MCH - Exam 2 Review condensed
100% Correct Answers Rated A+
MCH – EXAM 2 Review (condensed)
Symptoms of Early Labor: (Term Birth = 39 weeks)
* Excited Mother, irritable related to answering multiple questions & about contractions.
* Mothers pulse will be 100 BPM (choose answer TWICE in the select all that apply question)
Corticosteroid Therapy: only treatment shown to improve fetal survival (during preterm
labor 24-34)
Benefits: decrease in intraventricular hemorrhage, respiratory distress syndrome and
mortality
* betamethasone - 12 mg IM every 24 hours for two days
* dexamethasone -6 mg IM every 12 hours for two days.
** BOTH Meds help Baby’s Lungs Mature (watch for distractions in question)
Assessment of the preterm client : Obtain UA & Culture and sensitivity if indicated by leukocytosis
Preterm Rupture of Membranes (PROM): Rupture of membranes b4 37 weeks.
What to do: Doctor should perform a speculum exam and check for dilation/effacement
AVOID: digital exams bcuz they have been proven to increase morbidity & mortality
* avoid prolonging delivery when PROM occurs between 34+ weeks
Unborn baby w/pulmonary maturity (32-34 weeks) - go to hospital where care for pre-mature neonates is
good and induce labor & perform an amniocentesis. Prolonging pregnancy increases risk for: maternal
amnionitis, umbilical cord compression, prolonged hospitalization and neonatal infection.
* Delivery prior to 32 weeks has a high mortality rate.
* PROM occurring before 24 weeks = 6-7 days till delivery & many long term effects on the infant.
Antibiotics during PROM: reduces neonatal infections & prolong the latent period.
Exam question: (exam question will be what you WON’T do)
, MCH - Exam 2 Review condensed
100% Correct Answers Rated A+
You are reviewing orders for a PROM, and you understand that you ARE going to do the following:
* Monitor fetal heartrate
* administer antibiotics
* monitor vital signs
* SPECULUM exam
* Nurse will NOT use Hands (only done in a vaginal exam)
Determine if able to complete a fetal fibronectin test (FFN)
1. NO SEX in the last 24 hours
2. No rupture of membranes.
3. The fetal fibronectin test is a predictor test of delivery in the next two weeks.
* Sperm contains fetal fibronectin and would give a false positive result.
* Do this test from the weeks 24 to 34 weeks of pregnancy.
* A negative test is desired- no fetal fibronectin is found and pregnancy will continue for two more
weeks.
Determine if amniosure test should be done - checks for ruptured membranes.
* Negative means no rupture of membranes.
* Positive result means the bag of water is not intact.
Rule out bleeding: Place on continuous fetal monitoring.
* A non-stress test -the determination of the fetal heart rate over a 20-40 minute period.
* The fetal heart rate should accelerate by 15 beats and this acceleration should last 15 seconds, at
least two times in a 20 minute time frame.
NON REACTIVE test is no acceleration of 15X15 in 40 minutes-(40 min. is considered babies normal
sleep cycle)
100% Correct Answers Rated A+
MCH – EXAM 2 Review (condensed)
Symptoms of Early Labor: (Term Birth = 39 weeks)
* Excited Mother, irritable related to answering multiple questions & about contractions.
* Mothers pulse will be 100 BPM (choose answer TWICE in the select all that apply question)
Corticosteroid Therapy: only treatment shown to improve fetal survival (during preterm
labor 24-34)
Benefits: decrease in intraventricular hemorrhage, respiratory distress syndrome and
mortality
* betamethasone - 12 mg IM every 24 hours for two days
* dexamethasone -6 mg IM every 12 hours for two days.
** BOTH Meds help Baby’s Lungs Mature (watch for distractions in question)
Assessment of the preterm client : Obtain UA & Culture and sensitivity if indicated by leukocytosis
Preterm Rupture of Membranes (PROM): Rupture of membranes b4 37 weeks.
What to do: Doctor should perform a speculum exam and check for dilation/effacement
AVOID: digital exams bcuz they have been proven to increase morbidity & mortality
* avoid prolonging delivery when PROM occurs between 34+ weeks
Unborn baby w/pulmonary maturity (32-34 weeks) - go to hospital where care for pre-mature neonates is
good and induce labor & perform an amniocentesis. Prolonging pregnancy increases risk for: maternal
amnionitis, umbilical cord compression, prolonged hospitalization and neonatal infection.
* Delivery prior to 32 weeks has a high mortality rate.
* PROM occurring before 24 weeks = 6-7 days till delivery & many long term effects on the infant.
Antibiotics during PROM: reduces neonatal infections & prolong the latent period.
Exam question: (exam question will be what you WON’T do)
, MCH - Exam 2 Review condensed
100% Correct Answers Rated A+
You are reviewing orders for a PROM, and you understand that you ARE going to do the following:
* Monitor fetal heartrate
* administer antibiotics
* monitor vital signs
* SPECULUM exam
* Nurse will NOT use Hands (only done in a vaginal exam)
Determine if able to complete a fetal fibronectin test (FFN)
1. NO SEX in the last 24 hours
2. No rupture of membranes.
3. The fetal fibronectin test is a predictor test of delivery in the next two weeks.
* Sperm contains fetal fibronectin and would give a false positive result.
* Do this test from the weeks 24 to 34 weeks of pregnancy.
* A negative test is desired- no fetal fibronectin is found and pregnancy will continue for two more
weeks.
Determine if amniosure test should be done - checks for ruptured membranes.
* Negative means no rupture of membranes.
* Positive result means the bag of water is not intact.
Rule out bleeding: Place on continuous fetal monitoring.
* A non-stress test -the determination of the fetal heart rate over a 20-40 minute period.
* The fetal heart rate should accelerate by 15 beats and this acceleration should last 15 seconds, at
least two times in a 20 minute time frame.
NON REACTIVE test is no acceleration of 15X15 in 40 minutes-(40 min. is considered babies normal
sleep cycle)
