix thins out
-Measured from 0-100%
-Needs to be 100% for delivery
What is station? - ANSWER - Where the baby's head is in relation to the mother's
ischial spines
-Estimated and subjective
-High negative number= head less engaged
-High positive number= head more engaged
Types of breech position - ANSWER - -Frank Breech
-Single Footling Breech
-Complete Breech
*A strong indicator that C-Section is needed
Risks for breech position - ANSWER - Prolapsed cord as the head is not engaged
with the cervix
-A prolapsed cord compromises fetal circulation leading to variable or prolonged
deceleration and decreased fetal movement
-Apply manual pressure with fingers on fetal presenting part to decreased cord
compression
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