NUR2513 / NUR 2513 Final Exam Concept Guide (Latest 2024 / 2025): Maternal-Child Nursing / MCN – Rasmussen
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NUR2513 Maternal-Child
Nursing Concept Guide for
Comprehensive Final Review
Naegele’s Rule
OB Emergencies
Placenta Abruption
Placenta Previa
Prolapsed Cord
Eclamptic Seizures
Oxytocin
Indications for Use
o Inductions
o Postpartum Hemorrhage
o Post Delivery for both Vaginal and Cesarean Deliveries
Dosages
Mu/min equals how many mls/hours on infusion pump
Oxytocin comes in different size bags with so many units in a
bag. For Example, 20 units/1000mls
Continuous fetal heart monitoring for both contraction
frequency and baby’s heart rate.
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Intrauterine Resuscitation for tachysystole (frequent contractions less
than 1 minute in between contractions or fetal heart rate decelerations)
Left lateral position
Oxygen at 10 liters per rebreather mask
Stop the infusion of oxytocin
Notify the provider
Non-Stress Test
Nurse’s Responsibilities i.e., documentation
Indications for
Terminology: accelerations, decelerations, and variability
Magnesium Sulfate
Indications for Use
o PreEclampsia/Eclampsia
o Preterm Labor
Dosages
4-gram loading dose and then less for a rate (usually 2 grams/hour)
Magnesium is grams/hour. *How do you calculate this into mls/hour
get pdf at https://learnexams.com/search/study?query=
NUR2513 / NUR 2513 Final Exam Concept Guide (Latest 2024 / 2025): Maternal-Child Nursing / MCN – Rasmussen
Naegele’s Rule
how to predict due date, subtract 3 months add 7 days
OB emergency
Placenta Abruption
Dark red blood and painful. Placenta comes off the wall.
OB emergency
Placenta Previa
Bright red blood, not painful.
OB Emergency: Prolapsed Cord Presentation
When the umbilical cord exits the cervical Os before the fetus
OB emergency
Eclampsia Seizures
Tonic colonic seizures or coma in a patient with preeclampsia
Oxytocin Indications
Inductions to start uterine contractions for labor, postpartum hemorrhage and prevention of uterine atony and PPH
Oxytocin Dose
3 – 10 UNITS IM, AFTER INFANT AND PLACENTA.
Intrauterine resuscitation for tachysystole
Left lateral position
02 @ 10L via NRB
Stop oxytocin
Notify HCP
Non-stress test (NST)
assesses fetal well being during third trimester
Magnesium Usage in pregnancy
Pre eclampsia/ eclampsia.
Preterm labor- slows contractions
Magnesium dose
4 gram loading dose and less then for a rate. Mg is grams/ hour.
GTPAL system
G = gravidity (# of times pregnant)
T = term (38-42 weeks)
P = preterm birth (20-37 weeks)
A = abortion (< 20 weeks)
L = living children
ex: woman who is pregnant now, has 2 children, one born @ 38 weeks, one @ 42 weeks = 32002
Group B strep
Tested for @ 36-38 wks; if positive
Antibiotics starts when admitted for labor/birth of baby, but not sooner despite ROM; ROM does increase the risk to baby.
– can cause sepsis in newborn
– treated with penicillin G/ ampicillin/ cephalosporin/ etc…
**not done sooner since it can come right back.
glucose tolerance test (GTT)
24-28 weeks. Tests for initial diagnosis of diabetes mellitus; patient is given dose of glucose; then blood samples are taken at regular intervals to determine patient’s ability to use glucose properly
Urine Drug Screen
First prenatal visit
Risks of narcotic and illicit drug use during or around pregnancy
Stillborn, poor growth and uterine atony.
Postpartum Hemorrhage (PPH)
Excessive bleeding after childbirth; traditionally defined as a loss of 500 ml or more after a vaginal birth and 1000 ml after a cesarean birth
Leopold’s Maneuvers
Palpation to determine presentation and position of the fetus and aid in location of fetal heart sounds.
Head=hard, round, movable object
Buttocks=soft and irregular shape
Back=smooth, hard surface felt on one side of the abdomen
Irregular knobs and lumps on opposite side of abdomen may be hands, feet, elbows, and knees
Fetal heart tones location
– If vertex listen below the woman’s umbilicus
– If breech listen above the woman’s umbilicus
– As baby descends into pelvis the heart tones are heard lower and more toward midline
Deceased fetal movement
10 kicks at least Q 1-2hrs, if < 6 in 2hrs call HCP.
APGAR
appearance, pulse, grimace, activity, respiration. 0,1,2 points
cause of respiratory distress syndrome
Not enough surfactant
patent ductus arteriosus (PDA)
passageway (ductus arteriosus) between the aorta and the pulmonary artery remains open (patent) after birth
coarctation or the aorta
narrowing of the aorta
Tertalogy of Fallot
Pulomanry (infundib) Stenosis
Right Ventricular Hypertrophy
Overriding Aorta
VSD
Elevated epo, hemacrit from cyanosis
Hypoglycemia in newborn
-blood glucose of less than 40
-jitteriness, twitching, weak high pitched cry
-irregular RR
-cyanosis
-lethargy
-seizures
-eye rolling
Newborn Metabolic Screening: Phenylketonuria
Screened for before they are leaving the hospital, PKU can cause brain damage and severe intellectual disability if left untreated ( test for metabolic disease)
Newborn Metabolic Screening: Sickle Cell Disease
Tested when they are born from a blood test, keep them hydrated and pain under control
Congenital Adrenal Hyperplasia
Low cortisol levels
Maple Syrup Urine Disease
is caused by a defect in alpha keto acid dehydrogenase, leading to an inability to degrade branched amino acids (isoleucine, leucine, and valine). This illness classically results in poor feeding and dystonia as well asthe maple syrup scent (burnt sugar) in the patients urine after first couple days of life.
Moro reflex
Infant reflex where a baby will startle in response to a loud sound or sudden movement. Gone after 3 months
Sucking and rooting reflex
stroke baby’s cheek and they turn toward that side and look for nipple. present from birth- 7-12 months
grasp reflex
an infantile reflex in which an infant closes her hand into a fist when her palm is touched. 5-6 months
stepping reflex
a neonatal reflex in which an infant lifts first one leg and then the other in a coordinated pattern like walking. away after 2 months
Pincer grasp
the well-coordinated grasp that emerges at the end of the first year, involving thumb and index finger opposition. 6-12 months.
Newborn weight gain
In the newborn period, expect to see a weight gain of about an ounce per day once the maternal milk is in. 3x size at a year after birth.
Closures of fontanels
Front closer 12-18 months, Back closer 2-3 months.
Erickson’s stages
trust vs mistrust
autonomy vs shame and doubt
initiative vs guilt
industry vs inferiority
identity vs role confusion
intimacy vs isolation
generativity vs stagnation
integrity vs despair
Kubler-Ross’s stages of grief
1. Denial
2. Anger
3. Bargaining
4. Depression
5. Acceptance
Car seat safety
Use rear-facing car seat in back seat, preferably the middle until age 2 or until the child reaches max height and weight
fevers in infancy
100 degrees or higher, concerns include rectal perforation, lead to easy bleeding and painful bruising
failure to thrive
a condition in which infants become malnourished and fail to grow or gain weight for no obvious medical reason
Spastic Cerebral Palsy
A type of cerebral palsy in which the person has very tight muscles occurring in one or more muscle groups, resulting in stiff, uncoordinated movements
Atopic Dermatitis (Eczema)
Excess inflammation; dry skin, redness, and itching from allergies and irritants. Do daily baths no soap, use creams.
Measles (Rubeola)
airborne precautions
GERD in infants
– FFT
– Irritability
– rummination
– TXT – thickened feeds , + PPI
Dehydration in toddler
Mild = push oral fluids, Severe= IV fluids
Croup treatment
corticosteroids
nebulized epi, humidifiers.
Pertussis (whooping cough)
An airborne bacterial infection that affects mostly children younger than 6 years. Patients will be feverish and exhibit a “whoop” sound on inspiration after a coughing attack; highly contagious through droplet infection.
Falls with head strike
ICP- decreased LOC and RR
routine assessment
-height
-weight
Myringotomy tubes
incision into the tympanic membrane and insertion of tubes to allow drainage of fluid that might accumulate behind the eardrum
Most peds medications are based on what?
Weight
Kawasaki disease
(inflammation of blood vessles, hence the strawberry tongue) causes coronary artery aneurysms.
Resipiratory
viral= supported care, bacteria= antibiotics
preschool screening tests
Hearing, vision testing and review of immunizations
Medication admin
Up and back 4 years +, shake inhalers
Strep Pharyngitis
clinical features most sugggestive of group A B-hemolytic strp pharyngitis include(FLEA)
FEVER-over 100.4(38c)
LACK of cough
Pharyngotonsillar EXUDATE
ANTERIOR cervical adenopathy. Tx penicillin
post tonsillectomy care
-Cool water or fruit juice first (avoid red or brown to distinguish fresh blood)
-Milk products coat mouth & throat leading to clearing of throat & bleeding.
-Give unrestricted diet to increase food & liquid intake.
-Watch for signs of hemorrhage.
pneumonia
An inflammation of lung tissue, where the alveoli in the affected areas fill w/fluid. Wheezing
Asthma inhaler use
Find inhaler and assemble it
Shake the inhaler
Place inhaler in mouth and instruct the person to breath in deep for 3 to 5 seconds just before they push the inhaler
Tell them to hold the medication in their lungs for 10 seconds
anaphylactic shock
A severe reaction that occurs when an allergen is introduced to the bloodstream of an allergic individual. Characterized by bronchoconstriction, labored breathing, widespread vasodilation, circulatory shock, and sometimes sudden death.
Cystic Fibrosis and Medication Use
Use genetic condition effecting exocrine glands, salty tasting skin, wheezing, SOB, poor growth and weight gain, Med = pancreatic lipase, take before eating, mucus clogs ducts of pancreas
Immunosuppressed children
allow them to play with a hard plastic action figure because it can be disinfected easily. Handwashing!!
Varicella (Chicken Pox)
Viral disease characterized by skin lesions; lesions begin on the trunk and spread to the face and proximal extremities; transmitted by direct contact, droplet spread or freshly contaminated objects; communicable prodromal period to the time all lesions have crusted; progress through macular, popular, vesicular, and pustular stages
epiglottis position
tripod, can cause full airway obstruction be sure and have ET ready.
Suspected Abuse and your role
Mandatory reporter, to Law enforcement and supervisor.
Primary Dysmenorrhea/Breast Exam Education
use NSAIDS to help / breast exam every month
Iron Deficiency and how to take supplements
Drink with orange juice to help with absorption, may have black tarry stools
STI prevention
Abstinence (prevents all)
Monogamy with uninfected monogamous partner (prevents all)
Condoms (prevents some)
Medical checkups/tests for sexually active people (symptoms or not)
All sexual partners should be notified if a test is positive
Obesity and Growth
-maintain balanced eating
-participating in new sport
-increase activity, walk dog or ride bike
– Boys reach max height by 18-19ish
mental health adolescent
PTSD signs include, sleep disturbances, hyper vigilant, flashbacks, withdraw from family
Chronic Illnesses (socialization)
Try to keep them involved during illness or hospitalizations such as facetime, video games, allow to make own schedule if safe.
Difference between Type I and Type II diabetes
I: the body’s immune system destroys the cells that release insulin, eventually eliminating insulin production from the body. Without insulin, cells cannot absorb glucose
II: the body isn’t able to use insulin the right way. This is called insulin resistance. As type 2 diabetes gets worse, the pancreas may make less and less insulin. This is called insulin deficiency.
Insulin Admin
Clear before mixing cloudy
Seizure interventions
-remove dangerous objects
-gently guide to floor and loosen clothing
-turn on side to prevent choking
-do not insert anything between teeth
-do not be alarmed if seem to stop breathing momentarily
-if breathing actually stops, use rescue breathing techniques
Post seizure care:
-allow to rest or sleep
-call Dr if 1st seizure, followed by another seizure, or if lasts more than 5 min
-notify parent/caregiver
-observe safety precautions (may be groggy, confused, or weak)
Seizure types
Partial: Simple and Complex
Generalized: Absence, Myoclonic, Tonic-Clonic, Tonic, Atonic
Valproic Acid
Anticonvulsant
Fractures nursing assessment
focus on region distal to the broken area
pallor, temp, capillary refill, edema, pulses, sensation, motor function (paralysis), pain
pain unrelieved by meds=emergency
Osteomyelitis
inflammation of bone and bone marrow, need strong IV antibiotics
Traction and Immobilization
Assess the child’s position frequently, assess pin sites every 4 hours and ensure the rope’s knot is in contact with the pulley, keep them distracted or distracted think like legos, puzzles or drawing
Legg-Calve-Perthes Disease
Rare condition, ball of the femoral head loses its blood supply resulting in inflammation and irritation, Symptoms is a noticeable limp, also may have stiffness in hip or mild pain in the groin, thigh, or knee. Physical therapy is first treatment for mild symptoms, otherwise they need surgery
Cast Care
Cover with plastic before bathing, don’t put anything inside the cast, use cool setting on a hair dryer to help with itching and remain as active as possible with modifications
Immediate Priority of a superficial burn (relieve pain and discomfort).
Like a sunburn, get out of the sun and relieve the pain and discomfort immediate priority
Purpose of debridement
remove foreign material from wound; remove non-functioning cells/necrotic tissues
Burn degrees
1st degree: Red and painful
2nd degree: Blisters
3rd degree: No pain because of blocked and burned nerves
Chest Tube care
-observe for tidaling — air bubbling in water seal chamber
-d/n empty collection container
-d/n milk chest tubes
sickle cell anemia
a genetic disorder that causes abnormal hemoglobin, resulting in some red blood cells assuming an abnormal sickle shape
Glomerulonephritis
inflammation of the glomeruli of the kidney. Post strep infection
Cushing syndrome treatment
Remove cause of excess cortisol secretion
Gradually taper exogenous glucocorticoid medications
Surgical removal of tumors, chemotherapy, radiation
Proper PPE
If you have TB or HIV patient make sure to wear gloves and N95, gown and eye shield
Blood Administration Procedure
Obtain a unit of blood from the blood bank and verify the blood product with type and crossmatch results and at least 2 client identifiers with another nurse at the client’s bedside. The blood is obtained and infused one unit at a time
Assess the client, obtain vital signs for baseline, and teach signs of a transfusion reaction and how to call for help.
Use a Y tubing, prime with NS, and then clamp the NS side
Spike the blood product, leaving the blood side of the Y tube open while keeping the saline side clamped for infusion. The saline is only used to prime the tubing and flush after the infusion. It does not infuse simultaneously.
Set the infusion pump to deliver blood over 2-4 hours as prescribed. Rapid infusion of the blood puts the client at greater risk for transfusion reaction and fluid volume overload.
Remain with the client for at least the 1st 15 minutes and watch for signs of blood transfusion reaction, including fever, chills, nausea, vomiting, pruritus, hypotension, decreased urine output, back pain, and dyspnea. Stop the transfusion immediately if a reaction occurs. The first 15 minutes of infusion should be slow to watch for these reactions.
Take another set of vital signs 15 minutes after infusion starts and continue in accordance with facility policy. Always take a final set of vital signs after the infusion is complete.
On completion of the blood transfusion, open the saline side clamp of the Y tubing to flush all blood in the tubing through with NS.
Return the blood bag with the attached set-up to the laboratory after completion or dispose of in accordance with hospital policy. Use new IV Y tubing set-up for the second unit of blood.
Hyperopia
A condition in which visual images come to a focus behind the retina of the eye and vision is better for distant than for near objects — called also farsightedness.
Estropia
inward turning of the eye
NUR2513 / NUR 2513 Final Exam Concept Guide (Latest 2024 / 2025): Maternal-Child Nursing / MCN – Rasmussen
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