Nurses who study the incidences of diabetes in the United States would most likely be what type of nurse?
Community Health nurse
Public Health Nurse
In community assessment transportation, water and sanitation and housing all fit under the category of
Mortality is to the measurement of deaths as morbidity is to the measurement of_______
disease and injury
Ebola was a disease that had never occurred before in the USA. When Ebola broke out in Africa and moved to the United States through healthcare workers; The news was reporting on how many new people were getting the disease.....they were reporting the __________ of Ebola in America.
Select all parts of the epidemiologic triangle
Breast feeding has been shown too: (select 4)
decrease severity of diarrhea
decrease incidence of lower respiratory infection
prevent heart murmurs
be protective against allergies
decrease postpartum bleeding for mom
A well educated breast feeding mother 4 hours post delivery is very tired and is not able to sustain breastfeeding for a long time. She expresses concern that she won't let down milk because she can't breastfeed for a sustained period of time. A key thing to inform the mother about lactogenesis this early on is?
It is good for the baby to practice sucking even though you won't let down milk just yet.
Frequency of feedings not the duration of feedings is what is responsible for milk production.
We can give you medications to help with milk production since you're too tired to feed your baby.
Characteristics of colostrum that make it different from mature milk include: (pick3)
produced during pregnancy and 4 days pospartum
thick, creamy and yellow
rich in proteins and immunoglobulins
has higher fat then mature milk
An obese mother with very large breasts is having trouble breast feeding her infant. The nurse could suggest using the breast C hold and which position based on her body type?
A mother is very distraught that her baby isnt getting milk. The nurse is watching her breastfeed. Signs of milk transfer that the nurse should point out to ease the mother's concerns include all but which of the following?
When the mother gets thirsty
audible swallowing of infant
Milk leaking from the opposite breast while feeding
breast softening while feeding
The T in LATCH stands for what?
Type of nipple
Mouth open wide with lips flanged outward and visible
complete seal formed by mouth on breast
................... these are all assessments during which stage of SAIB (Systematic Assessment Of Infant At Breast)
SAIB 1: alignment/ positioning
SAIB 2: Areola Latchon
SAIB 3: Areola Compression/Sucking
SAIB 4: Audible Swallowing
A normal newborn feeds a minimum of ___________ in 24 hours and voids approximately _______ times a day
Prolonged Pregnancies (pregnancies greater than 40-42 weeks) are associated with which of the following (pick 4)
neonate born with excessive lanugo
decreased vernix leading to dry parchment-like skin
r/f uteroplacental insufficiency
r/f meconium aspiration
absent rooting reflex
hypoglycemia of newborn
Nursing interventions for Prolapsed Cord include:
When fetal bradycardia occurs, perform vaginal exam
Prolapse into vagina= exert upward pressure on presenting part to lift part off cord
If cord protrudes outside of vagina= gently replace cord
Hands and knees position for mom to get pressure off cord
DONT call doctor
A labor has just been complicated by Turtle Sign of the infant... This is associated with ____________________ and the least invasive intervention to try first to correct he problem would be ___________________.
Wood's screw maneuver
Assessment Findings associated with anaphylactoid Syndrome of Pregnancy (ASP) include all but which of the following
Sudden onset respiratory distress
Signs and Symptoms of Shock
Premature rupture of membranes, Postmature pregnancy, preeclampsia/eclampsia, and diabetes in a labor with no Cephalopelvic disproportions are all....
conditions that require emergency C-sections
indications for induction of labor
conditions that put the baby at severe risk for chromosomal anomalies
Identify the two women with Bishop Scores that would be most successful
Mom with 4 previous pregnancies with a bishop score of 4
Mom with 2 previous pregnancies with a bishop score of 6
First time mom with a bishop score of 5
First time mom with a bishop score of 9
Amnitomy is procedure to artificially rupture membranes
Dinoprostone (Prepidil) select the right information associated with this cervical ripening drug: (pick 3)
Contraindicated with asthma, htn, glaucoma
Contraindicated in women with C-section hx
Dose: 2.5mg vaginalls or .5mg to cervix, repeat 6-12hours
Dose: 10mg vaginally
Delay oxytocin for 6-12 hours
Oxytocin given with med
A non-FDA approved medication that should be cut by the pharmacy and has a maximum dose of 25 mcg for cervical ripening would be....
Pro's to using dinprostone (cervidil) for cervical ripening include:
adverse effects decrease within 15 min after removal of insert
hypertonic contractions begin 1 hour after adminstration
Oxytocin may be started 30-60min after removal
Pill is scored for easier cutting of dose
Higher doses of Sinoprostone (prepidil), DInoprostone (cervidil) and Misoprostol (cytotec) can be given in the in the instance of....
fetal distress and need for baby to get out immediately
paralysis of uterus
A doctor rights an order for a dose .5 mU/min of increased if tolerated to 1mU/min at 50 min intervals until a regular pattern of ctx is established.
What medication do you expect to be ordered with these parameters/doseing
Which two pts would you question an order of Pitocin (oxytocin) for?
MOm experiencing hypotonic contractions for past 6 hours
Mom with CPD
Mom with total placenta previa
Mom who's baby is showing frequent accelerations with contractions
Major indications for C-section (pick 4)
previous vaginal births
previous cesarean births
Accelerations of FHR
A mother is in labor and suddenly screams and says that she feels a "sharp" pain in her stomach, you assess contractions and realize her contractions have stopped. When you call the doctor you tell him that you believe she is suffering from?
seriously powerful carbonic anhydrase inhibitor, lowers intraoptic pressure fast also used to treat acute moutain sickness
Sodium polystyrene sulfonate (kayexalate)
Sodium plystyrene sulfonate (kayexalate) is an antihyperkalemic
K+ and HPO4- are to intracellular as ____ & _____ are to extracellular
A pt's electrolyte panel in the ICU is as follows: (identify the abnormal labs)
Hypercalcemia associated with : (pick 4)
Calcium level above 10.2
Calcium level above 8.6
Prominent _____ wave is to hypokalemia as prominent _____ wave is to hyperkalemia
What would the most likely lab value be for a pt. who has hypoactive deep tendon reflexes
Never give more than 120 mEq of K+ in 24 hours unless.....
The pt really needs it
The pt. is a diabetic
The pt. is monitored in the ICU
The pt. doesn't have a seizure condition
If a pt had a high phosphorus level (>4.4) you might expect to find that this pt is also suffering from
Tachypnea---- respiratory alkalosis
Dyspnea---- respiratory acidosis
The symptoms of hyponatremia are associated with a fluid shift into brain cells
They include (pick 5)
Choose only the Side effects of opioids, disregard any toxic effects
Naloxone (narcan) is used to
treat mild to moderate pain
to treat moderate to sever pain
as an antidote to narcotics
to help with the constipation side effect of narcotics
An appropriate medication to use for the third step on the WHO ladder of pain treatment would be?
Epidural pain control side effects include all of the following except...
legs feel heavy
may not feel urge to void
drop in BP
Incompetent Cervical Os treatment includes
medically induced abortion
Ectopic pregnancy symptoms: (pick 4)
abdominal pain that may localize to one side
positive pregnancy test
higher than normal levles of HCG
Hcg levels lower than normal pregnancy
rupture usually occurs before 12 wks
All of the following are associated with hydatiform mole except?
symptoms of preexlampsia before usual time of onset
absence of fetal hear rate
high levels of HCG with excessive Nausea and vomitting
Would be okay for a women to get pregnant again 6 weeks after the hydatidiform mole pregnancy
What medications is given IM to mom to improve enhance the production of lung surfactants in a mother showing signs or at risk for preterm labor
the 3 most important nursing assessments for a mother who is suspected to have magnesium toxicity from administration as an attempt to halt labor would be?
Respiratory rate, tendon reflexes, hourly urine output
Respiratory rate, calcium level, blood pressure
Tendon reflexes, pain level, Heart rate
uterine involution, blood pressure, heart rate
Hydraminos is too >2000 ml of amniotic fluid at term while _______________- is to <400ml of amniotic fluid at term
The most important things to remember from nursing standpoint when a women has a P.R.O.M. includes:
identified with ferning/pooling or nitozene paper
continuous monitoring maternal/fetal vital signs
maternal temp every hour
delay vaginal exams
prepare for amniotomy
Painful Bleeding during pregnancy around the 20th week with a contracted uterus and fetal deceleration is indicative of _________ while bleeding around the 7th month, no contracted uterus and stable fetal heart rate is indicative of_____________
hyperemesis gravidarum, placenta previa
abruptio placenta, placenta previa
placenta previa, abruptio placenta
Select all symptoms that are associated with mild preeclampsia (select 4)
Blood Pressure: 150/100
Proteinu>.3 but <2
onset at 20th week of labor
Bp >160 >/110
Pulmonary edema, Heart failure
A nurse would continue to observe for preeclampsia symptoms how many hours postpartum?
Aldomet (methyldopa) is prescribed for?
Gestational hypertesnion is hypertension with the absence of what two symptoms?
Placental accreta is
when vessels of umbilical cord divide some distance from the placenta
abnormal adherence, placenta grows into uterine wall
umbilical cord inserted at or near placental margin
extra lobe of placenta, as long as all lobes stay attached causes no complications
RhoGAM is given (300mg) to mom's at ______ weeks and within _______ hours after delivery for rh sensitization
2 weeks, 24 hours
28 weeks, 72 hours
20 weeks, 2 hours
40 weeks, 96 hours
At 2 days postpartum the uterus should be ?
midway between umbilicus and pubic symphysis
2 cm below belly button
4 cm below belly button
at the umbilicus
In a terms of analogy a contracted uterus functions like a ?
3 main interventions for a boggy uterus include all of the following EXCEPT?
baby to breast
tell mother to avoid peeing if possible
A VNA nurse is assessing a mother at home. She finds the uterus 6 cm below the umbilicus... What type of lochia would the nurse expect the mother to have?
A 3rd degree laceration extends through skin, mucous membrane, perineal body and involves the anal sphincter.... The difference between a 3rd degree laceration and a 4th degree laceration is?
4th degree has rectal wall extension
3rd degree includes perineal body involvment
4th degree doesn't involve the sphincter
Breast feeding is good birthcontrol postpartum
Pospartum blues and obsession with bodily functions are usually found during which phase
taking in phase
taking hold phase