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NURS 431 Final Exam
Normal Laboratory Values in Pregnancy - correct answer Platelets: 150,000-400, Serum Uric Acid: 1st Tri <3.0, 3rd Tri 4-5 mg/dL Creatinine: 0.4 to 0.8 mg/dl AST: 1st Tri 3-23, 2nd and 3rd Tri 3- 33 Prothrombin Time: 9.5- 13 Hemoglobin: 12- 16 Leukocytes: 5,600-12, Preconception care: STI (Genital Herpes) - correct answer Deliver baby via C-section Naegele's Rule - correct answer +7 days
Due date of pregnancy Weight gain in pregnancy - correct answer Underweight (BMI<18.5): 28 - 40lbs Healthy Weight (BMI 18.5-24.9): 25-35lbs Overweight (BMI 25.0-29.9): 15-25lbs
Obese (BMI>30.0): 11-20lbs) Infant Vital Signs - correct answer HR: 120- 160 RR: 30- 60 Temp(Axillary): 97.6-99. 5 P's of Labor & Birth - correct answer - Power - contractions
- Passenger - fetus
- Passageway - Pelvis & soft tissues
- Position of the fetus in relation to passage
- Person - maternal physiological and psychological well-being Leopold's Maneuver - correct answer - Assesses: •Fetal part in the fundus •Fetal part in the cervix •Fetal lie (spines line up)
- Hypotonic bladder due to trauma from birth = uterine retention. Urinary retention increases the risk of uterine atony = postpartum hemorrhage Nursing Care during fourth stage of labor - correct answer •Frequent assessments (every 15 minutes)
- Vital signs
- Fundus
- Bleeding •Initiate breastfeeding (skin-to-skin) •Many mother and babies are wide awake the first hour after birth
- Encourage maternal-infant attachment/bonding
- Often enter a stage of profound fatigue and may sleep for hours after this initial bonding & feeding period Nursing Care during fourth stage of labor: Continued - correct answer •Skin to skin contact •Encourage maternal- infant attachment and bonding •Encourage family infant bonding •Encourage breastfeeding
•Assess for bleeding - vital signs, fundus, pad Pregnancy Pain management (Opioids) - correct answer Nubain Butorphanol tartrate Meperidine hydrochloride Fentanyl Morphine Pregnancy Pain Management (Opioids): Considerations - correct answer Crosses placenta rapidly and easily (Do not give within 60- 90 min of birth... after 7-8 cm) Can cause neonatal narcosis (depressed RR, reduced LOC, low APGAR scores)- Naloxone used to reverse depression in infant after birth May affect interest/ability to breastfeed Not given before 4 cm because it can decrease contraction pattern if given too early
