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OB final exam & HESI 2024/2025 (100% verified) graded A+
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OBfinal
exam
&
HESI
The
nurse
should
be
concerned
after
the
assessment
finding
on
what
during
a
magnesium
sulfate
infusion
for
preeclampsia?
A.
a
sleepy,
sedated
effect
B.
a
respiratory
rate
of
10
bpm
C.
DTR
of
2+
D.
absence
of
ankle
clonus
-
ANSB
should
alert
the
nurse
for
respiratory
depression.
The
other
findings
are
considered
normal.
the
most
common
medical
complication
of
pregnancy
-
ANShypertension
preeclampsia
results
in
what
-
ANSdecreased
function
of
organs
(placenta,
liver,
kidneys,
brain)
due
to
vasospasms
diminishing
the
diameter
of
blood
vessels
.
a
woman
being
treated
with
magnesium
sulfate
should
be
considered
to
be
treated
successfully
if...
-
ANSno
seizures
occur
Mag
is
a
CNS
depressant,
NOT
an
antihypertensive
medication
antidote
for
magnesium
sulfate
-
ANScalcium
gluconate
HELLP
syndrome
-
ANSHemolysis
Elevated
Liver
enzymes
Low
Platelets
A
pregnant
woman
who
is
at
21
weeks
of
gestation
has
an
elevated
blood
pressure
of
140/98.
Past
medical
history
reveals
that
the
woman
has
been
treated
for
hypertension.
On
the
basis
of
this
information,
the
nurse
would
classify
this
patient
as
having:
-
ANSsuperimposed
preeclampsia
positive
ankle
clonus
indicates...
-
ANShyperactivity
and
is
a
cause
for
concern
which
antihypertensive
medication
would
cause
a
pregnant
woman
to
have
a
false
positive
Coombs
test?
-
ANSmethyldopa
(aldomet)
lab
values
for
preeclampsia
-
ANSelevated
hemoglobin
elevated
LDH
decreased
platelets
(below
100,000)
increased
BUN the
most
important
cause
of
perinatal
loss
in
diabetic
pregnancy
is...
-
ANScongenital
malformations
hypothyroidism
in
mother
could
cause
-
ANSmiscarriage
preeclampsia
and
hypertension
placental
abruption
stillbirth
low
birth
weight,
premature
A
patient
who
is
pregnant
already
has
Type
2
diabetes
with
a
hemoglobin
A1c
value
of
7.
The
nurse
would
categorize
this
patient
as
having:
-
ANSpregestational
DM
priority
assessment
for
pregnant
woman
experiencing
nausea
and
vomiting
-
ANSketonuria
A
pregnant
woman
has
maternal
phenylketonuria
(PKU)
and
is
interested
in
whether
or
not
she
will
be
able
to
breastfeed
her
baby.
Which
reaction
by
the
nurse
indicates
accurate
information?
-
ANSthe
patient
should
be
advised
to
not
breastfeed
the
infant
because
her
breast
milk
will
contain
large
amounts
of
phenylalanine
what
interventions
would
the
nurse
anticipate
to
be
ordered
by
the
physician
for
a
patient
in
a
thyroid
storm
during
delivery?
-
ANSadminister
oxygen
antipyretics
PTU
preeclampsia
protein
levels
-
ANSmild:
1+
on
dipstick
(0.3-2
g/24
hours)
severe:
3+
dipstick
(more
than
5
g/24
hr)
mag
toxicity
-
ANSflushing
sweating
hypotension
depressed
DTR
respiratory
depression
creatinine
levels
of
severe
preeclampsia
-
ANSelevated
(above
1.2)
platelet
levels
of
severe
preeclampsia
-
ANSdecreased
(below
100,000)
incompetent
cervix
-
ANSpremature
dilation
tx:
surgical
placement
of
cervical
cerclage
10-14
weeks
gestation
to
constrict
the
internal
os
provide
bed
rest,
hydration,
tocolysis
(to
inhibit
ctx),
no
sex
or
standing
for
a
long
time removed
at
37
weeks
gestation
or
prior
to
c/s
leading
cause
of
life-threatening
perinatal
infections
-
ANSGBS
can
lead
to
sepsis,
pneumonia,
or
meningitis
causing
permanent
neuro
disability
dx
with
vag
and
rectal
cultures
at
35-37
weeks
tx
with
antibiotics
opthalmia
neonatorum
is
caused
by
what
organism
-
ANSgonorrhea
(neisseria
gonorrhoeae)
mechanisms
of
labor
-
ANS1.
engagement
(lightening,
dropping)
2.
descent
3.
flexion
5.
internal
rotation
6..
extension
(begins
after
the
head
crowns)
7.
restitution
(realignment
of
the
fetal
head
with
the
body
after
the
head
emerges)
8.
external
rotation
(of
the
shoulders)
9.
explusion
variable
decels
-
ANScord
compression
are
not
as
uniform
as
early
and
late
decels
could
be
nonperiodic
(unrelated
to
ctx
times)
they
are
significant
when
FHR
repeatedly
declines
to
less
than
70
bpm
and
persists
at
level
for
at
least
60
seconds
before
returning
to
baseline
TX:
change
position,
administer
oxygen,
d/c
pit,
assess
mother's
vitals,
assist
with
amnioinfusion
to
decompress
cord
as
prescribed
Four
Stages
of
Labor
-
ANSSTAGE
1
a)
Latent
1-4
cm
dilation
w/
UC
15-30
minutes
apart
and
15-30
seconds
duration
b)
Active
4-7
cm
dilation
w/
UC
3-5
minutes
apart
for
30-60
seconds
c)
Transition
8-10
cm
w/
UC
2-3
min
apart
for
45-90
seconds
STAGE
2
exit
of
fetus
assess
every
5
minutes STAGE
3
placental
exit
<30
minutes
after
fetus
fundus
remains
firm
2
fingerbreadths
below
umbilicus
STAGE
4
about
up
to
4
hours
after
delivery
assess
Q15
for
first
hour,
Q30
for
second
hour,
and
hourly
for
3rd
and
4th
hour
what
score
of
the
bishop
scale
indicates
readiness
for
labor
induction
-
ANS6
bishop
scoring
-
ANS0-3
dilation
(0--
1
to
2--
3
to
4--
more
than
5)
effacement
(0
to
30--
40
to
50--
60
to
70--
80)
consistency
of
cervix
(firm--med--soft)
position
of
cervix
(posterior--mid--anterior)
station
(-3..
-2..
-1...
+1)
when
is
an
amniotomy
performed
-
ANSif
the
fetus
is
0
or
plus
station
and
membranes
haven't
ruptured
increases
the
risk
of
a
prolapsed
cord
and
infection
placenta
previa
-
ANSimproperly
implanted
placenta
(total,
partial,
marginal
in
relation
to
the
internal
os)
sudden,
PAINLESS,
BRIGHT
red
vaginal
discharge
SOFT,
RELAXED,
NONTENDER
uterus
fundal
height
is
higher
than
expected
abruptio
placenta
-
ANSpremature
separation
of
placenta
(after
20th
week
but
before
birth)
DARK
red
bleeding
(or
none
if
too
high),
PAINFUL,
TENDER
uterus
w/
RIGIDITY
fetal
distress
with
maternal
shock
in
which
placental
condition
would
vaginal
exams
be
contraindicated
-
ANSplacenta
previa
anticipate
what
intervention
for
abruptio
placentae
-
ANSdelivery
preterm
labor
-
ANSbefore
37
weeks
risks:
multifetal
pregnancy,
overdistended
uterus,
anemia,
age
extremities,
substance
abuse,
hx
of
obsteric
or
other
issues
(cardiac
issues)
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