Fluent Essays

I have completed handout until lesson 5. Use the same uploaded handout to fill rest of the handout from lesson 6 to 11 maternity_homework_2_hand_in___2_.docx Unformatted Attachment Preview MATERNITY & NEWBORN NURSING SECTION TWO EXERCISES, LESSON 1 Student Name: Manjit Sahota INSTRUCTIONS: Answer the following exercises by marking the lettered response that best answers the exercise, by completing the incomplete statement, or by writing the answer in the space(s) provided. 1. Hyperemesis gravidarum refers to severe nausea and vomiting. 2. A burning sensation in the epigastric and sternal region is known as: Heart burn 3. List the types of infections that may cause complications for a pregnant woman. Venereal diseases Urinary tract infection Human Immunodeficiency Virus ( HIV ) 4. List the nursing interventions for battered pregnant females. Assessing the emotional needs of the patient and significant support person. Promoting a trusting relationship that will foster self esteem and a positive pregnancy experience. Inform the patient and the spouse about counseling. 5. Rh incompatibility occurs when the Rh-negative pregnant patient carries an Rh-positive fetus. 6. Identify the types of abortions. Spontaneous abortion- the process starts of its own accord through natural causes. Induced abortion- intervention by outside source. Threatened abortion- possible, but can be prevented. Inevitable abortion- the process has gone so far that loss of the fetus will occur, cannot be prevented. Incomplete abortion- parts of the products of conception has been passed, but part (usually the placenta) is retained in the uterus. Complete abortion- all products (placenta and fetus) of pregnancy are eliminated. Special Instructions for Exercises 7 through 14. Match the terms in Column A with the correct definition or statement as listed in Column B. Place the letter of the correct answer in the space provided to the left of Column A. COLUMN A e 7. Abruptio placentae. COLUMN B a. Hemorrhage resulting from low implantation of the placenta on the interior uterine wall. f 8. Prolapsed umbilical cord. b. Lost of the fetus before 20 weeks of gestation. d 9. Varicosities. c. A baby born before the end of the 37th gestational week. a 10. Placenta previa. d. Seen as dark blue or purplish swellings. h 11. Eclampsia. e. Hemorrhage resulting from detachment of the placenta. c 12. Preterm labor and birth. f. An obstetric emergency during the birthing process. b 13. Abortion g. Can be transmitted to the infant through breast milk. g 14. HIV h. Classic signs of preeclampsia plus coma or convulsion. 15. Identify the types of placenta previa and abruptio placentae. a. Occurs when the separation is high in the uterine segment, causing the fundus of the uterus to rise. Moderate/high separation b. Occurs when the placenta is attached at the opening or border to the cervical os, but not covering it. Low implantation of placenta previa c. Occurs when the fetus head is present in the cervical os which prevents external hemorrhage. Severe complete separation. d. Occurs when the placenta completely covers the internal os. Total placenta previa. e. Occurs when the separation is low and is not complete; vaginal hemorrhage is evident. Marginal low separation. f. Occurs when the placenta partially covers the internal os Partial placenta previa. MATERNITY & NEWBORN NURSING - SECTION TWO EXERCISES, LESSON 2 INSTRUCTIONS: Answer the following exercises by marking the lettered response that best answers the exercise, by completing the incomplete statement, or by writing the answer in the space(s) provided. 1. What are the main factors involved in distinguishing between true and false labor? Contraction show Cervix Fetal movement 2. Complete dilatation of the cervix is considered 10 cm. 3. There are forces involved when the cervix is dilating. These forces are called: Uterine contractions. 4. There are four stages involved in the labor process. Each stage is referred to with different events. Fill in the blanks identifying each event. First stage - Dilating stage. Second stage - Delivery or expulsive stage. Third stage - Placental stage. Fourth stage - Recovery or stabilization stage. 5. The first stage of labor is categorized with three phases. They are: Latent ( early ) or prodromal. Active or accelerated. Transient or transitional. Special Instructions for exercises 6 through 18. Indicate whether the following statements/phrases are true or false by circling the T for true and F for false. 6. A cleansing enema is always given to the patient when she is in labor. F 7. Normal fetal heart rate ranges from 120 to 160 beats per minute. T 8. Rupture of the membranes is performed by the physician to induce or hasten labor. T 9. The primigravida patient is transferred to the delivery room when her cervix is completely effaced and dilated and the head or presenting part is crowning. T 10. The multipara patient is transferred to the delivery room when her cervix is completely effaced and dilated. T 11. A patient who has been transferred to the delivery room can be left alone for 2 minutes. F 12. APGAR is a method used for evaluating the condition of a newborn baby. T 13. Oxytocin can be administered prior to delivery of the placenta. F 14. A boggy uterus may indicate uterine atony or retained placental fragments. T 15. The contractions of true labor produce progressive dilation and effacement of the cervix. T 16. Show is present in false labor. F 17. The fetus heart may increase or decrease by 40 BPM during a contraction. F 18. A high risk patient is a candidate for continuous fetal monitoring. T 19. Complete the chart below to indicate what happens during each factor to identify true and false labor. TRUE LABOR FACTOR FALSE LABOR . Contractions Show Cervix Fetal Movement 20. In which phase of the first stage of labor does the contractions become stronger and last longer, usually 45 to 60 seconds? Active or accelerated phase. 21. In which phase of the first stage of labor does contractions become sharp, are more intensified, and last from 60 to 90 seconds? Transient or transitional phase. 22. What are the reasons some physicians consider giving fleets? To prevent fecal contamination of perineum during delivery. To cleanse the bowel, providing more room for fetal passage. To stimulate uterine contraction. 23. Where should you, the practical nurse, place your hands when you are palpating the patients contractions? Over the fundal area of the patients uterus. 24. Why is fetal monitoring performed? To detect presence of fetal life at the time of admission. To detect presence of fetal distress during labor. 25. The patient being nauseated and retching, irritable and uncooperative, complains of severe discomfort, and pleas for relief are all impending signs of labor during which stage of labor? Second phase. 26. What nursing care is performed in the delivery room? Never leave a patient alone or turn your back on the perinium. Encourage the patient to rest between contractions, and to push with contractions. Position patients legs in stirrups. Prep the patients perineum. 27. The activity of the normal birthing process includes: Crowning. Delivery of the head. Delivery of the anterior shoulder and posterior shoulder. Delivery of the trunk and the lower body. Clamping and cutting of the umbilical cord. 28. Information to be recorded about the delivery includes: Exact date and time of delivery. Sex of the infant. Condition of the infant after birth. Position of the infant at delivery. Type of episiotomy, lscerstions. spontaneous or forceps delivery. 29. What are the characteristics of a full bladder after delivery? Bulging of lower abdomen. Spongy feeling mass between the fundus and pubis. Displaced uterus from the midline, usually to the right. Increase in lochia flow. 30. What nursing care is performed to the patient after delivery? List 8 of the 16 tasks. Monitor the mothers vital signs and general condition. Check fundus. Provide care of perineum. Observe for signs of hemorrhage. Observe patients urinary bladder for distension. Evaluate perineal area for signs of developing edema/hematoma. Monitor lochia flow. Observe mother for chills. 31. List the five factors that may extend or influence the duration of labor. Passenger ( Fetus ). Passage ( birth canal ). Powers ( contractions ). Placenta. Psyche ( psychological state of a woman ). 32. If the patients uterus should relax after delivery, what nursing care should be given? Massage the fundus until it is firm. 33. Lochia is the maternal discharge of blood, mucus, and tissue from the uterus. 34. What are the signs of placental separation? The uterus becomes globular in shape and firmer. The uterus rises in the abdomen. The umbilical cord descends 3 inches or more further out of the vagina. 35. The onset of rhythmic contractions, the relaxation of the uterine smooth muscles which results in effacement or progressive thinning of the cervix, and dilation or widening of the cervix is known as: Labor. MATERNITY & NEWBORN NURSING - SECTION TWO EXERCISES, LESSON 3 INSTRUCTIONS: Answer the following exercises by marking the lettered response that best answers the exercise, by completing the incomplete statement, or by writing the answer in the space(s) provided. 1. What three factors may predispose a woman to a precipitate delivery? A multipara with relaxed pelvic or perineal floor muscles. May have an extremely short period of contraction. A multipara with usually strong, forceful contractions. 2-3 forceful contractions may cause the baby to appear rapidly. Inadequate warning of imminent birth due to absence of painful sensations during labor. 2. List the dangers of precipitate delivery. MATERNAL _________________________ Laceration of the cervix vagina, and/or perineum. Hemorrhaging originating from lacerations, hematomas or the uterus. Infections as a result of non sterile environment. NEONATAL _________________________ May cause intracranial hemorrhaging resulting from a sudden change in pressure on the fetal head during expulsion. May cause aspiration of amniotic fluid, if unattended at or immediately following delivery. Infection as a result of unsterile delivery. 3. List the priority equipment found in a sterile obstetric or precipitate delivery pack. Gloves. Towels/cloth. Bulb syringe. Hemostat or cord clamps. Scissors. Dry blanket/cloth. 4. What should be provided if there is no sterile equipment available? Paper, towel, blanket or coat to place under patients buttocks. Ligating material such as string, yarn, or shoelaces to tie the umbilical cord. A sharp instrument such as scissors, a knife, or razor to cut the umbilical cord. A dry cloth to wrap infant in after delivery. 5. When should you bulb suction amniotic fluid from the infants mouth? After delivery of the head. 6. What should be done in the following situations? Tight nuchal cord -- Clamp it twice and cut between the clamps. Cord is loose, cannot be lifted over infants head -- Slide the cord over the delivering baby. 7. What can happen if you slap an infants buttocks to stimulate breathing? May cause bruising of a large surface area. May result in compromising circulatory volume. 8. What is the purpose of drying and wrapping an infant immediately after delivery? To prevent heat loss. 9. How often should you check the mothers uterine fundus during the first hour after delivery? Every 10 to 15 minutes. 10. After delivery, why should the mother void often? To prevent bladder distension. 11. List six of the nine facts that should be documented about the birth. Time of delivery. Approximate time of placental expulsion, appearance and completeness. Sex of the infant. Presence of natural cord and method of reduction. Maternal condition including; affect, amount of bleeding, and status of uterine contraction. Fetal position and presentation. MATERNITY & NEWBORN NURSING - SECTION TWO EXERCISES, LESSON 4 INSTRUCTIONS: Answer the following exercises by marking the lettered response that best answers the exercise, by completing the incomplete statement, or by writing the answer in the space(s) provided. 1. What are the two sources of discomfort during childbirth? Visceral discomfort e.g., abdominal or internal organs. Perineal discomfort. 2. To evaluate the degree of pain experienced by the patient during childbirth, what areas are observed? What the mother says. Patients response. Facial expression. Colo of skin. Blood pressure, pulse, and respirations. Posture. 3. Decreasing the intensity of pain and minimizing the degree to which the patient is bothered by pain are considered: Goals of nursing measure to minimize discomfort during child birth. Minimizes the degree to which patient is bothered by pain allowing her to progress faster and keeping her from becoming so fatigued. 4. In providing comfort measures to the patient during childbirth, why is the side lying position preferred? It increases placental flow. 5. In minimizing the fear and pain and promoting positive family relationships, relaxation techniques includes breathing during contractions, concentration on the focal point, and effleurage to include the pelvic tilt and abdominal exercises, you are encouraging the use of: Psychoprophylaxis. 6. Analgesic medications taken during labor affects the fetus, mother, and: Labor and delivery process. 7. Analgesics are the most common form used in obstetrics today. They are: Morphine. Stadol. Demerol. Nubain. Nisentil. 8. Anesthetic refers to a technique or medication that partially or completely eliminates sensation or feeling. 9. What are the two types of nerve-blocking anesthetics? Local. Regional. 10. List the regional anesthetics used in childbirth. Paracervical block. Pudendal block. Saddle block ( low spinal ). Caudal epidural, and lumbar epidural. 11. Complete the following statements (nerve blocking anesthetics). a. Local produces anesthesia only in the area where injected. b. An injection of a dilute local anesthetic into the paracervical nerve endings through the vagina is a Paracervical block . c. An injection of anesthetic agent directly into the spinal column to cause loss of sensation below the injection site is known as a Saddle block ( low spinal ). d. A Pudendal block is administered just prior to delivery. e. An injection of anesthetic agent in the peridural space through the sacral hiatus is known as a Caudal. f. An injection of anesthetic agent on top of the dura space through the 3rd and 4th or 5th lumbar space is known as a Lumbar epidural. 12. What two regional anesthetics require frequent observation and must be administered by a physician? Caudal epidural. Lumbar epidural. 13. What are the disadvantages of using general anesthesia during childbirth? 1. The patient is unable to participate. 2. There is an increased risk of maternal aspiration. 3. It can cause fetal anesthesia, fetal depression, and possible anoxia. 4. There is possibility of hemorrhaging. 14. What are the two most frequent side effects that may occur to the obstetric patient receiving anesthesia? Maternal hypotension. Fetal bradycardia. MATERNITY & NEWBORN NURSING - SECTION TWO EXERCISES, LESSON 5 INSTRUCTIONS: Answer the following exercises by marking the lettered response that best answers the exercise, by completing the incomplete statement, or by writing the answer in the space(s) provided. 1. List six conditions that could increase a pregnant woman chances of having premature labor. Spontaneous rupture of membranes. Cervical incompetence. Uterine anomalies. Over distended uterus caused by hydramnios or 2 or more fetuses. Anomalies of the products of conception. Fetal death. 2. Assemble resuscitation equipment and make sure it functions properly is one of the nursing interventions when: a. Amniotic fluid enters into an opened maternal blood sinus. b. Preterm delivery is imminent. c. Multiple fetuses are known. d. C-sections are performed. 3. List the four classifications of dystocia. 1. Pelvic dystocia. 2. Uterine dystocia. 3. Soft tissue dystocia. 4. Fetal dystocia. 4. What type of episiotomy is made on the midline but directed to the right or left? Mediolateral episiotomy. FOR EXERCISES 5 THROUGH 13. Match the terms in Column A with the correct definition or statement as listed in Column B. Place the letter of the correct answer in the space provided to the left of Column A. COLUMN A e 5. Induction of labor. COLUMN B a. Surgical incision made into the abdomen and uterus to deliver the fetus. h 6. Oversized baby. f 7. Episiotomy. b. Labor that is difficult which is due to mechanical and functional factors. i 8. Multiple pregnancy. c. Labor that occurs prior to 38 weeks gestation. g 9. Post term labor. d. Significant shortening of the internal diameters of the bony pelvis. b 10. Dystocia c 11. Preterm labor. d 12. Pelvic dystocia. a 13. Cesarean section. e. Deliberate initiation of uterine contractions prior to their spontaneous onset and after the period of viability. f. An incision into the perineum made to facilitate delivery. g. Pregnancy that goes beyond 42 weeks gestation. h. An infant that weighs more than 4500 grams. i. Two or more fetuses in the uterus at the same time. 14. Complication associated with oversized babies and their delivery are given below. Write the type of complication described in the blank before the description. a. Shoulder dystocia. The fetus head may deliver, but the shoulders are too large for the pelvic inlet. b. Trauma to the birth canal. Possible lacerations of the vagina or of the perineum. c. Trauma to the fetus. Dislocation of the fetus cervical vertebrae or fracture of the clavicle. 15. List the special situations in labor and delivery. Preterm labor. Post term labor. Induction of labor. Dystocia of labor. Oversized babies. Amniotic fluid embolism. Multiple pregnancies. Cesarean section. Episiotomies. Forceps delivery. FOR ITEMS 16 THROUGH 27. The following statements/phrases may be true or false. Indicate the correct answer by circling the T for true and F for false. ——————————————————————————————————————— 16. Preterm labor is not interrupted if there is severe bleeding or if the fetus is already dead. T 17. The amniotic fluid is frequently thin in post term pregnancy, therefore, tracheal suctioning immediately at delivery is not performed. F 18. An enema may be used to stimulate contractions if the patient is ready to deliver. T 19. Most oversized babies are girls. F 20. A Cesarean section is performed if an oversized fetus fails to descend. T 21. A possible prolapsed cord is considered a possible complication during labor and delivery of multiple births. T 22. Only on physician and on nurse should be notified to assist in multiple births. F 23. The physician sutures the episiotomy (incision) after delivery of the fetus. F 24. A Cesarean section is classified as major surgery. T 25. Forceps delivery aids in shortening the second stage in dystocia. T 26. The fetal head must be engaged for forceps delivery. T 27. Midforceps delivery is an easy forceps delivery. F MATERNITY & NEWBORN NURSING - SECTION TWO EXERCISES, LESSON 6 INSTRUCTIONS: Answer the following exercises by marking the lettered response that best answers the exercise, by completing the incomplete statement, or by writing the answer in the space(s) provided. 1. The _____________________ is known as the first six weeks after delivery of a baby. 2. Afterpains are intensified by _____________________________ .. 3. List the three types of lochia flow in order of occurrence. _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ 4. ______________________________ helps to conserve body fluids. 5. The hormones that stimulated breast development during pregnancy decreases promptly after delivery. What determines, in part, the time it takes for these hormones t ... Purchase answer to see full attachment