NSPN 7200 FINAL EXAM QUESTIONS ANSWERED CORRECTLY LATEST UPDATE 2026

NSPN 7200 FINAL EXAM QUESTIONS ANSWERED CORRECTLY LATEST UPDATE 2026 When are corticosteroids administered for PTL(What gestation typically) - Answers Women at risk for PTL between 24-34 weeks gestation but can be used as early as 22 weeks if resuscitation and intensive care is planned When will antibiotics be ordered for PTL - Answers if membranes are ruptured, GBS+, GBS status is unknown What is the usual antibiotic ordered in PTL - Answers Penicillin What is Magnesium Sulphate given for in PTL for? And when is it given? - Answers Neuroprotective agent and administered at 34 weeks and birth is imminent (likelihood of delivering in 24 hours) How is imminent birth defined? - Answers High likelihood of birth within 24 hours due to either active labour (cervix 4cm dilated) or planned preterm delivery for maternal/fetal conditions Other than when signs of toxicity exist when should MgSO4 treatment be discontinued in relation to PTL - Answers When delivery is no longer imminent, or there has been 24 hours of MgSO4 treatment Name 4 minor side effects of MgSO4 - Answers Flushing, burning at IV site, metallic taste on tongue, sweating, N&V Name 4 serious side effects of MgSO4 - Answers Respiratory depression, absent refexes, hypotension, tachycardia, pulmonary edema Identify two potential neonatal affects(related to high doses of MgSO4) - Answers Hypotonia and Apnea Physical Activity and Food can increase someones chances of delivering a preterm baby - Answers FALSE. They pose no risk to preterm labour Nursing Implications for Preterm Labour - Answers Ongoing assessment of maternal/fetal wellbeing, medication admin, communication with interprofessional team, preparing for delivery How may assessments differ in PTL during labour - Answers May be difficult to palpate uterine contractions depending on gestational age and size of womens abdomen. Notify NICU Resus team Ensure all equipment is ready and in the room and appropriate to babies size PTL can progress quickly so be prepared! Preterm:At what gestational age should the baseline rate and variability be similar to a term fetus - Answers 32 weeks Would you expect the baseline FHR of a preterm fetus at 28 weeks gestation to be higher or lower FHR than a term fetus. - Answers Higher. This is related to maturity of the central and autonomic nervous systems and cardiovascular systems. The sympathetic nervous system, which increases heart rate, matures before the parasympathetic system which slows heart rate. As the fetus matures, the baseline heart rate will decrease and the heart rate variability will increase. Why might you see more cord compression (Baroreceptor response) in a preterm fetus - Answers There is less Wharton's jelly protecting the umbilical cord as the fetus moves around. Extremely Preterm - Answers 28 weeks gestation Moderately Preterm - Answers 28-34 weeks gestation Late Preterm - Answers 34-36+6 weeks gestation List some potential health consequences for the preterm infant - Answers Respiratory distress, asphyxia, ineffective thermoregulation, feeding problems, infection, hyperbilirubinemia, metabolic disturbances, fluid and electrolyte imbalances, neurologic and behavioural problems, nutritional deficits, chronic respiratory disease, cardiovascular disease, hematologic disturbances What does PWSCOA mean - Answers Pink- Establish and maintain respirations Warm- Ability to regulate temperature Sweet- Maintain blood sugar Clean- Employ infection prevention strategies Organized- Maintain an optimum state Attached- Promote attachment with family How does PWSCOA affect care for the preterm neonate - Answers Pink-RDS due to surfactant deficiency, and respiratory support Warm: Very thin skin and do not have sufficient brown fat stores to create a sufficient heat production response Sweet: Low glycogen stores, high energy expenditures (increased work of breathing), low caloric intake, which places them at risk for hypoglycemia, and not able to coordinate suck, swallow and breathing required for oral feeding Organized: Face challenges due to immature organ systems and the high stress environment where their care takes place Attached: Skin to skin, Kangaroo care can improve physiologic stability, improve sleep/wake cycles, reduce stress and crying, reduce pain and facilitate neurodevelopment and maturation in the neonate Clean: Due to an immature immune system, frequent interventions and multiple care providers they are at increased risk for infection Mothers of preterm infants experience higher levels of ___________ - Answers postpartum depression, distress, anxiety, and post traumatic stress Is the breast milk a woman produces when she has a preterm infant different than the milk she produces for a term infant? - Answers YES! Preterm breastmilk has increased protein content, lipid content that is more specific for a preterm infant, and higher IgA concentration. And the predominant whey protein of preterm breast milk has anti-infective properties and the lactose has increased absorption in preterm infants Benefits for a preterm fetus to recieve breastmilk - Answers protection from necrotizing enterocolitis protection from infection increased feeding tolerance earlier attainment of full enteral feedings decreased risk for later allergy improved retinal function improved neurocognitive development suppression of oxidative stress reduced heart disease later in life reduced health care costs When is hypertension in pregnancy diagnosed? - Answers When blood pressure is equal to or greater than 140/90 mmHg on the average of atleast two readings taken after 5 minutes of rest and at least 15 minutes apart using the same arm What is severe hypertension defined as - Answers Blood pressure equal to or greater than 160/110mmHg on the average of two readings taken 15 minutes apart using the same arm What are some adverse maternal outcomes of hypertensive disorders of pregnancy - Answers Renal failure, coagulopathy, liver failure, placental abruption, seizures, stroke Define Chronic (Pre-Existing) Hypertension - Answers hypertension that developed before pregnancy or at 20 weeks gestation Define Gestational Hypertension - Answers hypertension that develops for the first time at 20 weeks gestation with no evidence of preeclampsia Define Preeclampsia - Answers gestational hypertension with new onset proteinuria and/or one or more adverse conditions. List some adverse conditions that you might see with preeclampsia - Answers Severe headache, visual disturbances, low platelet count, elevated serum creatinine, RUQ or epigastric pain, elevated liver enzymes (AST,ALT), FGR, Oligohydramnios, absent or reversed end diastolic flow by umbilical artery doppler velocimetry, chest pain/dyspnea, oxygen saturation 97% What is the theory for why preeclampsia occurs? - Answers Defective placental implantation which leads to a mismatch of utero-placental supply and fetal demands and the mismatch leads to endothelial cell dysfunction What are the three characteristics of preeclampsia - Answers Generalized vasospasm, dysfunctional cascade of coagulation, leaky vessels Risk factors for preeclampsia - Answers family history extremes of reproductive age (19 or 40 years) primigravida multiple gestation diabetes renal disease collagen vascular disease first pregnancy with a new partner limited sperm exposure such as donor insemination or oocyte donation a history of preeclampsia obesity thrombophilia disorders What are two potential complications of preeclampsia - Answers Eclampsia and HELLP syndrome What is eclampsia - Answers The onset of seizure activity or coma in a woman with preeclampsia who has no history of pre-existing pathology that can result in seizure activity HELLP Syndrome - Answers Laboratory diagnosis Hemolysis Elevated liver enzymes Low platelets Clinical presentation of HELLP Syndrome - Answers General malaise, flu-like symptoms, epigastric or RUQ pain Also assess for: severe headache and visual disturbances Preeclampsia is characterized by - Answers preeclampsia is characterized by vasoconstriction, activation of the clotting cascade, and leaky vessels. Hemolysis occurs as red blood cells try to squeeze through constricted vessels. Decreased perfusion to the liver leads to ischemia, resulting in a release of liver enzymes, and low platelets result from widespread activation of the clotting cascade What causes endothelial dysfunction in preeclampsia - Answers Placental ischemia Why would a woman experience epigastric pain in preeclampsia - Answers Liver edema and subcapsular hematoma When preeclampsia is suspected what bloodwork should be ordered - Answers CBC, platelet, INR, PTT, fibrinogen, serum creatinine and uric acid, glucose, AST, ALT, LDH, albumin, bilirubin, urinalysis and urine protein creatinine ratio (PCR) What assessments can you do to assess fetal well being in someone with a hypertensive disorder in pregnancy - Answers NST, US, Fetal Movement Counts, BPP, Doppler studies When should someone with chronic hypertension deliver? - Answers Initiation of delivery can be offered at 38-39+6 weeks gestation, however should be advised from 40 weeks gestation When should someone with gestational hypertension deliver? - Answers For women whose gestational hypertension began at 37 weeks gestation, initiation of delivery may be offered at 38-39+6 weeks gestation, but should be advised from 40 weeks. For those women who have presented with gestational hypertension ≥37 weeks gestation, initiation of delivery should be discussed at this time. WHen should someone with preeclampsia deliver? - Answers is only resolved with delivery of the placenta. Timing of delivery must consider maternal and fetal well-being. For women at: Viability-33+6 weeks gestation, expectant management in a center capable of caring for a preterm infant. 34-36+6 weeks gestation, timing of delivery is individualized based on maternal and neonatal risks. Current guidelines state to consider initiation of delivery between 36-36+6 weeks gestation. ≥37 weeks gestation, initiation of delivery is recommended. What are the first line hypertensives typically used in pregnancy - Answers Beta Blockers (Labetolol) and other meds are: oral methyldopa, long acting oral nifedipine, then hydralazine, clonidine and thiazide diuretics What is MgSO4 used for in women with preeclampsia? - Answers MgSO4 is also used to prevent and treat eclamptic seizures in women with preeclampsia by depressing the central nervous system (CNS). It may also be used for women with symptoms such as severe headache, visual disturbances, right upper quadrant (RUQ) pain or epigastic pain, elevated liver enzymes, low platelets, and progressive renal insufficiency (Magee et al., 2022). The dose is 4gm IV loading bolus over 20 minutes, followed by 1 gm per hour infusion What is the antidote for MgSO4 - Answers Calcium Gluconate How might MgSO4 impact the fetus/neonate? - Answers Loss of tone, apnea, respiratory depression, reduced variability in the FHR Signs of MgSO4 toxicity - Answers absent deep tendon reflexes, respiratory depression, slurred speech, cardiac arrest, chest pain, muscle weakness, decreased LOC