Nursing Bullets: Medical-Surgical Nursing Part VII

  1. A mother should allow her infant to breast-feed until the infant is satisfied. The time may vary from 5 to 20 minutes.
  2. Nitrazine paper is used to test the pH of vaginal discharge to determine the presence of amniotic fluid.
  3. A pregnant patient normally gains 2 to 5 lb (1 to 2.5 kg) during the first trimester and slightly less than 1 lb (0.5 kg) per week during the last two trimesters.
  4. Neonatal jaundice in the first 24 hours after birth is known as pathological jaundice and is a sign of erythroblastosis fetalis.
  5. A classic difference between abruptio placentae and placenta previa is the degree of pain. Abruptio placentae causes pain, whereas placenta previa causes painless bleeding.
  6. Because a major role of the placenta is to function as a fetal lung, any condition that interrupts normal blood flow to or from the placenta increases fetal partial pressure of arterial carbon dioxide and decreases fetal pH.
  7. Precipitate labor lasts for approximately 3 hours and ends with delivery of the neonate
  8. Methylergonovine (Methergine) is an oxytocic agent used to prevent and treat postpartum hemorrhage caused by uterine atony or subinvolution.
  9. As emergency treatment for excessive uterine bleeding, 0.2 mg of methylergonovine (Methergine) is injected I.V. over 1 minute while the patient’s blood pressure and uterine contractions are monitored.
  10. Braxton Hicks contractions are usually felt in the abdomen and don’t cause cervical change. True labor contractions are felt in the front of the abdomen and back and lead to progressive cervical dilation and effacement.
  11. The average birth weight of neonates born to mothers who smoke is 6 oz (170 g) less than that of neonates born to nonsmoking mothers.
  12. Culdoscopy is visualization of the pelvic organs through the posterior vaginal fornix.
  13. The nurse should teach a pregnant vegetarian to obtain protein from alternative sources, such as nuts, soybeans, and legumes.
  14. The nurse should instruct a pregnant patient to take only prescribed prenatal vitamins because over-the-counter high-potency vitamins may harm the fetus.
  15. High-sodium foods can cause fluid retention, especially in pregnant patients.
  16. A pregnant patient can avoid constipation and hemorrhoids by adding fiber to her diet.
  17. If a fetus has late decelerations (a sign of fetal hypoxia), the nurse should instruct the mother to lie on her left side and then administer 8 to 10 L of oxygen per minute by mask or cannula. The nurse should notify the physician. The side-lying position removes pressure on the inferior vena cava.
  18. Oxytocin (Pitocin) promotes lactation and uterine contractions.
  19. Lanugo covers the fetus’s body until about 20 weeks’ gestation. Then it begins to disappear from the face, trunk, arms, and legs, in that order.
  20. In a neonate, hypoglycemia causes temperature instability, hypotonia, jitteriness, and seizures. Premature, postmature, small-for-gestational-age, and large-for-gestational-age neonates are susceptible to this disorder.
  21. Neonates typically need to consume 50 to 55 cal per pound of body weight daily.
  22. Because oxytocin (Pitocin) stimulates powerful uterine contractions during labor, it must be administered under close observation to help prevent maternal and fetal distress.
  23. During fetal heart rate monitoring, variable decelerations indicate compression or prolapse of the umbilical cord.
  24. Cytomegalovirus is the leading cause of congenital viral infection.
  25. Tocolytic therapy is indicated in premature labor, but contraindicated in fetal death, fetal distress, or severe hemorrhage.
  26. Through ultrasonography, the biophysical profile assesses fetal well-being by measuring fetal breathing movements, gross body movements, fetal tone, reactive fetal heart rate (nonstress test), and qualitative amniotic fluid volume.
  27. A neonate whose mother has diabetes should be assessed for hyperinsulinism.
  28. In a patient with preeclampsia, epigastric pain is a late symptom and requires immediate medical intervention.
  29. After a stillbirth, the mother should be allowed to hold the neonate to help her come to terms with the death.
  30. Molding is the process by which the fetal head changes shape to facilitate movement through the birth canal.
  31. If a woman receives a spinal block before delivery, the nurse should monitor the patient’s blood pressure closely.
  32. If a woman suddenly becomes hypotensive during labor, the nurse should increase the infusion rate of I.V. fluids as prescribed.
  33. The best technique for assessing jaundice in a neonate is to blanch the tip of the nose or the area just above the umbilicus.
  34. During fetal heart monitoring, early deceleration is caused by compression of the head during labor.
  35. After the placenta is delivered, the nurse may add oxytocin (Pitocin) to the patient’s I.V. solution, as prescribed, to promote postpartum involution of the uterus and stimulate lactation.
  36. Pica is a craving to eat nonfood items, such as dirt, crayons, chalk, glue, starch, or hair. It may occur during pregnancy and can endanger the fetus.
  37. A pregnant patient should take folic acid because this nutrient is required for rapid cell division.
  38. A woman who is taking clomiphene (Clomid) to induce ovulation should be informed of the possibility of multiple births with this drug.
  39. If needed, cervical suturing is usually done between 14 and 18 weeks’ gestation to reinforce an incompetent cervix and maintain pregnancy. The suturing is typically removed by 35 weeks’ gestation.
  40. During the first trimester, a pregnant woman should avoid all drugs unless doing so would adversely affect her health.
  41. Most drugs that a breast-feeding mother takes appear in breast milk.
  42. The Food and Drug Administration has established the following five categories of drugs based on their potential for causing birth defects: A, no evidence of risk; B, no risk found in animals, but no studies have been done in women; C, animal studies have shown an adverse effect, but the drug may be beneficial to women despite the potential risk; D, evidence of risk, but its benefits may outweigh its risks; and X, fetal anomalies noted, and the risks clearly outweigh the potential benefits.
  43. A patient with a ruptured ectopic pregnancy commonly has sharp pain in the lower abdomen, with spotting and cramping. She may have abdominal rigidity; rapid, shallow respirations; tachycardia; and shock.
  44. A patient with a ruptured ectopic pregnancy commonly has sharp pain in the lower abdomen, with spotting and cramping. She may have abdominal rigidity; rapid, shallow respirations; tachycardia; and shock.
  45. The mechanics of delivery are engagement, descent and flexion, internal rotation, extension, external rotation, restitution, and expulsion.
  46. A probable sign of pregnancy, McDonald’s sign is characterized by an ease in flexing the body of the uterus against the cervix.
  47. Amenorrhea is a probable sign of pregnancy.
  48. A pregnant woman’s partner should avoid introducing air into the vagina during oral sex because of the possibility of air embolism.
  49. The presence of human chorionic gonadotropin in the blood or urine is a probable sign of pregnancy.
  50. Radiography isn’t usually used in a pregnant woman because it may harm the developing fetus. If radiography is essential, it should be performed only after 36 weeks’ gestation.