NR 327 Week 5 Maternal-Child Nursing
Exam Study Guide Latest Guide 2023
Fundus assessment post partum – Correct Answer – firm and
near level of umbilicus
recheck after voiding
clots interfere with uterine contraction
support uterus when expelling clots to prevent inversion
additional oxytocin maybe needed
Post partum assessment: lochia – Correct Answer – Amount
Color
Odor
constant trickle, dribble, or oozing indicated excessive bleeding
and requires immediate attention
normal odor is fleshy, earthy, or musty
foul odor suggest infection
Bladder elimination assessment – Correct Answer – distention
displacement of uterus
fundus after emptying bladder
breast post partum assessment – Correct Answer – should be
soft and tender
observe size, shape and symmetry
assess for flat or retracted nipples
assess for signs of nipple trauma
palpate for firmness or tenderness
Post partum assessment lower extremities – Correct Answer –
palpate pedal pulses
assess for edema
assess DTRs
promote early ambulation
Nutrition after birth for a lactating mother – Correct Answer –
Energy
protein
fats
vitamins and minerals
Energy – Correct Answer – first 6 months of lactation, the
estimate energy requirements is 330 additional calories
second 6 months requires 400 additional calories
specific concerns for lactating mothers – Correct Answer –
Dieting: no major diet changes
adolescence
vegan diet
avoidance of dairy products
inadequate diet
alcohol
caffeine
fluids
download pdf at https://learnexams.com/search/study?query=
NR 327 Week 4 Exam Study
Guide 2023 Graded A+ Latest
2023/2024
Five Factors of adequate fetal oxygen – Correct Answer –
sufficient maternal blood flow and volume to the placenta
normal maternal oxygen saturation
adequate exchange of oxygen and carbon dioxide
open circulatory path from placenta to fetus through umbilical cord
vessels
normal fetal circulatory and oxygen carrying functions
uteroplacental circulation – Correct Answer – maternal blood
circulates around villi
Fetal Placental Circulation – Correct Answer – Established by the
umbilical vessels that connect to vessels within the developing
embryo.
fetal heart rate regulation – Correct Answer – Mechanisms that
regulate FHR are balanced to maintain cardiac output at a level
that keeps the fetal heart and brain oxygenated. Fetal cardiac
output increase is accomplished primarily by an increase in the
heart rate. Conversely, a marked decrease in FHR decreases the
cardiac output.
Five fetal factors that interact to regulate FHR include the:
•Autonomic nervous system
•Baroreceptors
•Chemoreceptors
•Adrenal glands
•Central nervous system
The balance among forces that increase and those that slow the
heart rate result in the characteristic fluctuations in FHR during
late pregnancy.
EMF instrumentation – Correct Answer – intermittent auscultation
and palpation
-should be performed in a consistent manner
bedside fetal monitor and transducers – Correct Answer –
Modern labor and delivery units have wireless monitoring
systems.
External fetal heart rate is obtained via Doppler, or ultrasound.
Uterine activity is acquired via tocodynamometer (toco).
auscultation and palpation benefits – Correct Answer – -Widely
available and easy to use with proper training
-Less invasive than EFM
-Outcomes comparable to EFM in low risk women
Inexpensive
-Atmosphere more natural than technologic
-Comfortable for the woman
-Offers women freedom of movement and ability to ambulate to
promote normal labor
-1:1 nursing care promotes “doula effect” benefits.
-Allows easy FHR and UA assessment during use of
hydrotherapy
auscultation and palpation limitations – Correct Answer – Difficult
to perform in some situations, such as hydramnios and maternal
obesity
Patient may be intolerant of clinician’s touch during contraction.
Does not provide a permanent, documented visual record of the
FHR or UA
Counting of FHR is intermittent.
Cannot assess visual patterns of FHR variability or periodic and
non-periodic changes
Unable to determine UA intensity objectively
Significant events, such as prolonged decelerations, may occur
during periods when the FHR is not auscultated.
May not allow early detection of FHR changes reflective of
hypoxemia
download pdf at https://learnexams.com/search/study?query=
NR 327 Week 3 Exam Study
Guide Latest 2023 |
Chamberlain
Preexisting DM neonatal effects – Correct Answer –
Hypoglycemia
Hypocalcemia
Hyperbilirubinemia
Respiratory distress syndrome
Gestational diabetes risk factors * – Correct Answer – Overweight
Maternal age over 25
previous birth outcome often associated with GDM
GDM in previous pregnancy
HX of abnormal glucose tolerance
HX of DM in close relative
member of a high risk ethic group
HX of prediabetes
HX of PCOS
Screening for GDM – Correct Answer – Glucose challange test
(24-28 weeks)
-1 hour test, 50 g of oral glucose solution
-if abnormal >140mg/dl
–3 hr glucose tolerance test
Oral Glucose Tolerance Test (OGTT) – Correct Answer –
performed to confirm a diagnosis of diabetes mellitus and to aid in
diagnosing hypoglycemia
Fasting: 95mg/dl
1 hour: 180 mg/dl
2 hours: 155 mg/dl
3 hours: 140 mg/dl
GDM therapeutic management – Correct Answer – -Diet ->
carbohydrates should be 30 kcal/kg/day (approximately 40% of
calories should be from CHO (carbohydrates, 20% from protein,
and 40% from fat), Caloric and two or more snack intake should
be distributed throughout 3 meals. Bedtime snack should include
a complex carbohydrate and a protein
-Exercise -> regular exercise improves glucose metabolism, offers
cardiorespiratory benefits, and aids in weight control
-Glucose monitoring -> if 4-hour fasting BGL exceeds 95 mg/dL or
2-hour postprandial BGL exceed 120 mg/dL -> INSULIN
ADMINISTRATION IS STARTED
-Fetal surveillance -> kick counts, U/S assessment of fetal growth
and amniotic fluid volume, BPP, NST, OCT, or amniocentesis to
assess lung maturity
Cardiac disease classification – Correct Answer – rheumatic heart disease
▪ sometimes follows a streptococcal pharyngitis
download pdf at https://learnexams.com/search/study?query=
NR 327 Week 2 Exam Study
Guide 2023 | Chamberlain
Pregnancy screening tests – Correct Answer – To detect
congenital anomalies
-first trimester screening (FTS)
-triple screen
-quad screen
Pregnancy diagnostic test – Correct Answer – most precise test
for a given condition
-chorionic villus sampling
-amniocentesis
-preimplantation genetic diagnosis (PGD)
ultrasound – Correct Answer – high frequency sound waves
obtain real time images of maternal structures, placenta, amniotic
fluid, and fetus
transabdominal ultrasound – Correct Answer – Ultrasound
transducer is maneuvered back and forth across the maternal
abdomen.
Allows visualization of multiple structures
transvaginal ultrasound – Correct Answer – Requires specially
shaped transducer
Commonly used in the first trimester
May be used later for cervical length measurements and clearer
images of placental location
first trimester ultrasonography purpose * – Correct Answer – –
confirm pregnancy
-verify location of pregnancy
-identify multifetal gestation
-determine gestation age
-identify markers
-determine the locations of the uterus, cervix, and placenta
second and third trimester ultrasonography purpose * – Correct
Answer – -confirm fetal viability
-evaluate fetal anatomy
-determine gestational age
-assess serial fetal growth
-compare growth of fetus in multifetal gestations
-evaluate four of five markers in the biophysical profile
-locate placenta when placenta previa is suspected
-determine fetal presentation
First trimester screening (FTS) * – Correct Answer – cell free fetal
DNA
Second trimester multiple marker screening * – Correct Answer –
reports risk for trisomy 21 and 18, open neural tube defects
triple screen test * – Correct Answer – The Triple Test combines
the AFP, beta hCG, and estriol serum level values. The hormone
level results are used in a formula to figure out the risk for a
Down’s syndrome infant. Diagnostic test for genetic anomalies is
chromosome testing.
Quad screening * – Correct Answer – blood test done at 16-18
weeks to measure AFP, HCG, Estriol, and Inhibin A
Alpha-fetoprotein (AFP) – Correct Answer – A blood test that
measures the level of alpha-fetoprotein in the mothers’ blood
during pregnancy as an indicator of possible birth defects in a
fetus
offered at 16-18 weeks
considerations:
gestational age
-maternal weight
download pdf at https://learnexams.com/search/study?query=
NR 327 Week 1 Exam Study
Guide 2023 | Chamberlain
Doula – Correct Answer – trained labor support person who
provides physical and emotional support throughout labor and
sometimes during the postpartum period, many doulas meet with
the family before birth and offer pregnancy, childbirth, and
parenting classes
The Joint Commission (TIC) – five core measures for perinatal
care – Correct Answer – decrease the rate of elective deliveries,
decrease the rate of cesarean births, increase the rate of
antenatal administration of steroids in preterm labor, decrease the
rate of newborns with septicemia or bacteremia, and increase the
rate of exclusive breastfeeding
Effects of Cost Containment on Maternity Care – Correct Answer
- -mothers are discharged at 48 hours for a vaginal birth and 96
hours after a cesarean section birth -> little time for adequate
teaching and little time to assess infant for subtle health issues
Common Types of Perinatal Home Care – Correct Answer – –
Antepartum Home Care: Most preconceptional and low-risk
antepartum care takes place in private offices or public clinics
-Postpartum and Neonatal Home Care: Providing the necessary
education to new mothers about their self- care, basic care of
their infants, and signs of problems they should report after
discharge is a challenge for health care professionals, after
discharge various services may be offered for home care
(lactation consult)
-Home Care for High-Risk Neonates: Neonatal home care nurses
may provide care to infants who are discharged from the acute
care facility with serious medical conditions
Maternal and Infant Mortality – Correct Answer – -maternal
mortality has steadily increased, mothers have more chronic
conditions like HTN and diabetes that can increase the risk of
pregnancy-related complications
-pregnancy-related deaths are usually cased by infection or
sepsis, hemorrhage, and cardiovascular disease
-pregnancy-related deaths are 4x high in black women than white
women** major disparity – we need to eliminate this
-infant mortality rate: death before the age of 1 year, neonatal
mortality rate: death before 28 days of life
-infant mortality causes: Congenital malformations, premature
birth, maternal complications of pregnancy
-infant mortality rate in the United States ranked twenty-sixth
among developed nations
women’s health – Correct Answer – -CVD is the leading cause of
death in the United States, obesity is another major growing issue
-Teen birthrates have decreased, teen pregnancy rate higher in
United States compared to other industrialized nations
nurse’s role – Correct Answer – -develop interpersonal skills to
communicate, teach, and collaborate with patients, family, and
other members of the health care team
-Nurses are expected to base their practice on valid and current
research and use critical thinking and the nursing process to
identify and intervene for a variety of problems
-The roles of the nurse include: communicator (therapeutic
communication), teacher, advocate, collaborator, researcher, and
manager (delegating tasks)
Certified nurse midwives – Correct Answer – -graduate level
(Master of Science [MS] or Doctor of Nursing Practice [DNP])
-qualified to take complete health histories and per- form physical
examinations
-they can provide complete care during pregnancy, childbirth, and
the postpartum period
-practice approach of the CNM to childbirth is noninterventionist
and supportive to low-risk patients
Nurse Practitioner (NP) – Correct Answer – -master or doctoral
level and certification who provide primary care for specific groups
of patients
-they obtain a complete health history, perform physical
examinations, order and interpret laboratory and other diagnostic
studies, and provide primary care for health maintenance and
health promotion
download pdf at https://learnexams.com/search/study?query=
NR327 / NR 327 MaternalChild Nursing Test 1 |
Questions and Answers Graded
A+ Latest 2023| Chamberlain
What should the uterus feel like 24 hours after birth? – Correct
Answer – the uterus should feel like a firmly contracted ball
roughly the size of a large grapefruit. It should be easily located at
about the level of the umbilicus. Lochia should be dark red
What is the first nursing intervention in uterine atony? – Correct
Answer – Massage the fundus until firm
What does Methergine do? – Correct Answer – Stimulates uterine
contraction and causes arterial vasoconstriction
What is contraindicated for Methergine? – Correct Answer –
Hypertension
What does Hemabate do? – Correct Answer – Treatment of
postpartum hemorrhage caused by uterine atony
What is contraindicated for Hemabate? – Correct Answer –
Asthma
What is the second most common cause of postpartum
hemorrhage? – Correct Answer – Trauma
What is the therapeutic management for trauma post part
hemorrhage? – Correct Answer – Typically surgical repair. For
small hematoma, they will be reabsorbed. For larger hematomas,
evacuation and ligation may need to occur.
What are the two most common causes of late post parts
hemorrhage? – Correct Answer – Subinvolution
Fragments of placenta are still in uterus
What education should be provided to women for them to be able
to assess late postpartum hemorrhage? – Correct Answer – How
to assess the fundus
Normal characteristics and duration of lochia flow.
What type of shock is a woman at risk for after delivery? – Correct
Answer – Hypovolemic shockWhat is the earliest sign of hypovolemic shock? – Correct
Answer – Tachycardia
What is uterine atony? – Correct Answer – There is a lack of
muscle tone, this allows for bleeding from the endometrial arteries
at the placental site.
What are risk factors for uterine atony? – Correct Answer –
obesity
too much amniotic fluid
long labor, large baby
download pdf at https://learnexams.com/search/study?query=