CONCORDIA NUR 418 PEDS/OB Exam 1 — Pediatric and Obstetric Nursing
Knowledge Assessment
Focus of Community Based Maternal Child Health Programs (Maternal child Discussion board) -
(ANSWER)Specific objectives of MCH Care focuses on the reduction of maternal, perinatal, infant and
childhood mortality and morbidity and the promotion of reproductive health and the physical and
psychosocial development of the child and adolescent within the family.
Community Based Delegation - (ANSWER)Community based nurse: serves communities with greater
risks and barriers to achieving positive maternal and child health outcomes
obstetric/neonatal nurse: work with pregnant women to ensure healthy pregnancies before, during, and
after childbirth, works directly with newborn infants
What can be delegated? - (ANSWER)•Delegate to role below nurse. Cannot delegate assessment. Stable
condition. Predictable. YES to bathing NO to assessing a wound
Family Centered Care concepts (FCC Care Video ) - (ANSWER)Focus shifted from the biomedical aspect
of a child's condition to view the child in the context of their family Use of interdisciplinary team specific
per fam Employees dignity, respect, collaboration, participation, information sharing
•Family is involved in the care planning. Increases adherance, improves outcomes Maintain routines,
foods, languages
Assigning Parity - (ANSWER)-number of times a woman has given birth to a fetus with a gestational age
of 20 weeks or more (alive or stillborn) G= total number of times pregnant T= number of term infants
born (Between 38-42wks) P= number of preterm infants born (Between 20-37 wks) A= number of
abortions before 20 weeks L= number of children currently living
Parity - (ANSWER)-multipara: 2 or more births at more or 20 weeks -nulipara: no births at more than 20
weeks gestation -primapara: 1 birth at more than 20 weeks gestation
Fundal height - (ANSWER)-fundal height in cm should equal weeks of gestation + or - 2 -12 weeks=
above symphysis pubis -16 weeks= halfway between symphasis pubis and umbilicus -20 weeks= on the
umbilicus
*Top of uterus, cervix is base
, CONCORDIA NUR 418 PEDS/OB Exam 1 — Pediatric and Obstetric Nursing
Knowledge Assessment
False Labor - (ANSWER)-Braxton hicks: uterus contractibility increases in response to increased estrogen
levels -can begin in second trimester but some women dont feel them until 3rd -contractions are
irregular with no particular pattern -as uterus enlarges they are more noticeable -ensure adequate fluid
intake and recommend maternity girdle for uterus support
False Labor Changes - (ANSWER)*False labor: if no change in cervix within 2 hours, irregular contractions
(hydrate patient) *True labor: If cervix changes (effacement & dilation)
Fetal Monitoring (OB ch 9 pg 272 Box 9-1) - (ANSWER)Overall Goals: - support maternal coping and labor
progress - Maximize uterine blood flow - Maximize umbilical blood flow - Maximize oxygenation -
Maintain appropriate uterine activity
Fetal Monitoring (OB ch 9 pg 272 Box 9-1) - Nurse Interventions - (ANSWER)Nursing actions: - Review
plan/expectations with woman and her family - Maintain calm environment - Stay at the bedside as
much as possible - Monitor only at the level needed for this patient - Frequent position changes/upright
positioning - Judicious use of technology-0
Safe Ranges and Therapeutic Levels - (ANSWER)-if a med is dosed below minimum safe range= child isnt
getting therapeutic dose -if a med is dosed above safe range= may be toxic, severe medical
consequences
Nonpharm: Bradley method - (ANSWER)It's a medication-free method that emphasizes relaxation as a
form of pain reduction during labor. But it's also a comprehensive plan that focuses on healthy living
throughout your pregnancy.
Pediatric Physiological Differences to medication - (ANSWER)-immature blood brain barrier -increased
permeability of skin and conjunctiva -immature cardiovascular system -higher metabolic rate -
differences in protein binding -altered absorption patterns -delayed gastric emptying, relative lack of
gastric acid -immature renal function -high total water volume -low body fat -rapidly growing tissues -
large body surface area
Higher water volume Lower body fat Increased skin permeability Immature blood brain barrier
Postpartum Assessment (OB Chp 12) - (ANSWER)*supine position -pain level -last urine and BM -LOC -VS
-cap refil -edema -breast for redness -check fundus (fundal height, boggy, firm) -check peri pad and note
Knowledge Assessment
Focus of Community Based Maternal Child Health Programs (Maternal child Discussion board) -
(ANSWER)Specific objectives of MCH Care focuses on the reduction of maternal, perinatal, infant and
childhood mortality and morbidity and the promotion of reproductive health and the physical and
psychosocial development of the child and adolescent within the family.
Community Based Delegation - (ANSWER)Community based nurse: serves communities with greater
risks and barriers to achieving positive maternal and child health outcomes
obstetric/neonatal nurse: work with pregnant women to ensure healthy pregnancies before, during, and
after childbirth, works directly with newborn infants
What can be delegated? - (ANSWER)•Delegate to role below nurse. Cannot delegate assessment. Stable
condition. Predictable. YES to bathing NO to assessing a wound
Family Centered Care concepts (FCC Care Video ) - (ANSWER)Focus shifted from the biomedical aspect
of a child's condition to view the child in the context of their family Use of interdisciplinary team specific
per fam Employees dignity, respect, collaboration, participation, information sharing
•Family is involved in the care planning. Increases adherance, improves outcomes Maintain routines,
foods, languages
Assigning Parity - (ANSWER)-number of times a woman has given birth to a fetus with a gestational age
of 20 weeks or more (alive or stillborn) G= total number of times pregnant T= number of term infants
born (Between 38-42wks) P= number of preterm infants born (Between 20-37 wks) A= number of
abortions before 20 weeks L= number of children currently living
Parity - (ANSWER)-multipara: 2 or more births at more or 20 weeks -nulipara: no births at more than 20
weeks gestation -primapara: 1 birth at more than 20 weeks gestation
Fundal height - (ANSWER)-fundal height in cm should equal weeks of gestation + or - 2 -12 weeks=
above symphysis pubis -16 weeks= halfway between symphasis pubis and umbilicus -20 weeks= on the
umbilicus
*Top of uterus, cervix is base
, CONCORDIA NUR 418 PEDS/OB Exam 1 — Pediatric and Obstetric Nursing
Knowledge Assessment
False Labor - (ANSWER)-Braxton hicks: uterus contractibility increases in response to increased estrogen
levels -can begin in second trimester but some women dont feel them until 3rd -contractions are
irregular with no particular pattern -as uterus enlarges they are more noticeable -ensure adequate fluid
intake and recommend maternity girdle for uterus support
False Labor Changes - (ANSWER)*False labor: if no change in cervix within 2 hours, irregular contractions
(hydrate patient) *True labor: If cervix changes (effacement & dilation)
Fetal Monitoring (OB ch 9 pg 272 Box 9-1) - (ANSWER)Overall Goals: - support maternal coping and labor
progress - Maximize uterine blood flow - Maximize umbilical blood flow - Maximize oxygenation -
Maintain appropriate uterine activity
Fetal Monitoring (OB ch 9 pg 272 Box 9-1) - Nurse Interventions - (ANSWER)Nursing actions: - Review
plan/expectations with woman and her family - Maintain calm environment - Stay at the bedside as
much as possible - Monitor only at the level needed for this patient - Frequent position changes/upright
positioning - Judicious use of technology-0
Safe Ranges and Therapeutic Levels - (ANSWER)-if a med is dosed below minimum safe range= child isnt
getting therapeutic dose -if a med is dosed above safe range= may be toxic, severe medical
consequences
Nonpharm: Bradley method - (ANSWER)It's a medication-free method that emphasizes relaxation as a
form of pain reduction during labor. But it's also a comprehensive plan that focuses on healthy living
throughout your pregnancy.
Pediatric Physiological Differences to medication - (ANSWER)-immature blood brain barrier -increased
permeability of skin and conjunctiva -immature cardiovascular system -higher metabolic rate -
differences in protein binding -altered absorption patterns -delayed gastric emptying, relative lack of
gastric acid -immature renal function -high total water volume -low body fat -rapidly growing tissues -
large body surface area
Higher water volume Lower body fat Increased skin permeability Immature blood brain barrier
Postpartum Assessment (OB Chp 12) - (ANSWER)*supine position -pain level -last urine and BM -LOC -VS
-cap refil -edema -breast for redness -check fundus (fundal height, boggy, firm) -check peri pad and note
