Maternal And Child Health Nursing (Intrapartum And Postpartum)

Amniocentesis is the procedure where an OB/GYN physician removes a sample of amniotic fluid from the uterus during the 14th to 16th weeks of gestation. This procedure is commonly performed to diagnose any genetic abnormalities or chromosomal disorders in the fetus. It involves inserting a needle into the amniotic sac and withdrawing a small amount of fluid for testing. Amniocentesis is a crucial diagnostic tool in prenatal care and allows for early detection of potential health issues in the unborn baby.

Placenta previa is a condition where the placenta is implanted in the lower uterine segment. It can be classified as partially, totally, or marginal. This condition can cause bleeding during pregnancy, especially during the third trimester, and can be a risk factor for complications during childbirth. It requires close monitoring and may require medical intervention or a cesarean delivery to ensure the safety of both the mother and the baby.

The nurse will suggest eating a dry cracker before getting out of bed in the morning as a self-care measure for morning sickness. This is because eating a dry cracker can help alleviate nausea and settle the stomach. It is a simple and easily accessible remedy that can be done before starting the day.

“I know this will be difficult” acknowledges the problem and suggests a resolution to it. “Don’t worry..” offers some relief but doesn’t recognize the patient’s feelings. “..I didn’t get to the bad news yet” would be inappropriate at any time. “Your hair is really pretty” offers no consolation or alternatives to the patient.

Vastus lateralis is the most appropriate location.

The nurse is implementing the assessment phase of the nursing process by taking the client's vital signs. Assessment involves gathering information about the client's health status, including their current symptoms and vital signs, in order to identify any potential health issues or areas of concern. By assessing the client's vital signs, the nurse is gathering important data that will help inform any further actions or decisions in the nursing process.

During the later part of the 3rd trimester, the mother may experience shortness of breath due to the fundus of the uterus being high and pushing the diaphragm upwards. As the uterus expands to accommodate the growing fetus, it pushes against the diaphragm, reducing the lung's capacity to fully expand and causing the feeling of breathlessness. This is a normal occurrence in pregnancy and is not necessarily a complication or an allergic reaction.

All invasive procedures, including surgery, catheter insertion, and administration of parenteral therapy, require sterile technique to maintain a sterile environment. All equipment must be sterile, and the nurse and the physician must wear sterile gloves and maintain surgical asepsis. In the operating room, the nurse and physician are required to wear sterile gowns, gloves, masks, hair covers, and shoe covers for all invasive procedures. Strictisolation requires the use of clean gloves, masks, gowns and equipment to prevent the transmission of highly communicable diseases by contact or by airborne routes. Terminal disinfection is the disinfection of all contaminated supplies and equipment after a patient has been discharged to prepare them for reuse by another patient. The purpose of protective (reverse)isolation is to prevent a person with seriously impaired resistance from coming into contact who potentially pathogenic organisms.

Human chorionic gonadotrophin (hCG) is the hormone responsible for a positive pregnancy test. This hormone is produced by the placenta after the fertilized egg implants in the uterus. hCG levels increase rapidly in the early stages of pregnancy and can be detected in a urine or blood test, indicating that a woman is pregnant. Estrogen and progesterone are also important hormones during pregnancy, but they are not specifically responsible for a positive pregnancy test. Follicle stimulating hormone is involved in the menstrual cycle and egg development, but it is not directly related to pregnancy.

The nursing process is best described as a systematic, rational method of planning and providing nursing care for individuals, families, groups, and communities. It involves a series of steps that include assessment, diagnosis, planning, implementation, and evaluation. By following this process, nurses are able to provide comprehensive and holistic care to their patients, ensuring that all their needs are met and that the care provided is evidence-based and effective.

Green vegetables and liver are a great source of folic acid.

To calculate the EDD by Nagele’s rule, add 7 days to the first day of the last menstrual period and count back 3 months, changing the year appropriately. To obtain a date of September 27, 7 days have been added to the last day of the LMP (rather than the first day of the LMP), plus 4 months (instead of 3 months) were counted back. To obtain the date of November 7, 7 days have been subtracted (instead of added) from the first day of LMP plus November indicates counting back 2 months (instead of 3 months) from January. To obtain the date of December 27, 7 days were added to the last day of the LMP (rather than the first day of the LMP) and December indicates counting back only 1 month (instead of 3 months) from January.

The client has been pregnant four times, including current pregnancy (G). Birth at 38 weeks’ gestation is considered full term (T), while birth form 20 weeks to 38 weeks is considered preterm (P). A spontaneous abortion occurred at 8 weeks (A). She has two living children (L).

The best method used to assess the client's temperature in this scenario is the axillary method. This is because the client is alert and able to cooperate with the nurse, making it possible to obtain an accurate temperature reading through the armpit. Additionally, the client's condition of dehydration may affect oral temperature readings, and the radial method is not commonly used for assessing temperature. Heat sensitive tape is not a reliable method for temperature assessment.

A decrease in alpha-fetoprotein in the amniotic fluid is associated with an increased risk of trisomy 21, also known as Down syndrome. Trisomy 21 is a genetic disorder caused by the presence of an extra copy of chromosome 21. It is characterized by intellectual disability, developmental delays, distinct physical features, and an increased risk of certain health conditions. The decrease in alpha-fetoprotein levels can be detected through prenatal screening tests and can help identify the risk of Down syndrome in the fetus.

Vitamin D is associated with the reduction in the incidence of prostate cancer in a population exposed to tolerable amounts of sunlight. This is because sunlight is a natural source of vitamin D, and it plays a crucial role in regulating cell growth and preventing the development of cancer cells. Vitamin D has been found to inhibit the growth of prostate cancer cells and promote their death, thus reducing the risk of developing prostate cancer. Therefore, ensuring adequate levels of vitamin D through sunlight exposure or supplementation can help in the prevention of prostate cancer.

The correct answer is AV node. In the normal conduction system of the heart, the AV node is responsible for conducting electrical signals from the atria to the ventricles. It acts as a gatekeeper, delaying the transmission of the signal to allow for the atria to fully contract before the ventricles are activated. This delay ensures efficient pumping of blood and coordination between the atria and ventricles.

Abruptio placentae is described as premature separation of a normally implanted placenta during the second half of pregnancy, usually with severehemorrhage. Placenta previa refers to implantation of the placenta in the lower uterine segment, causing painless bleeding in the third trimester of pregnancy. Ectopic pregnancy refers to the implantation of the products of conception in a site other than the endometrium. Incompetent cervix is a conduction characterized by painful dilation of the cervical os without uterine contractions.

The correct answer is "sinus rhythm" or "Sinus rhythm". Sinus rhythm refers to the normal electrical activity of the heart, where the electrical impulses originate from the sinus node. This is the normal rhythm of a healthy heart and is characterized by a regular and consistent pattern on the ECG strip. By documenting "sinus rhythm" or "Sinus rhythm" on the client's chart, it accurately describes the normal electrical activity of the heart during the ECG recording.

The Z track technique is the best action to prevent tracking of the medication. This technique involves pulling the skin to one side before injecting the medication, creating a zigzag or "Z" shape. This helps to seal the medication within the muscle and prevents it from leaking into the subcutaneous tissue. Using a small gauge needle may reduce discomfort, but it does not specifically prevent tracking of the medication. Applying ice on the injection site may help with pain and swelling, but it does not prevent tracking. Administering at a 45-degree angle does not have any effect on preventing tracking.

Preterm labor is best described as labor that begins after 20 weeks’ gestation and before 37 weeks’ gestation. The other time periods are inaccurate.

Pressure ulcers are most likely to develop in patients with impaired mental status, mobility, activity level, nutrition, circulation and bladder or bowel control. Age is also a factor. Thus, the 88-year old incontinent patient who has impaired nutrition (from gastric cancer) and is confined to bed is at greater risk.

Fatigue, muscle cramping, and muscle weaknesses are symptoms of hypokalemia (an inadequate potassium level), which is a potential side effect of diuretic therapy. The physician usually orders supplemental potassium to prevent hypokalemia in patients receiving diuretics. Anorexia is another symptom of hypokalemia. Dysphagia means difficulty swallowing.

The mother may have physiologic anemia due to the increased need for red blood cell mass as well as the fetal requires about 350-400 mg of iron to grow
About 400 mgs of Iron is needed by the mother in order to produce more RBC mass to be able to provide the needed increase in blood supply for the fetus. Also, about 350-400 mgs of iron is need for the normal growth of the fetus. Thus, about 750-800 mgs iron supplementation is needed by the mother to meet this additional requirement.

An ultrasound is a positive sign of pregnancy because it can confirm the presence of a developing fetus in the uterus. This imaging technique uses sound waves to create images of the fetus and can provide important information about the health and development of the pregnancy. Fetal movement felt by the mother and enlargement of the uterus can also be signs of pregnancy, but they are subjective and can vary from person to person. A positive pregnancy test indicates the presence of the pregnancy hormone hCG, but it is not a definitive confirmation of pregnancy as false positives can occur.

Chorionic villi sampling is the procedure in which a physician removes a small piece of villi, which are finger-like projections in the placenta, between 8 to 12 weeks' gestation under ultrasound guidance. This procedure is used to diagnose genetic disorders and chromosomal abnormalities in the fetus.

An increase in alpha-fetoprotein is associated with neural tube defects. Alpha-fetoprotein is a protein produced by the developing fetus and is normally found in high levels in the amniotic fluid and maternal blood. An increase in alpha-fetoprotein levels can indicate a problem with the development of the neural tube, which is the precursor to the brain and spinal cord. Neural tube defects are birth defects that occur when the neural tube fails to close properly during early embryonic development. This can lead to conditions such as spina bifida and anencephaly.

The three elements necessary to establish a nursing malpractice are nursing error (administering penicillin to a patient with a documented allergy to the drug), injury (cerebral damage), and proximal cause (administering the penicillin caused the cerebral damage). Applying a hot water bottle or heating pad to a patient without a physician’s order does not include the three required components. Assisting a patient out of bed with the bed locked in position is the correct nursing practice; therefore, the fracture was not the result of malpractice. Administering an incorrect medication is a nursing error; however, if such action resulted in a serious illness or chronic problem, the nurse could be sued for malpractice.

Thick, tenacious secretions, a dry, hacking cough, orthopnea, and shortness of breath are signs of ineffective airway clearance. Ineffective airway clearance related to dry, hacking cough is incorrect because the cough is not the reason for the ineffective airway clearance. Ineffective individual coping related to COPD is wrong because the etiology for a nursing diagnosis should not be a medical diagnosis (COPD) and because no data indicate that the patient is coping ineffectively. Pain related to immobilization of affected leg would be an appropriate nursing diagnosis for a patient with a leg fracture.

The nurse should take the client's body temperature using the axillary method. This is because the client has undergone oral surgery, which may make it difficult or uncomfortable for them to use the oral method. The skin being flushed and warm could indicate inflammation or infection, which may affect the accuracy of the oral temperature. The axillary method is a non-invasive and convenient way to measure body temperature, especially when other methods are not suitable or contraindicated.

The answer provided is 40 bpm, 40bpm, 40. This indicates that the heart rate of the patient is 40 beats per minute.

The normal ratio of bicarbonate to carbonic acid in the body is 20:1. This ratio is important for maintaining homeostasis, as it helps regulate the pH of the blood and other bodily fluids. Bicarbonate acts as a buffer, helping to neutralize acids in the body, while carbonic acid helps regulate the levels of carbon dioxide in the blood. This balance is crucial for proper functioning of various physiological processes in the body.

Malpractice is defined as injurious or unprofessional actions that harm another. It involves professional misconduct, such as omission or commission of an act that a reasonable and prudent nurse would or would not do. In this example, the standard of care was breached; a 3-month-old infant should never be left unattended on a scale.

Studies have shown that patients and nurses both respond well to primary nursing care units. Patients feel less anxious and isolated and more secure because they are allowed to participate in planning their own care. Nurses feel personal satisfaction, much of it related to positive feedback from the patients. They also seem to gain a greater sense of achievement and esprit de corps.

A client with abruptio placentae may exhibit concealed or dark red bleeding, possibly reporting sudden intense localized uterine pain. The uterus is typically firm to boardlike, and the fetal presenting part may be engaged. Bright red, painless vaginal bleeding, a palpable fetal outline and a soft nontender abdomen are manifestations of placenta previa.

100ml/60 min X 15 gtt/ 1 ml = 25 gtt/minute

The nurse should first monitor fetal heart tone. After an amniotomy is performed, the umbilical cord may be washed down below the presenting part and cause umbilical cord compression, which would indicate by vitiable deceleration on the fetal heart tracing.

This option is inappropriate to include in the teaching plan because exercise has a positive effect on insulin production and can help control diabetes. It is important for the pregnant client to engage in regular exercise as part of their diabetic management plan.

Orange juice is the best option to take the iron supplement with because it contains vitamin C. Vitamin C enhances the absorption of iron in the body. Iron supplements are better absorbed in an acidic environment, and the vitamin C in orange juice helps to create this environment in the stomach. This increases the effectiveness of the iron supplement and ensures that the client is able to absorb and utilize the iron properly.

The correct answer is to drink at least 2 liters of fluid 2 hours before the procedure and not void until the procedure is done. This instruction is given to ensure that the mother has a full bladder during the abdominal ultrasound. A full bladder helps to push the uterus up and provides a better visualization of the fetus.

The given answer states that the heart rate of the patient is 140 bpm. This indicates that the patient's heart is beating at a rate of 140 beats per minute. The ECG strip provided may contain information or patterns that suggest this heart rate. However, without visual representation of the ECG strip, it is difficult to provide a more detailed explanation.

The knee to chest position gets the weight off the baby and umbilical cord, which would prevent blood flow. Calling the physician or midwife, and arranging for blood sampling are IMPORTANT, but they have a lower priority than getting the baby off the cord.

Oral communication that injures an individual’s reputation is considered slander. Written communication that does the same is considered libel.

Calcium is the correct answer because a deficiency in this mineral can lead to various health conditions such as tetany, osteomalacia, osteoporosis, and rickets. Tetany is characterized by muscle spasms and contractions, while osteomalacia and osteoporosis are conditions that weaken the bones. Rickets is a condition that affects bone development in children. Calcium is essential for maintaining strong and healthy bones, and a deficiency can result in these harmful effects on the body.

Abruptio placentae refers to the partial or complete premature detachment of the placenta from its site of implantation in the uterus. This condition typically occurs in the late third trimester of pregnancy or during labor. The term "abruptio placentae" is used to describe this medical condition.

Crowing, which occurs when the newborn’s head
or presenting part appears at the vaginal opening, occurs during the second stage of labor. During the first stage of labor, cervical dilation and effacement occur. During the third stage of labor, the newborn and placenta are delivered. The fourth stage of labor lasts from 1 to 4 hours after birth, during which time the mother and newborn recover from the physical process of birth and the mother’s organs undergo the initial readjustment to the nonpregnant state.

During the third stage of labor, which begins with the delivery of the newborn, the nurse would promote parent-newborn interaction by placing the newborn on the mother’s abdomen and encouraging the parents to touch the newborn. Collecting a urine specimen and other laboratory tests is done on admission during the first stage of labor. Assessing uterine contractions every 30 minutes is performed during the latent phase of the first stage of labor. Coaching the client to push effectively is appropriate during the second stage of labor.

Classic symptoms of DVT include muscle pain, the
presence of Homans sign, and swelling of the affected limb. Midcalf pain, tenderness, and redness, along the vein reflect superficial thrombophlebitis. Chills, fever and malaise occurring 2 weeks after delivery reflect pelvic thrombophlebitis. Chills, fever, stiffness and pain occurring 10 to 14 days after

Assault is the unjustifiable attempt or threat to touch or injure another person. Battery is the unlawful touching of another person or the carrying out of threatened physical harm. Thus, any act that a nurse performs on the patient against his will is considered assault and battery.