The nurse is assessing a new mother's efforts to bond with her newly born infant. Identify three (3) factors that can impact effective bonding between mother and infant? -Disgust when the infant voids, stools, or spits up -Expresses disappointment in the infant -Turns away from the infant A nurse is providing community education regarding risk factors for ovarian cancer. Identify five (5) risk factors associated with the development of ovarian cancer. (Review the Med Surg RM) Risk Factors include: -Over 40 years of age -Nulliparity or first pregnancy after 30 years of age -Family history of ovarian, breast, or colon cancer -History of dysmenorrhea or heavy bleeding -Endometriosis A nurse is caring for a client who was diagnosed with group B streptococcus during her initial screening. What effects can this infection have on her pregnancy? Effects on pregnancy include: -Premature rupture of membranes -Preterm labor and delivery -Chorioamnionitis -Infections of the urinary tract -Maternal sepsis A nurse is caring for a client undergoing infertility testing. The client asks why a hysterosalpingography has been ordered. What is the nurse's best response? -The nurse would respond by saying, “It is an a radiological procedure in which dye will be used to assess the patency of your fallopian tubes”. This study source was downloaded by 100000885989274 from CourseHero.com on 06-05-2024 04:37:45 GMT -05:00 https://www.coursehero.com/file/39532702/RN-Capstone-Maternal-Newborndocx/ A nurse is caring for a client in the third stage of labor. What nursing interventions should be taken during this stage? -Instruct the client to push once findings of placental separation are present. Keep mother/parents informed of progress of placental expulsion and perineal repair if appropriate. -Administer oxytocics expulsion of the placenta to occurs to stimulate the uterus to contract and thus prevent hemorrhage. -Gently cleanse the perineal area with warm water and apply a perineal pad or ice pack to the perineum. -Promote baby-friendly activities between the family and the newborn, which facilitates the release of endogenous maternal oxytocin What would the nurse teach to the postpartum mother before administering the Rho(D) Immune Globulin? -Rho(D) must be given to an Rh negative mother with an Rh positive baby, within 72 hours of birth. A titer must be pulled three months later to make sure the mother’s body has built up the appropriate immunity. What is the priority nursing action during an oxytocin infusion? -Priority action is to monitor uterine activity, discontinue if contraction frequency is 2 to 3 minutes and duration is longer than 90 seconds. What are five (5) essential components of therapeutic communication when responding to a client who is postoperative following a mastectomy? Time: Plan for and allow adequate time to communicate with others. Attentive behavior or active listening: Use this as a means of conveying interest, trust, and acceptance. Caring attitude: Show concern and facilitate an emotional connection and support among nurses and clients, families, and significant others. Honesty: Be open, direct, truthful, and sincere. Trust: Demonstrate to clients, families, and significant others that they can rely on nurses without doubt, question, or judgment. Empathy: Convey an objective awareness and understanding of the feelings, emotions, and behavior of clients, families, and significant others, including trying to envision what it must be like to be in their position. This study source was downloaded by 100000885989274 from CourseHero.com on 06-05-2024 04:37:45 GMT -05:00 https://www.coursehero.com/file/39532702/RN-Capstone-Maternal-Newborndocx/ Nonjudgmental attitude: A display of acceptance of clients, families, and significant others encourages open, honest communication. A nurse is instructing a newly diagnosed client with fibrocystic breast tissue disorder about diet. What should the nurse instruct the client to avoid in their diet? (Review the Med Surg RM) a. Alcohol b. Caffeine C. Milk d. Orange juice What three (3) teaching points should the nurse discuss with a client experiencing dysmenorrhea? -Take aspirin or another pain reliever like naproxen or nonsteroidal anti-inflammatory drugs (NSAIDs) -Place heating pad or hot water bottle on your lower back or abdomen or take a warm bath. -Avoid foods that contain caffeine and salt. Avoid smoking and drinking alcohol. What are five (5) adverse effects noted with epidural analgesia administration during labor? 5 adverse effects: -Inhibition of bowel and bladder elimination sensations -Bradycardia or tachycardia -Hypotension -Respiratory depression -Elevated temperature What medications are administered to treat Streptococcus B-Hemolytic infection during labor? -Azithromycin or amoxicillin This study source was downloaded by 100000885989274 from CourseHero.com on 06-05-2024 04:37:45 GMT -05:00 https://www.coursehero.com/file/39532702/RN-Capstone-Maternal-Newborndocx/ What assessment should the nurse perform before administering pain medication to a laboring client who reports the need to have a bowel movement? -The nurse would perform a vaginal check. A nurse is caring for a client with hyperemesis gravidarum. Describe nursing care and medication therapy for the client diagnosed with hyperemesis gravidarum. Nursing care includes: Monitor I&O. -Assess skin turgor and mucous membranes. -Monitor vital signs. -Monitor weight. -Have the client remain NPO for 24 to 48 hr Medication therapy would involve: -IV lactated Ringer’s for hydration. - Pyridoxine (vitamin B6) and other vitamin supplements as tolerated. - Antiemetic medications (ondansetron, metoclopramide) cautiously for uncontrollable nausea and vomiting. - Use corticosteroids to treat refractory hyperemesis gravidarum. A nurse is administering oxytocin to a client in labor. What are symptoms of uterine hyperstimulation that would cause the nurse to discontinue this medication? Symptoms include: -Contraction frequency more often than every 2 min -Contraction duration longer than 90 seconds -Contraction intensity that results in pressures greater than 90 mm Hg as shown by IUPC -Uterine resting tone greater than 20 mm Hg between contractions -No relaxation of uterus between contractions A complication of a newborn after birth is hypoglycemia. What is the cause of hypoglycemia in a newborn? Which newborns are at greater risk of this complication? Identify nursing assessments and interventions to address this newborn complication. This study source was downloaded by 100000885989274 from CourseHero.com on 06-05-2024 04:37:45 GMT -05:00 https://www.coursehero.com/file/39532702/RN-Capstone-Maternal-Newborndocx/ Causes of hypoglycemia: -Poor nutrition for the mother during pregnancy -Birth defects -Congenital metabolic diseases -Not enough oxygen at birth (birth asphyxia) -Liver disease Newborns that are at greater risk would be: -Preterm infant -LGA or SGA -Stress at birth, such as cold stress and asphyxia Nursing assessment findings include: -Poor feeding -Jitteriness/tremors -Hypothermia -Diaphoresis -Weak cry -Lethargy Interventions to address the complication: -Initiate IV dextrose for a symptomatic newborn. -Provide frequent oral and/or gavage feedings or continuous parenteral nutrition early after birth to treat hypoglycemia. -Monitor the neonate’s blood glucose level closely per facility protocol The mother of a newborn asks the nurse what is the soft swollen mass located on her infant’s scalp after a non-traumatic vaginal delivery. The nurse does not note any discoloration. How should the nurse respond? -The nurse would explain that it is caput succedaneum, it is localized swelling of the soft tissues of the scalp caused by the pressure on the head during labor. This is an expected finding that can be palpated as a soft edematous mass and can cross over the suture line. The swelling usually resolves within 3 to 4 days and does not require any treatment. This study source was downloaded by 100000885989274 from CourseHero.com on 06-05-2024 04:37:45 GMT -05:00 https://www.coursehero.com/file/39532702/RN-Capstone-Maternal-Newborndocx/ What are causes of late decelerations of fetal heart rate? What are nursing interventions to take if these occur? Causes of late decelerations include: uteroplacental insufficiency causing inadequate fetaloxygenation, maternal hypotension, placenta previa, abruptio placentae, uterine hyperstimulation with oxytocin, preeclampsia, and late- or post-term pregnancy Interventions to take: -Place client in side-lying position. -Insert an IV catheter if not in place, and increase rate of IV fluid administration. -Discontinue oxytocin if being infused -Administer oxygen by mask at 8 to 10 L/min via nonrebreather face mask. -Elevate the client’s legs The nurse is assessing an expectant female who is suspected to have varicella-zoster (VZV). What assessment findings would indicate VZV and what complications should be monitored for if VZV is present? (Information found in the Nursing Care of Children and Maternal Newborn RM) -Assessment findings include pain along sensory nerves in addition to a region of patchy erythema, regional lymphadenopathy, grouped vesicles, and pruritus. The area involved is may be tender to palpation. -Complications that should be monitored for include preterm labor, encephalitis, and varicella pneumonia. What education should the nurse provide to the postpartum client regarding mastitis? -Thoroughly wash hands prior to breastfeeding - To completely empty her breasts with each feeding to prevent milk stasis, which provides a medium for bacterial growth. - Encourage the client to use ice packs or warm packs on affected breasts for discomfort - Continue breastfeeding frequently (at least every 2 to 4 hr), especially on the affected side. - Encourage to wear a well-fitting bra for support. This study source was downloaded by 100000885989274 from CourseHero.com on 06-05-2024 04:37:45 GMT -05:00 https://www.coursehero.com/file/39532702/RN-Capstone-Maternal-Newborndocx/ Powered by TCPDF (www.tcpdf.org)
