Maternal Newborn ATI

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1.

FHR can be heard by Doppler at:

10-12 weeks GA

2.

When should you start measuring a

woman's fundal height?

After 12 weeks GA

3.

Between 18 and 30 weeks the

fundal height should measure
what?

It should equal the

week of gestation

4.

MSAFP screening is done:

15-22 weeks of
gestation

5.

Smoking tobacco during

pregnancy is associated with :

Low Birth Weight

6.

Pregnant mothers should consume

how much water each day?

2 to 3 Liters of water
from food and
beverage sources.

Regarding kick counts, what are

signs that a woman needs further
evaluation?

Fetal movements of
less than 3 in one hour
No fetal movement for
12 hours

The recommended weight gain

during pregnancy is usually:

25-35lbs
3-4 lb in first trimester
1 lb per week in the
last two trimesters

7.

8.

9.

Foods high in folic acid are:

Leafy vegetables
Dried peas
Dried beans
Seeds
Orange juice

It is recommended that _____ mcg

of folic acid be taken during
pregnancy.

600

It is recommended that clients

who are lactating consume ____
mcg of folic acid.

500

12.

What vitamin aids in the

absorption of Iron?

Vitamin C

13.

The clients bladder needs to be

_____ before an ultrasound.

Full

14.

BPP: normal score is

8-10

15.

BPP abnormal score is

<4

16.

If a BPP comes back as 6.....

It should be retested

17.

BPP assess for

Fetal well being

10.

11.

18.

NST

most widely used technique for

antepartum evaluation of fetal well
being performed during the third
trimester.

19.

Reactive NST

FHR is a normal baseline rate with

moderate variablity
Two accelerations to 15 bpm for at least
15 secs in 20 min period

20.

A non reactive NST

would indicate
what about the
fetus?

The fetal heart rate does not accelerate

adequately with fetal movement.
-A BPP or CST will need to be done now

21.

Positive CST is
normal or
abnormal

abnormal

22.

Positive CST is
indicated when:

Persistent and consistent late decels on

more than half of the contractions.

23.

An amniocentesis
may be performed
when?

After 14 weeks gestation

24.

AFP can be
measured from the
amniotic fluid
between:

16 and 18 weeks

25.

Presence of PG on a
fetal lung test is
associated with:

Respiratory distress

26.

CVS can be done at

10-12 weeks

27.

Quad screen can be

done when?

15-20 weeks GA

28.

MSAFP can be done

when?

16-18 weeks of gestation

29.

Amniocentesis
requires the
bladder to be:

empty

30.

Labor usually
occurs ___ hrs after
ROM.

24

31.

First stage of labor:

1-1.5 cm (onset of labor)

32.

Latent phase of
labor:

0-3 cm
mild to moderate contractions
irregular
q 5-30 min
lasts 30-40 sec

33.

Active phase of
labor:

4-7 cm
moderate to strong contractions
regular
q 3-5 min
lasts 40-70 sec

34.

Transition phase of labor

8-10 cm
strong to very strong
contractions
q 2-3 min
lasts 45-90 sec

35.

Second stage of labor:

Full dilation
Intense contractions
BIRTH!!

36.

Third stage of labor:

Delivery of placenta

37.

Fourth stage:

Maternal stabilization of
vital signs

38.

First stage pain:

internal visceral
may be felt as back/leg
pain

39.

Second stage pain:

somatic
occurs with fetal descent
and expulsion

40.

Third stage pain:

similar to first stage pain

41.

Pain S&S:

Increased BP
Tachycardia
Hyperventilation

42.

Absent or undetectable
variability is considered:

Non-reasurring

43.

Minimal variability:

> undetectable but

<5/min

44.

Moderate variability:

6-25/min

45.

Marked variability:

>25/min

46.

Accelerations mean:

Healthy fetal/placental
exchange

47.

Fetal bradycardia means (less

than 60)

Uteroplacental
insufficiency
Umbilical cord prolapse
Maternal hypotension
Prolonged umbilical cord
compression
Fetal congenital heart
block
Anesthetic meds

48.

Fetal tachycardia means:

Maternal infection
Fetal anemia
Fetal heart failure
Fetal cardiac dysrythmias
Maternal use of cocaine
or meth
Maternal dehydration

49.

Decrease or loss of variability

means:

Meds that depress the

CNS
Fetal hypoxemia
w/resulting acidosis
Fetal sleep cycle
congenital
abnormalities

50.

Early decels mean:

Compression of the
fetal head resulting
from uterine
contraction
Vaginal exam
Fundal pressure

51.

Late decels mean:

UPI causing
inadequate fetal
oxygenation
Maternal hypotension
placental abruption
Uterine
hyperstimulation
w/pitocin

52.

Variable decels mean:

Umbilical cord
compression
Short cord
Prolapsed cord
Nuchal cord
Oligohydraminos

53.

Fetal descent and cervical dilation

are caused by

Frequency, duration,
and strength of
contractions

54.

What is the sensation the patient

will feel when completion of
dilation and fetal descent?

She will feel like she

needs to take a big ole
poooo!

55.

First degree laceration extends

through:

skin of perineum

56.

Second degree laceration extends

through:

skin of perineum
muscles of perineum

57.

Third degree laceration extends

through:

skin of perineum
muscles of perineum
anal sphincter

58.

Fourth degree laceration extends

through:

skin of perineum
muscles of perineum
anal sphincter
anterior rectal wall

59.

Third stage:
Signs of placental separation from
the uterus are indicated by:

fundus firmly
contracting
swift gush from
introitus of dark blood
umbilical cord appears
to lengthen as placenta
descends
vaginal fullness of exam

60.

There is a high risk of

_________ surrounding
external cephalic version.

Cord prolapse

73.

PP the mom should consume

______ to_______ ml of water each
day.

2000-3000

61.

Regarding BISHOP scoring,

when is a woman ready for
labor?

A score of
9 for nulliparas
5 or more for multiparas

74.

500

62.

Mechanical methods to
ripen cervix:

balloon caths
hydroscopic dilators and
sponges
laminara tents
synthetic dilators and
sponges

Encourage women who are

lactating to add an additional ___
calories/day to their
prepregnancy diet.

75.

Teach the clent to avoid sexual

intercourse until:

episiotomy/laceration is
healed
&
vaginal discharge has
turned white

Methods of induction

prostaglandins applied
cervically
admin of IV oxytocin
amniotomy
stripping of membranes
nipple stimulation

76.

Postpartum disorders are:

unexpected events or
occurrences that may
happen during the PP
period

77.

Deep Vein Thrombosis S&S

Leg pain
Chills
Unilateral swelling,
warmth, redness
Warm extremity
Calf tenderness
Elevated temp
Cough
Tachycardia

78.

Thrombophlebitis: position arm:

Above the lever of the

heart

79.

Thrombosis tx drugs:

Heparin
Warfarin (coumadin)

80.

Pulmonary Embolus S&S

Chills
Apprehension
Pleruitic Chest pain
Dyspnea
tachypnea
hemoptysis
heart murmurs
peripheral edema
distended neck veins
elevated temp
hypotension
hypoxia

81.

DIC risk factors

abruptio placenta
AFE
missed abortion
fetal death in utero
Severe preeclampsia or
eclampsia (GHTN)
Septicemia
cardiopulmonary arrest
hemorrhage
hydatiform mole

63.

64.

Dystocia

prolonged, difficult labor

65.

Before administering
pitocin, where should the
fetus be?

engaged in the birth canal at

a minimum of 0 station.

66.

Discontinue oxytocin if:

contraction frequency more

often than every 2 mins
contraction duration longer
than 90 seconds
no relaxation of uterus
between contractions
uterine resting tone greater
than 20 mmHg between ctx

67.

Labor typically begins

within ___ hours after ROM.

12

68.

An amnioinfusion can be
used to:

Reduce severity of variable

decelerations (cord
compression)
Dilute meconium-stained
amniotic fluid

69.

Caput Succedaneum is:

Normal
Should resolve within 24 hrs

70.

For breast engorgement:

apply cool compresses b/t

feedings
apply warm compresses
take warm shower b4 breast
feeding

71.

Cold cabbage leaves

may also be applied to

breasts to decrease swelling
and relive discomfort

72.

Postpartum the mother

should not lift anything that
is heavier than:

the infant

Post partum
hemorrhage is
considered to occur
if the client loses how
much blood?

more than 500 mL after vaginal birth

more than 1000 mL after c/s

Two complications
that can occur
following PP
hemorrhage include:

hypovolemic shock
anemia

84.

PP hemorrhage VS
findings:

Tachycardia
Hypotension

85.

Meds given to tx PP
hemorrhage

Oxytocin
Methergine
Cytotec
Hemabate

86.

Subinvolution is
when:

87.

Subinvolution s&s

82.

83.

92.

APGAR
scoring is:

a brief physical exam done immediately

following birth to rule out abnormalities.

93.

APGAR of 0-3
indicates

severe distress

94.

APGAR or 4-6
indicates

moderate distress

95.

APGAR of 7-10
indicates

no distres

96.

APGAR
Heart rate
scoring

0= absent
1= <100
2= >100

97.

APGAR
RR scoring

0= absent
1= slow, weak cry
2= good cry

The uterus remains enlarged with

continued lochial discharge and may
result in PP hemorrhage

98.

APGAR
Muscle tone
scoring

0= Flaccid
1= some flexion
2= well-flexed

increased vag bleeding

uterus enlarged and higher than
normal in the abd relative to
umbilicus
boggy uterus
prolonged lochia d/c with irregular or
excessive bleeding

99.

APGAR
Reflex
irritability

0= none
2= grimace
3= cry

100.

APGAR
Color scoring

0= Blue, pale
1= pink body, cyanotic hands and feet
(acrocyanosis)
2= Completely pink

101.

Normal
newborn
weight range:

2500-4000 grams

102.

Low birth
weight

less than 2500 grams

103.

Term birth

between 38 weeks and 42 weeks

104.

Grunting and
nasal flaring
are:

signs of respiratory distress

105.

crackles and
wheezing are
signs of

fluid or infection in the lungs

106.

Newborn BP
should be

60-80 systolic and 40-50 diastolic

107.

Newborn
temp should
be

97.7-98.9

108.

Milia

small raised white spots on nose, chin, and

forehead

109.

mongolian
spots

bluish purple spots of pigmentation

110.

telangectiatic
nevi

flat pink or red marks that easily blanch and

are found on the newborns back of the
neck, nose, upper eye lids, and middle of the
forehead

88.

Risk factors for

subinvolution of
uterus:

Pelvic infection and endometritis

Retained placental fragments not
completely expelled from the uterus

89.

Inversion of the
uterus

Retained placenta
Uterine atony
Excessive fundal pressure
Abnormally adherent placental
tissue
Multiparity
Fundal implantation of the placenta
Extremem traction applied to the
umbilical cord
Leiomyomas

90.

91.

Inversion of uterus
s&s

Retained placenta:

pain in lower abd

vag bleeding
dizziness
low BP
pallor
Placenta or fragments of the placenta
remain in the uterus preventing the
uterus from contracting which leads
to uterine atony or subinvolution
Med given: oxytocin....if unsuccessful
then tocolytic for d&c

111.

nevus flammues
(port wine stains)

a capillary angioma below the surface of

the skin that is purple or red, varies in
size and shape, is commonly seen on
face and does not blanch or disappear.

112.

erythema
toxicum

pink rash that appears suddenly

anywhere on the body of a term
newborn during the first 3 weeks.

113.

caput
succadaneum

localized swelling of the soft tissues of the

scalp caused by pressure on the head
during labor.........normal
finding......crosses suture line

114.

cephalhematoma

collection of blood between periosteum

and skull bone that it covers
does not cross suture line
results from trauma during birth

115.

normal newborn
RR

30-60

116.

When can
bathing by
immersion be
done?

When the newborn's umbilical cord has

fallen off and the circumcision has
healed on males

117.

How long should

the newborn
nurse?

15-20 minutes (but don't educate the

mother on the timing)

118.

Newborns who
are formula fed
should be
burped:

every 15-30 mLs

119.

Newborns should
have how many
diapers a day?

6-8 wet diapers

3-4 stools per day

120.

Cord infection
s&s:

moist and red

foul odor
purulent drainage

121.

Chlamydia s&s

Vulvar itching
Vag spotting
White, watery vaginal discharge

122.

Gonorrhea S&S

Urethral discharge
Painful urination
Frequency
Yellowish-green vag discharge
Reddended vulava & vag walls

123.

GBS can be tested

when?

35-37 week GA

124.

Candida Albicans
S&S

Vulvar itching
Thick, creamy white vag discharge
Vulvar redness
White patches on vag walls
Gray white patches on tongue and
gums

125.

Terbutaline
(Brethine)

Uses to relax uterine smooth muscle to

inhibit uterine activity

126.

Indomethacin

is an NSAID that suppresses preterm

labor & uterine contraction.

127.

Betamethoasone

Glucocorticoid given to enhance fetal

lung maturity and surfactant production.

128.

MSAFP screening
done when?

15-22 weeks