HESI OB Hints
HESI OB Hints
• Insulin therapy for Muslim woman who fasts from sunrise to sundown.
Answer: Contact primary care provider to
... [Show More] re-evaluate the insulin therapy.
• Vitamin K is given within 1 hour of birth to the newborn to prevent bleeding disorders
• Adolescent nutrition therapy. Pregnant adolescents must have proper nutrition because they tend to lack knowledge in this area.
• Place a foam wedge under the client who is placed into a lithotomy position to relieve light headedness.
• Know characteristics of newborns that are LGA (Large for gestational age)
• Stop Pitocin drips for women who are experiencing symptoms of hyperstimulation.
• Study RhoGham….what is it used for and why.
• Adminiser IV fluids if BP is low and Pulse is high.
• Study Phototherapy for jaundice. Why is it used? Pathological vs Physiological.
• Postpartum hemorrhage treatment
• Fetal tachycardia in womb…means check temperature of the mother.
• Uterine atony
• Foul smelling lochia = infection
• Know fundal heights
• Know fetal presentation positions
• PKU test
• Woman come in shouting in the ER my water has broke something about keeping her calm is the answer, not find her gestational age
• women broken arm comes in (abuse question) answer is to look for addition bruising markings
• women should be assessed for abuse in private, away from the male partner, by a nurse who is familiar with local resources and knows how to determine the safety of the client
• calcium gluconate heart patient ecg monitoring
• Ultrasound best way to determine gestational age
• women has large baby monitor uterine tone
• women is supine and is comfortable place pillow wedge
• jewish women tay-sachs disease
• genetic disease where baby loses motor skills and mental function after a few months. Jews are at risk
• women wants to exercise swimming; stretching best answers
• Erthromycin ribbon strip in lower conjunctiva
• Calcium gluconate antidote to mag sulfate
• man think his wife is crazy when she can feel the fetus move; she is talking to the baby
• this is normal sign of maternal-fetal bonding during pregnancy; talking to fetus in utero, massaging abdomen, and nicknaming fetus are all healthy psychosocial activities
• prolapse cord – place woman in extreme trendeluburg or knee chest position
• perineum pressure - retrocele;cystocele <- read on that
• Cystocele is the relaxation of the anterior vaginal wall with prolapse of the bladder. Rectocele is the relaxation of the posterior vaginal wall with prolapse of the rectum.
• moro reflex - shoulder dystocia
• clavicle fracture can lead to limited motion of arm, crepitus over bone, and absence of moro reflex on affected side
• biparietal diameter - 9.25 cm at term
• HIV AZT- 6 hours
• Generic: Zidovudine (AZT) Brand: Retrovir. Treatment of infections with HIV. Infants should be given 2 mg/kg orally every 6 hours within 12 hours of birth
• HIV pt. should not breast feed
• epigastric pain – seizure pe
• could be a sign that the woman is experiencing a eclamptic seizure
• contraception there were 2 read up on diaphragm needs to be resized or another about <-read 2 answers look the same. women breast feeding sponge and foam
• Diaphragm needs to be resized following a pregnancy, abortion, pelvic surgery, or weight loss or gain of 20 lbs or more. Nothing containing estrogen should be used as contraceptive (decreases milk supply). Condoms, diaphragm, copper IUD, cervical cap, sponge, spermicidal jelly/foam/cream are all ok.
• circumcision - petroleum jelly gauze
• cleaning baby – use clean water
•
• a question gives you alot of vitals - answers is the 20 lbs of weight gain gestational diabetes
• Rhogam- 72 hrs
• Injection of Rh immune globulin given within 72 hours after birth
• Rhogam question about antibodies for her next rh+ baby
• Rhogam prevents formation of antibodies that could risk future pregnancies
• Caput succedaneum - crosses the suture line - normal will go away 3-4 days
• Something about this: Although development of the mammary glands is functionally complete by mid pregnancy, lactation is inhibited until a decrease in estrogen level occurs after the birth. A thin, clear, viscous secretory material (precolostrum) can be found in the acini cells by the third month of gestation. Colostrum, the creamy, white-to-yellowish to orange premilk fluid, may be expressed from the nipples as early as 16 weeks of gestation
• Precipitous labor may result from hypertonic uterine contractions that are tetanic in intensity. Maternal and fetal complications can occur as a result. Maternal complications include uterine rupture, lacerations of the birth canal, amniotic fluid embolism, and postpartum hemorrhage. Fetal complications include hypoxia, caused by decreased periods of uterine relaxation between contractions, and intracranial hemorrhage related to rapid birth
• TSH T4- metabolic deficiencies
• Hypothyroidism happens when infants cant produce sufficient amounts of thyroid hormone (T4), which is needed for normal metabolism, growth, and brain development. You’ll see an elevated TSH and low T4.
• question about umbilical cord alcohol diaper
• fold baby’s diaper away from stump (or buy newborn diapers with cut-out space for stump) so it is exposed to air and doesn’t come in contact with urine). Clean stump daily with cotton swab dipped in rubbing alcohol. Keep dry
• prolapse cord gauze water
• wrap cord loosely in a sterile towel saturated with warm sterile saline (if cord is protruding from vagina)
• some question on shock - start iv 18g needle
• Tetanic contractions stop pitocin
• sore breast - monitor the woman infant for positioning
• incorrect positioning of baby on breast is most common reason for sore nipples. Get as much areola as possible in mouth. Break suction with little finger into baby’s mouth.
• some question on eating during labor and eating i think i put anesthesia risk
• NPO, maybe ice chips in case of stat C/S and general anesthesia.
• some question on monitoring an infant i believe i put blue tongue
• baby’s lips, tongue, or mucus membranes in mouth turn blue, this is cyanosis. Baby needs oxygen.
• there was a question on transition phase i think i put monitor uterine contractions or it was maintain control read up on this
• Preeclampsia question- Nursing assessment will include questioning regarding headache, blurred vision, scotoma, nausea, vomiting, fetal movement, and epigastric discomfort or pain.::::::blurred vision headache
• some question with answer doing a cbc count the answer was all stats neg for c-section *** wierd question
• african american 28 weeks - glucose test
• for determination of gestational diabetes
• rheumatic fever heart problem - excess fluid volume
• caused by strep infection. G-Pen prophylactically once a month
• know nagel rule
• count back 3 months and add 7 days (feb has 28 days)
• read on DIC
• spontaneous bleeding from gums/nose, petechaie, excessive bleeding from sit of slight trauma, tachycardic, decreased platelets, diaphoresis, increased PTT/PT. Interventions include correct underlying cause, volume replacement, O2, monitor urinary output via foley (renal failure is consequence of DIC). Administer heparin IV in first phase (coagulation phase) to block formation of thrombin (not Coumadin). If in hemorrhagic phase, administer clotting factors.
• fundus up to the right have the women try to void
• This is a sign of bladder distention, which prevents uterus from contracting normally. Help woman empty bladder ASAP
• assessing fundus the other hand is to maintain control or something like that
• Leopold maneuver?
• gynecoid best shape
• classic female type (most common).
•
1. You are instructing a pregnant woman on the best dietary source of folic acid:
a. Peanuts with the shell still on
2. A woman who has PIH is admitted for induction. She is receiving oxytocin __ m/U min. She begins to complain of a headache. She is 6 cm dilated, her contractions are 1 to 2 minutes apart and 60-75 seconds in length. What is your initial action?
A. Discontinue the pitocin
3. A pregnant woman is admitted to the ER from being in a motor vehicle accident. She is laying supine on stretcher. Her BP is 90/56. What is your initial action?
A. Tilt the stretcher (something about offsetting the placenta)
4. You are showing a woman with Gestational DM how to self administer insulin shots. She tells you that because of her religion she is not allowed to eat or drink during the daylight hours for a few weeks. What is the best action?
A. Collaborate with the healthcare provider to make an alternative insulin schedule
5. A baby is born to an HIV + woman, who was treated with AZT during labor. What is the most important intervention?
A. Make sure the newborn receives AZT within 6 hours of birth
6. A baby is about to get immunizations before being discharged, what is the priority action?
A. Get the consent form signed for Hep b immunization
7. A woman gives birth in a taxi cab on the way to the hospital. She is confirmed to have active Herpes blisters. What is the nurse’s priority upon admitting the newborn to the NICU?
A. Bring the newborn to the isolation area
8. A woman takes an at home urine pregnancy test, what hormone is responsible for her positive result?
A. Human Chorionic Gonadotropin (HCG)
9. Non breast-feeding mother experiencing engorgement
Answer: avoid stimulation and wear tight fitting bra
10. Breastfeeding woman with mastitis of the left breast
Answer: have her do warm compresses to the left breast (apply heat)
11. Described swelling and blood on babys skull that doesn’t cross suture line, asked what you should do
Answer: Notify HCP of cephalhematoma
12. Question about woman with bleeding and “boggy fundus” asks what you should do
Answer: massage fundus until firm
13. Gave a scenario about a woman who was in active labor on a Pitocin drip, and described her contractions as pretty close together but they were lasting a long time (tetanic contractions) asked whats the most important thing you need to do first
Answer: discontinue Pitocin
14. There was a question about a husband calling in saying that his wife is depressed and doesn’t like the baby, what should you tell him
Answer: something like tell him to monitor her and call back if they get worse or these things don’t subside in a couple weeks
15. There was a question asking about what things you would need to check for dilation
Answer: sterile glove and lube
16. Question about WHY you give rhogam to a mother after giving birth?
Answer: so the Rh negative mother doesn’t build antibodies incase she has another rh+ baby in future (something like that)
17. Question about why you wouldn’t wanna give a mother in labor food?
Answer: food increases risk for aspiration incase general anesthesia is needed later [Show Less]