OB HESI V2 EXAMS 2023

OB HESI V2 EXAMS 2023 During the postpartum period a client tells a nurse that she has been having leg cramps. Which foods should the nurse encourage the client to eat? 1 Liver and raisins Cheese and broccoli 3 Eggs and lean meats 4 Whole-wheat breads and cereals Ans- cheese and broccoli need calcium A pregnant client with severe preeclampsia is receiving IV magnesium sulfate. What should the nurse keep at the bedside to prepare for the possibility of magnesium sulfate toxicity? 1Oxygen 2Naloxone 3Calcium gluconate 4Suction equipment Ans- calcium gluconate The antagonist of magnesium sulfate is calcium gluconate. Oxygen is ineffective if the action of magnesium is not reversed. Naloxone is unnecessary; it is an opioid antagonist. Suction equipment may be necessary if the client has excessive secretions after a seizure. The priority intervention is trying to prevent a seizure. A client arrives at the clinic in preterm labor, and terbutaline (Brethine) is prescribed. For what therapeutic effect should the nurse monitor the client? 1increased blood pressure and pulse 2Reduction of pain in the perineal area 3Gradual cervical dilation as labor progresses 4Decreased frequency and duration of contractions Ans- decreased frequency and duration of contractions Terbutaline sulfate (Brethine) is a β-mimetic that acts on the smooth muscles of the uterus to reduce contractility, which in turn inhibits dilation and the frequency and duration of contractions. Although terbutaline may increase blood pressure and pulse, this is a side, not a therapeutic, effect requiring frequent assessments. Terbutaline is not an analgesic. It should stop cervical dilation rather than increase it. greenish amniotic fluid indicates Ans- meconium in amniotic fluid and dr should be notified immediately pt on magnesium sulfide, what base line assessment is needed Ans- repsiration rate LOC is also affected but do not need a baseline hydatidiform mole Ans- causes extra large utereus lepolds maneuver on patient with placental previa expects Ans- high floating, presenting part A client's membranes rupture during labor. The nurse immediately assesses the electronic fetal heart rate. Variable decelerations lasting more than 90 seconds, followed by bradycardia, are observed on the monitoring strip. What does the nurse suspect as the cause of this change? 1Fetal acidosis 2Prolapsed cord 3Head compression 4uteroplacental insufficiency Ans- prolapsed cord This variable pattern with bradycardia is an ominous sign; it is indicative of cord compression, which can result in fetal hypoxia. Immediate intervention is required. Fetal acidosis occurs with uteroplacental insufficiency, not in response to a prolapsed cord. Early decelerations are associated with head compression and are benign. Late decelerations and tachycardia are associated with uteroplacental insufficiency, not a prolapsed cord. heart burn while pregnant Ans- don't take antacids with sodium A 36-year-old woman comes to the emergency department complaining of severe abdominal cramping and heavy bleeding. She informs the nurse that she is 10 weeks pregnant. Cervical examination reveals heavy bleeding; the cervical os is open and tissue is present. Which type of miscarriage is the client experiencing? 1Missed 2Complete 3Inevitable 4Threatened Ans- inevitable Miscarriage is inevitable because the cervical os has opened, heavy bleeding is occurring, and tissue is present with the bleeding. In a missed miscarriage, the fetus has died but the products of conception are retained in utero for as long as several weeks. There may be no bleeding or cramping, and the os is closed. In a complete miscarriage all fetal tissue has already passed and the cervix is closed; there may be slight bleeding. Symptoms of a threatened miscarriage include spotting and a closed cervical os. There may be mild cramping. blood in urine in catheter back during c-section indicates Ans- incisional nick in the bladder risk for hypotonic uterine dystocia Ans- twin gestation placental previa Ans- when the placenta covers the opening of the cervix most likely to have it is a 30y/0m g6p5 signs of a ruptured tubal pregnancy occur when Ans- 6 weeks into pregnancy this is when the fallopian tube is no longer able to get any larger megaloblastic anemia in pregnancy Ans- can cause neural tube defects mother needs to be started on folic acid supplements asap vaginal hematoma Ans- pain is severe and vagina feels full and heavy classification of magnesium sulfate Ans- CNS depressant pt. receiving lovenox for DVT, what sign is most concerning Ans- dyspnea when a patient is on magnesium sulfate Ans- keep room dark and quiet Taking-in Phase — Ans- For the first day or two after the birth, new mothers need extra food and rest. Cesarean mothers need even more rest. All new mothers also need "mothering" themselves so they can successfully mother their new babies. New fathers also may have difficulty adjusting to parenting. Partners can make a special effort to support each other during this big change in their lives. Taking-hold Phase — Ans- During this phase, parents focus on learning to care for their new baby. Temporary mood swings and feelings of vulnerability on the part of the new mother are not uncommon. Each partner may feel neglected as they become more involved with the baby, overlooking their partner's needs or feelings. Letting-go Phase — Ans- The couple will continue their relationship that they had before the birth of the baby. The older brothers and sisters get to know the baby at this time. magnesium sulfate and the importance of deep tendon reflexes Ans- indicates respiratory depression nursinging intervention for pt. with placental previa Ans- document amount of bleeding after internal fetal heart monitor placement dr listens to fetal heart rate for 1 full minute to monitor Ans- uterine cord prolapse risk factor for abruptio placentae Ans- hypertension positive Contraction stress test indicates Ans- Late decelerations of the fetal heart rate are occurring with each contraction. also uteroplacental insufficiency A nurse administers two serial intramuscular injections of betamethasone (Celestone) to a woman at 32 weeks' gestation who has been admitted in preterm labor. The nurse knows that this medication is given to: Ans- stimulate surfactant production. Corticosteroids stimulate surfactant production; they also have been shown to reduce the incidence of intraventricular hemorrhage. Betamethasone (Celestone) does not affect the labor process, increase placental perfusion, or affect the intensity of contractions. low lying placenta in third trimester puts mom at risk for Ans- painless vaginal bleeding pt. with pre-eclampsia is admitted, after vitals are taken what is next priority Ans- checking pt. reflexes chorionic villi sampling when can it be done Ans- 10 weeks and no later than 12 weeks magnesium sulfate: how to know when you have reached therapeutic level Ans- deep tendon reflexes +2 what to assess before administration of magnesium sulfate Ans- patellar reflexes and urinary output threatened abortion Ans- vaginal spotting, abdominal cramping, closed cervix vertex postion Ans- proper for delivery risk when undergoing IVF Ans- tubal pregnancy mom with mitral valve stenosis, ,what symptom indicates cardiac difficulties Ans- syncope for exertion what contraindicates pitocin Ans- herpes infectio