Module 1 Week 2 Maternity & Newborn

A nurse is caring for a client who is 2 hours postpartum. The client reports feeling dizzy and lightheaded. Upon assessment, the nurse notes that the uterine fundus is boggy, and the client's perineal pad is saturated with blood. What should the nurse do first?. Apply oxygen at 10 L/min via face mask. Increase the rate of the IV fluid infusion. Perform fundal massage until the uterus is firm. Assess blood pressure.

A 34-year-old patient at 32 weeks gestation is admitted to the hospital with painless, bright red vaginal bleeding. The patient is diagnosed with placenta previa after an ultrasound. The fetal heart rate is 140 beats per minute, and the patient's vital signs are stable. Which of the following nursing actions should the nurse implement first?. Prepare the patient for an immediate cesarean section. Administer prescribed corticosteroids to promote fetal lung maturity. Place the patient on bed rest with continuous fetal monitoring. Start an intravenous line and administer fluids to maintain hydration.

A 28-year-old client is admitted into the Labor and Delivery Unit. Labor and Delivery Unit Notes 0800: A 28-year-old client, gravida 2, para 1 (G2P1), at 39 weeks gestation, arrives at the Labor and Delivery Unit reporting regular contractions. The contractions began approximately five hours ago and have increased in intensity, now occurring every five minutes and lasting about 60 seconds each. She describes them as painful but manageable. The client denies any rupture of membranes and reports normal fetal movement. She has no known medical conditions and had a previous spontaneous vaginal delivery at 40 weeks without complications. The client is currently taking prenatal vitamins daily and has no known allergies. Administer IV fluids as ordered to maintain hydration. Encourage the client to ambulate, if tolerated, to promote labor progression. Position the client in supine position to improve fetal monitoring. Monitor fetal heart rate patterns continuously for signs of fetal distress. Prepare for immediate cesarean section due to cervical dilation of 4 cm. Assess pain level regularly and offer non-pharmacological pain relief options.

A 28-year-old client is admitted into the Labor and Delivery Unit. Labor and Delivery Unit Nurse Notes Labor and Delivery Unit Notes 0800: A 28-year-old client, gravida 2, para 1 (G2P1), at 39 weeks gestation, arrives at the Labor and Delivery Unit reporting regular contractions. The contractions began approximately five hours ago and have increased in intensity, now occurring every five minutes and lasting about 60 seconds each. She describes them as painful but manageable. The client denies any rupture of membranes and reports normal fetal movement. She has no known medical conditions and had a previous spontaneous vaginal delivery at 40 weeks without complications. The client is currently taking prenatal vitamins daily and has no known allergies. Time: 09:15 AM The client reports increased contraction intensity. Contractions are now occurring every 3-4 minutes, lasting 60-75 seconds, and are described as much stronger. The client is becoming more uncomfortable and is asking about pain relief options. A repeat cervical check reveals further progression: 6 cm dilated, 90% effaced, with the fetal head now at 0 station. Time: 10:00 AM The client reports a sudden increase in discomfort and pressure. Contractions remain regular, every 2-3 minutes, but the fetal heart rate monitor begins to show signs of variable decelerations. The fetal heart rate dips to 110 bpm during contractions but recovers between them. The nurse suspects umbilical cord compression, and further assessment is needed. The nurse is caring for a client in labor with signs of umbilical cord compression, evidenced by variable deceleration on the fetal heart rate monitor. For each intervention below, click to indicate if it is appropriate or not appropriate for managing this situation. Reposition the client to her side or knee-chest position. Administer oxygen via face mask. Increase the infusion rate of IV fluids. Perform amnioinfusion as prescribed. Prepare the client for an immediate cesarean section. Notify the healthcare provider of the variable decelerations. Encourage the client to push with each contraction.

A 28-year-old client is admitted into the Labor and Delivery Unit. Labor and Delivery Unit Nurse Notes Labor and Delivery Unit Notes 0800: A 28-year-old client, gravida 2, para 1 (G2P1), at 39 weeks gestation, arrives at the Labor and Delivery Unit reporting regular contractions. The contractions began approximately five hours ago and have increased in intensity, now occurring every five minutes and lasting about 60 seconds each. She describes them as painful but manageable. The client denies any rupture of membranes and reports normal fetal movement. She has no known medical conditions and had a previous spontaneous vaginal delivery at 40 weeks without complications. The client is currently taking prenatal vitamins daily and has no known allergies. Time: 09:15 AM The client reports increased contraction intensity. Contractions are now occurring every 3-4 minutes, lasting 60-75 seconds, and are described as much stronger. The client is becoming more uncomfortable and is asking about pain relief options. A repeat cervical check reveals further progression: 6 cm dilated, 90% effaced, with the fetal head now at 0 station. Time: 10:00 AM The client reports a sudden increase in discomfort and pressure. Contractions remain regular, every 2-3 minutes, but the fetal heart rate monitor begins to show signs of variable decelerations. The fetal heart rate dips to 110 bpm during contractions but recovers between them. The nurse suspects umbilical cord compression, and further assessment is needed. Doctor's Orders 1. Reposition the client to her left or right side. 2. Administer oxygen 10 L/min via face mask. 3. Administer 500 ml of IV fluids bolus. 4. Prepare for amnioinfusion as per protocol. 5. Monitor fetal heart rate continuously for signs of persistent decelerations or fetal distress The nurse has reviewed the doctor's orders. Click to highlight below the doctor's order the nurse should perform first. Reposition the client to her left or right side. Administer oxygen 10 L/min via face mask. Administer 500 ml of IV fluids bolus. Monitor fetal heart rate continuously.

A 28-year-old client is admitted into the Labor and Delivery Unit. Labor and Delivery Unit Nurse Notes Labor and Delivery Unit Notes 0800: A 28-year-old client, gravida 2, para 1 (G2P1), at 39 weeks gestation, arrives at the Labor and Delivery Unit reporting regular contractions. The contractions began approximately five hours ago and have increased in intensity, now occurring every five minutes and lasting about 60 seconds each. She describes them as painful but manageable. The client denies any rupture of membranes and reports normal fetal movement. She has no known medical conditions and had a previous spontaneous vaginal delivery at 40 weeks without complications. The client is currently taking prenatal vitamins daily and has no known allergies. Time: 09:15 AM The client reports increased contraction intensity. Contractions are now occurring every 3-4 minutes, lasting 60- 75 seconds, and are described as much stronger. The client is becoming more uncomfortable and is asking about pain relief options. A repeat cervical check reveals further progression: 6 cm dilated, 90% effaced, with the fetal head now at 0 station. Time: 10:00 AM The client reports a sudden increase in discomfort and pressure. Contractions remain regular, every 2-3 minutes, but the fetal heart rate monitor begins to show signs of variable decelerations. The fetal heart rate dips to 110 bpm during contractions but recovers between them. The nurse suspects umbilical cord compression, and further assessment is needed. Time: 12:30 PM - Fetal Delivery The client delivered a healthy baby via spontaneous vaginal delivery. The variable decelerations were successfully managed, and no further complications occurred. The newborn was delivered safely, and the mother is stable. Doctor's Orders 1. Reposition the client to the left side or right side. 2. Administer oxygen 10 L/min via face mask. 3. Administer 500 ml IV fluid bolus. 4. Prepare for amnioinfusion as per protocol. 5. Monitor fetal heart rate continuously for signs of persistent decelerations or fetal distress. Assess the fundus for firmness and location every 15 minutes for the first hour. Encourage the client to empty her bladder within the first hour after delivery. Administer oxytocin as prescribed to promote uterine contractions. Place the newborn skin-to-skin with the mother to promote bonding and breastfeeding. Delay perineal hygiene care to avoid interrupting skin-to-skin contact. Monitor the client for excessive vaginal bleeding or signs of hemorrhage.

A 28-year-old client is admitted into the Labor and Delivery Unit. Labor and Delivery Unit Notes 0800: A 28-year-old client, gravida 2, para 1 (G2P1), at 39 weeks gestation, arrives at the Labor and Delivery Unit reporting regular contractions. The contractions began approximately five hours ago and have increased in intensity, now occurring every five minutes and lasting about 60 seconds each. She describes them as painful but manageable. The client denies any rupture of membranes and reports normal fetal movement. She has no known medical conditions and had a previous spontaneous vaginal delivery at 40 weeks without complications. The client is currently taking prenatal vitamins daily and has no known allergies. Time: 09:15 AM The client reports increased contraction intensity. Contractions are now occurring every 3-4 minutes, lasting 60- 75 seconds, and are described as much stronger. The client is becoming more uncomfortable and is asking about pain relief options. A repeat cervical check reveals further progression: 6 cm dilated, 90% effaced, with the fetal head now at 0 station. Time: 10:00 AM The client reports a sudden increase in discomfort and pressure. Contractions remain regular, every 2-3 minutes, but the fetal heart rate monitor begins to show signs of variable decelerations. The fetal heart rate dips to 110 bpm during contractions but recovers between them. The nurse suspects umbilical cord compression, and further assessment is needed. Time: 12:30 PM - Fetal Delivery The client delivered a healthy baby via spontaneous vaginal delivery. The variable decelerations were successfully managed, and no further complications occurred. The newborn was delivered safely, and the mother is stable. Time: 09:00 AM - 2 Days Post-Delivery The client reports feeling emotionally overwhelmed, tearful, and experiencing frequent mood swings. She mentions feeling anxious and tearful without any specific reason. The client is otherwise physically healthy, and her vital signs remain stable. The client, two days post-delivery, reports feeling emotionally overwhelmed, tearful, and experiencing frequent mood swings. She mentions feeling anxious and tearful without any specific reason. Her vital signs are stable, and she is physically healthy. Based on these symptoms, what is the most likely condition the client is experiencing? Select the correct condition from the drop-down list: Based on these symptoms, what is the most likely condition the client is experiencing?. Postpartum Blues. Postpartum Depression. Postpartum Psychosis.

A 28-year-old client is admitted into the Labor and Delivery Unit. Labor and Delivery Unit Notes 0800: A 28-year-old client, gravida 2, para 1 (G2P1), at 39 weeks gestation, arrives at the Labor and Delivery Unit reporting regular contractions. The contractions began approximately five hours ago and have increased in intensity, now occurring every five minutes and lasting about 60 seconds each. She describes them as painful but manageable. The client denies any rupture of membranes and reports normal fetal movement. She has no known medical conditions and had a previous spontaneous vaginal delivery at 40 weeks without complications. The client is currently taking prenatal vitamins daily and has no known allergies. Time: 09:15 AM The client reports increased contraction intensity. Contractions are now occurring every 3-4 minutes, lasting 60-75 seconds, and are described as much stronger. The client is becoming more uncomfortable and is asking about pain relief options. A repeat cervical check reveals further progression: 6 cm dilated, 90% effaced, with the fetal head now at 0 station. Time: 10:00 AM The client reports a sudden increase in discomfort and pressure. Contractions remain regular, every 2-3 minutes, but the fetal heart rate monitor begins to show signs of variable decelerations. The fetal heart rate dips to 110 bpm during contractions but recovers between them. The nurse suspects umbilical cord compression, and further assessment is needed. Time: 12:30 PM - Fetal Delivery The client delivered a healthy baby via spontaneous vaginal delivery. The variable decelerations were successfully managed, and no further complications occurred. The newborn was delivered safely, and the mother is stable. Time: 09:00 AM - 2 Days Post-Delivery The client reports feeling emotionally overwhelmed, tearful, and experiencing frequent mood swings. She mentions feeling anxious and tearful without any specific reason. The client is otherwise physically healthy, and her vital signs remain stable. Doctor's Orders 1. Reposition the client to the left side or right side. 2. Administer oxygen 10 L/min via face mask. 3. Administer 500 ml IV fluid bolus. 4. Prepare for amnioinfusion as per protocol. 5. Monitor fetal heart rate continuously for signs of persistent decelerations or fetal distress. The nurse is caring for a postpartum mother experiencing postpartum blues two days after delivery. For each intervention below, determine whether it is expected or unexpected for managing this condition. Provide education about the typical duration and causes of postpartum blues. Offer assistance with infant care to reduce maternal stress. Encourage the mother to express her feelings. Monitor for hallucinations, delusions, or suicidal thoughts. Administer a low-dose benzodiazepine to reduce anxiety. Promote skin-to-skin contact and bonding with the baby. Administer IV fluids to prevent dehydration.

A nurse is assessing a newborn to determine gestational age. Which physical assessment finding would most likely indicate a term newborn?. Umbilical cord moist to touch. Anterior and posterior fontanels non-bulging. Plantar creases present on the anterior two-thirds of the sole. Milia present on the bridge of the nose.

A newborn's father is concerned that his baby does not have good control of their hands and arms. Which response by the nurse is most appropriate to explain the infant's development in terms that the parent can easily understand?. Neurologic development occurs in a predictable head-to-toe (cephalocaudal) and center-to-outward (proximodistal) manner. Uncoordinated movements of the arms are abnormal. Mild hypotonia in the upper body is expected. Asymmetric muscle tone is typical in newborns.

When providing client education on breastfeeding, which factor should the nurse include as directly influencing the amount of breastmilk a mother produces?. The newborn's weight. The mother's breast size. The newborn's sucking stimulus. The mother's nipple erectility.

The nurse, who provides care to a group of newborns in the neonatal unit, observes that when the newborn's head is turned to one side in the supine position, the extremities on that side extend while the opposite extremities flex. How should the nurse document this finding?. Tonic neck reflex. Moro reflex. Cremasteric reflex. Babinski reflex.

The nurse is conducting a neurological assessment of a newborn. Which findings are expected or not expected for a newborn? For each potential intervention, click to specify whether the assessment finding is expected or not expected. Asymmetrical fine jumping movements of the leg and arm muscles. Fanning and hyperextension of the toes when the sole is stroked upward from the heel. Grasping a finger placed in the neonate's palm. Muscle flaccidity not relieved by holding the newborn. Weak, but effective sucking movements.

A nurse is assessing a 4-hour-old male newborn born at 38 weeks via uncomplicated delivery. The infant's Apgar scores were 7 at one minute and 9 at five minutes. The newborn is B Rh-, and the mother is O Rh+. Which finding during the physical assessment should be most concerning to the nurse?. Dark blue patch on the gluteal area. Fine hair on the shoulders. Blue-tinged hands. Yellow-tinged face.

The nurse evaluates the laboratory test results of the neonate who is 4 hours old. A 4-hour-old neonate, born at 39 weeks of gestation via spontaneous vaginal delivery, is brought to the Neonatal Intensive Care Unit (NICU) due to signs of lethargy, poor feeding, and jitteriness observed during the initial newborn assessment. The mother's prenatal course was unremarkable, with no significant medical history except for gestational diabetes managed through diet. The nurse evaluates the laboratory test results of the neonate who is 4 hours old. Which of the following results would be expected or unexpected?. Hemoglobin 20g/dL. Hematocrit 54%. Serum glucose 34 mg/dL. Total serum bilirubin 3.1 mg/dL. White blood cell count 24,000/mm3. Serum Calcium 8 mg/dL.

The nurse is caring for the newborn who has hyperbilirubinemia and is receiving phototherapy. Which of the following nursing interventions are appropriate, and which are not appropriate?. Change the newborn's position every 2 hours. Remove the newborn's clothing except for the diaper. Close the newborn's eyes before applying the eye shield. Keep the newborn under the phototherapy light during feedings. Discontinue phototherapy if the newborn has an increased number of stools.

A nurse provides care to a newborn in the neonatal unit with physiologic jaundice. Which suggestion should the nurse provide to the mother as the best treatment for physiologic jaundice?. Switching permanently to formula. Giving supplemental water feedings. Increasing the frequency of breastfeeding sessions. Withholding all oral feedings from the newborn.

A nurse is caring for a newborn admitted for well-controlled hyperbilirubinemia. The parents have requested a circumcision, which will be performed the next day. What is the most essential nursing intervention following this procedure?. Administer oral acetaminophen every 8 hours for a maximum of 3 doses in 24 hours. Apply petroleum jelly or A&D ointment to the site with every diaper change until the site is healed. Assess the site for signs of hemorrhage. Teach the parents to remove the yellowish exudate that forms over the glans using a diaper wipe.

A 3-day-old newborn is being evaluated in the neonatal unit. The baby was born at 38 weeks of gestation to a mother with a history of alcohol use during pregnancy. The healthcare team suspects Fetal Alcohol Syndrome (FAS) due to several observed physical and developmental abnormalities. The nurse is preparing to educate the staff about the key clinical manifestations of FAS to ensure appropriate identification and care for infants affected by prenatal alcohol exposure. The nurse is planning a staff education program about Fetal Alcohol Syndrome (FAS). Which of the following should the nurse include as appropriate clinical manifestations of FAS, and which are not appropriate?. Large for gestational age at birth. Small head circumference at birth. Smooth philtrum and thin upper lip. Low-set ears. Impaired gross motor development. Weak suck reflex and difficulty feeding.

The nurse is caring for a 2-day-old female neonate. The nurse is caring for a 2-day-old female neonate, born via vaginal delivery at 37 weeks of gestation. Apgar scores were 6 at one minute and 9 at five minutes. Maternal history includes alcohol use throughout the first and second trimesters, with the last use three months ago. No use of recreational drugs or tobacco. Temp: 97.8°F HR: 150 bpm RR: 50 breaths per minute BP: 85/45 mmHg 02 Sat: 97% (room air) Weight: 2.9 kg Height: 47 cm Head Circumference: 33 cm The nurse is planning care for this neonate. For each potential intervention, specify whether it is appropriate or not appropriate for the care of the client. Monitor intake and output. Decrease environmental stimuli. Provide the client with small, frequent feedings. Assess the client's ability to suck and swallow. Instruct the parent to discontinue breastfeeding.