NOTES & STUDY GUIDE FOR OB Ch. 25—Due Date: 4/10/2014 (see 1c):
1. Obtain a separate 2-3 ½ inch Notebook and label it: Maternal & Newborn Nursing ( include your name)
a. Include tabs (labeled & durable) for each of the 4 chapters & include a sheet protector at the end of each unit
for listed drug cards. All areas are expected to be completed thoroughly, especially when asked to discuss info in
“details.” Notebooks not meeting these standards will receive a Failing test grade & be returned for corrections.
b. Students are to bring this notebook, as well as any other pertinent resources daily to scheduled clinical days.
c. Note: Due to the length of the OB material that has to be discussed & time constraints, your ATI Secured OB Test
Score (5/20/2014), will be your OB Exam Test grade Exam (it will be a double grades for diseases & meds), you
will also be given an additional 15 OB/ Calculation questions, that will be averaged into your ATI OB Test score
(this score will be included in your OB Meds Test grade).
2. Define Ch. 25 key terms as listed (list the 27 terms separately at the beginning of each Unit)
3. Review the physiology of conception & be sure to include the following:
a. What is the survival time for an egg and sperm after ovulation or ejaculation?
b. Which chromosome determines the sex of the child?
c. Where does the ovum usually implant?
d. Discuss the physiological changes of the zygote & uterine lining after implantation.
e. Name the 2 membranes of the amniotic sac.
f. What 3 functions does amniotic fluid provide?
g. What lab tests are ordered to determine pregnancy?
4. Discuss the anatomic and physiologic alterations that occur during pregnancy.
a. Discuss both embryonic fetal development & physiology
5. Summarize table of fetal develop. & maternal events during preg.and drug substances to avoid (table 25-1)
6. Summarize both diagnostic tests & assessment tools used to assess fetal well-being. Include purpose &
description as well as nursing responsibilities (as appropriate).
7. In detail, describe maternal physiology ( include the following)
a. Hormonal changes
b. Uterus
c. Breasts
d. Maternity cycle
8. Explain the FDA pregnancy categories and its significance (include chart/graph).
9. Describe the health promotion recommendations for antepartal care.
10. Identify the components of antepartal assessment.
11. Differentiate among the presumptive, possible, and positive signs of pregnancy.
12. Define Nagele’s rule and how to calculate.
13. Describe the recommended schedule of prenatal visit.
14. List and describe the danger signs that might occur during pregnancy.
1
NOTES & STUDY GUIDE FOR OB Ch. 25 Cont’d
15. Describe nutritional requirements during pregnancy; lactation and infancy (refer to chapter listed in text for
add’l info).
16. Discuss the expected weight gain during pregnancy.
17. What is the caloric increase during pregnancy, and the protein increase in grams?
18. Define pica and describe problems associated with its consumption.
19. Briefly describe: the common discomforts of pregnancy (include changes in each body system, hygiene,
activity level/rest, sleep, stress, role, self-perception and cognitive perception.
20. Explain the rationale for childbirth classes and list topics generally discussed.
21. Discuss cultural practices and beliefs that may affect ongoing health care during pregnancy.
22. Identify nursing diagnoses relevant to care of the prenatal patient.
2
NOTES & STUDY GUIDE FOR OB Ch. 26:
1. Define Ch. 26 key terms as listed (list the terms separately at the beginning of each Unit)
2. Describe the various theories of the onset of labor.
3. Describe the signs and symptoms of impending labor.
4. Distinguish between true and false labor signs & symptoms.
5. Explain the tests used for ROM.
6. Explain in detail, the five factors that affect the labor process.
7. Describe the indicators of fetal distress & the nurse’s responsibilities for each indicator.
8. Describe the changes in the fetal heart rate & list the nurse’s responsibility (as indicated).
9. Define & describe the various presentations & positions of the fetus.
10. Describe in detail, the “powers” involved in labor and delivery.
11. Describe in detail, the mechanisms of labor.
12. Identify the stages of labor in detail & the nursing actions during each stage ( beginning, end & duration).
a. What complications should the nurse watch for during the 1st stage of labor?
b. Describe four times/situations when the FHT are checked during the 1st stage of labor?
13. Describe the function of uterine contractions during the second stage of labor.
14. Describe the assessment for labor and delivery.
15. Explain breathing techniques beneficial for the patient in labor.
16. Describe 2 methods of inducing labor.
17. Identify & describe in detail common SEs of an epidural block.
18. Describe in detail APGAR grading of the newborn.
19. Describe in a summary the newborn infant’s response to birth.
20. What are the methods for identifying the newborn?
21. Discuss nursing interventions related to labor and delivery (all 6 topics including the 10 subtopics of the
psychosocial assessment).
22. Outline & summarize medical interventions related to labor and delivery (7 areas).
23. Describe fetopelvic disproportion.
24. Compare & contrast the type of anesthesia used for L&D (include route of administration, area(s)
anesthetized, possible SEs on mother & fetus and nsg interventions after administration).
1. Using your adult med text & pharm text review the following medications & be familiar with:
trade name, action, indications, SEs, contraindications & Nsg implications including antidotes (Information is
to be included in your notes and a drugs card with all the required information clearly shown must be placed in
your notes at end of each unit. If Drugs are repeated, include information in the notes but it’s not necessary to have
multiple drug cards).
a.
b.
c.
d.
e.
f.
g.
Miosoprostol
Magnesium sulfate
Meperidine
Methyergonovine
Oxyocin ( include fetal effects)
Prostaglandin E
Ritrodrine
h.
i.
j.
k.
l.
m.
Fentanyl
Carboprost tromethamine
Promethazine hydrochloride
Nalbuphine hydrochloride
Hydroxyzine pamoate
Naloxone hydrochloride ( include fetal effects)
25. Identify nursing diagnoses relevant to the woman in labor.
3
NOTES & STUDY GUIDE FOR OB Ch. 27:
1. Define Ch. 27 key terms as listed (list the terms separately at the beginning of each Unit)
2. Using the BUBBLE-HE acronym, in detail describe postpartum assessment of the mother. Describe normal & possible
abnormal findings and the nurse’s responsibility (when appropriate).
3. Identify the physiologic changes in detail that occur in the postpartum period (must include all body systems
(including perineum & rectal areas).
4. Why is the fundus massaged immediately following delivery and in the recovery room?
5. Describe the normal characteristics of the fundus following delivery (include info found in box 27-1).
6. Why would a nurse massage a boggy fundus?
7. Describe the process when a woman is transferred from the recovery area.
8. Provide a detail Summary of nsg assessment of interventions for the mother:
(be sure to incl. info found in boxes 27-2, 27-3, 27-4, 27-5 & 27-6). You may include *questions below in your
summary. Must clearly identify answers.
9. When is the pre pregnancy weight achieved?*
10. Why is voiding a concern for the nurse during the PP period & what are signs of urinary retention (list 3)?*
11. Why is a lack of bowel elimination a problem during the PP period? What is the tx?*
12. In detail , describe guidelines for assessing lochia ( include expected & unexpected changes in color/ flow,etc *
13. What is the Chloasma of pregnancy?*
14. Review Box 27-7 & 27-8: You are to include info/summary from each topic listed and include in your notes.
15. Describe the psychosocial adaptations that occur postpartum (includes 6 areas & include info from box 27-11 and
Table 27-3). In this section include 5 different cultural/values regarding parenting in when discussing values &
beliefs.
16. Describe interventions to prevent infant abductions (don’t merely copy box 27-12; read your text).
17. Discuss laws related to discharge a newborn.
18. Describe the assessment of the normal newborn immediately after delivery ( include the following
information):
a.
b.
c.
d.
e.
When physical characteristics are evaluated.
When neurological assessments are evaluated ( & rationale)
What are normal vital signs for a newborn?
What might cause a bulging anterior fontanel in the newborn & treatment?
A detail assessment of the newborn’s physical characteristics (include all 11 areas); include Box 27-13
in your information. In describing the reflexes most commonly observed in the newborn (list what the reflex
is, what’s observed & when it’s no longer observed).
19. In detail summarize the nsg assessment of interventions for the newborns; there are 9 areas to
summarize in addition be sure to (include boxes 27-5, 27-6, & 27-14). Although this is not all the info
expected in your summary; include the following information & identify it clearly in your summary.
a. for the health management & health perception section be sure to include the following :(rationale
for checking infant’s ID, instructions re: handwashing, safety, infant’s positioning ( sleeping, feeding), car seats as well
as dx tests & info to discuss with parents)
b.
c.
d.
e.
Why vitamin K is routinely administered
What is a normal wt. loss for an infant in the 1st few days of life & rationale?
Define colostrum & describe the stages of production, when it’s produced & appearance
Describe the benefits of breast milk
f.
In detail compare & contrast human milk & Bovine’s milk (discuss pros & cons)—this info isn’t necessarily the same for
questions (14-15)—must review nutrition section in text for these answers.
g. What is typically is the 1st feeding for bottle fed infants & the rationale?
h.
i.
The normal temp of the room & bath water to prevent chilling & the rationale
Procedure for the 1st bath and hair shampoo
4
NOTES & STUDY GUIDE FOR OB Ch. 27 cont’d:
j.
k.
l.
m.
n.
o.
p.
q.
r.
What vernix caseosa is and how it’s handled & rationale
Routine practices for the infants bath re: the use of ivory soap, oils & powders according to Wong
Pros & cons of cloth vs. disposable diapers
Care & nsg instructions re: umbilical cord
Care & nsg instructions re: circumcision
Why is elimination (bowel & urine) checked carefully in the newborn?
What type of newborn cry may indicate a problem?
Capabilities of a newborn & methods used to assist infant to open eyes
Infant quieting techniques
20. Explain common variations that may be observed in the newborn.
21. Describe the nutritional needs and feeding of the newborn ( review basic nutrition chapter for info)
22. Compare the nutritional composition of breast & bottle milk.
23. Explain parent-child attachment (bonding).
24. Using your adult med text & pharm text review the following medications & be familiar with:
trade name, action, indications, SEs, contraindications & Nsg implications including drug antidotes ( Information is
to be included in your notes and a drugs card with all the required information clearly shown must be
placed in your notes at end of each unit. If Drugs are repeated, include information in the notes but it’s
not necessary to have multiple drug cards).
a. Codeine with Tylenol
b. Ibuprofen
c. Simethicone
d. Rho(D) immune globulin ( RhoGAM)—route,
when given & to whom?
e. Rubella
f. Vitamin, prenatal
g. Oxytocin ( include fetal effects)
h.
i.
j.
k.
l.
m.
n.
Methyergonovine
Witch Hazel
Dibucaine ointment
Vitamin K ( route)
Purified lanolin cream
Erythromycin ophthalmic ointment/drops
Benzocaine
25. Identify nursing diagnoses relevant to the postpartum woman.
5
NOTES & STUDY GUIDE FOR OB Ch. 28:
1.
2.
3.
4.
5.
6.
Define Ch. 28 key terms as listed (list the terms separately at the beginning of each Unit)
In detail, list those conditions that increase maternal and fetal risk (include info from Box 28-1 & 28-2).
What are 2 life- threatening complications associated with an Ectopic pregnancy?
In detail, discuss bleeding disorders that can occur during pregnancy.
Using a venn-diagram compare & contrast placenta previa & abruption placenta.
In detail, identify diagnostic tests used to determine high-risk situations (when appropriate include time
during preg. to take test & nsg interventions).
7. In detail, describe the HELLP syndrome & its medical implications.
8. Discuss pregnancy-induced hypertension.
9. What is the difference between pre-eclampsia and eclampsia?
10. Why is the left lateral position beneficial for pregnant women?
11. Identify preexisting maternal health conditions that influence pregnancy (TB, DM & Cardio). Include info
on the patho, clinical manifestations, assessment, dx tests, mgmt., nsg interventions & teaching. May use
ATI’s disease templates to describe this information.
12. Why is control of the mother’s blood sugar of major importance during pregnancy? What are the possible
complications if the blood sugar isn’t maintained at a normal level?
13. In detail, using the TORCH acronym list the infectious diseases most likely to cause serious complications.
14. In detail, discuss complications related to age:
a. Care of the pregnant adolescent.
b. Older pregnant woman
15. Identify concerns related to preterm infants.
16. In detail, describe the complications related to newborns at risk (5 areas to include). Include information listed in
table 28-4 in your summary on substance abuse.
17. Explain the hemolytic diseases of the newborn, clinical manifestations, assessment dx tests and nsg interventions.
18. What causes erythroblastosis fetalis?
19. What type of post-partum (PP) pt. would receive RhoGAM? (Including all pertinent nsg instructions to give to pt.)
20. What is the medical tx to reduce serum bilirubin, when is this treatment given and what nsg actions are
performed?
21. Discuss the problems created by alcohol and drug abuse* (may be included with your answer for question #16).
22. Submit a summary on complications related to PP mental health problems.
23. Using your adult med text & pharm text review the following medications & be familiar with:
trade name, action, indications, SEs, contraindications & Nsg implications & drug antidotes ( Information is
to be included in your notes and a drugs card with all the required information clearly shown must be
placed in your notes at end of each unit. If Drugs are repeated, include information in the notes but it’s
not necessary to have multiple drug cards).
a. Acyclovir
e. Magnesium sulfate ( MgSO4)
b. Hepatitis B immune globulin (HBIG)
f. Ritrodrine
c. Hydralazine
g. Naloxone hydrochloride ( include fetal
effects)
d. Lung surfactant
h. Terbutaline
24. Discuss nursing diagnoses related to high-risk conditions of the mother and newborn.
6