NUR 353 Reproduction Exam 2 Practice
Questions and Correct Answers
What do you assess for when looking for signs of pre-eclampsia? ✅-epigastric pain
-proteinuria,
-headaches
-blurred vision
-edema
-weight gain of >5 lbs in 1 week
-hyperflexic DTRs
What is the difference between pre-eclampsia and gestation HTN? ✅proteinuria
What are signs of magnesium toxicity? Antidote? ✅hypoflexic DTRs, fatigue, decrease
LOC, lower RR, weak grip (all b/c it depresses CNS); calcium gluconate
Does insulin cross placenta? ✅No, but glucose does. So, when mother eats a lot of
sugar baby makes more insulin to compensate. When born, baby can be hypoglycemic
(shaky & sick) b/c it has all this insulin, but no glucose.
When is GTT done? ✅26 & 28 weeks
Cut off for 1 hour GTT? ✅140, now 3 hour needed
Results of what mean mom has GDM? ✅When 3 hour GTT done, 2 or more results
are NOT within normal range
How can ectopic pregnancy cause early pregnancy bleeding? ✅Implantation outside of
uterus, then ruptures causing hemorrhaging
What is an incompetent cervix? ✅easily opens w/ contractions; risk for pre-term labor
What is placenta previa? ✅placenta blocks cervix
What to avoid with placenta previa? ✅vaginal exams, intercourse
Placenta previa can cause what to mother and fetus? ✅hemorrhage, decrease oxygen
and blood to fetus
What is placenta abruption? ✅placenta prematurely detaches from uterus
,What can cause placenta abruption? ✅HTN, cocaine, blunt trauma, smoking, poor
nutrition
How is placenta abruption DIFFERENT from placenta previa? ✅pain
What does the BISHOP score include and determine? ✅dilation, effacement, station,
consistency, and position; determines if the cervix is ready for labor
What do we want the BISHOP score to be? ✅above 8/10
What makes cervix ripen? ✅cervidil, prostaglandin gel, inflated foley cath bulb, and
cytotec
What induces labor? ✅amnio hook to break sac, IV pitocin
What is labor augmentation? ✅making labor strong, closer, and more effective
What meds prevent pre-term labor? ✅tocolytics (ex. Magnesium Sulfate, terbutaline)
What matures fetal lungs? ✅betamethasone
When does one use vacuum or forceps? ✅maternal exhaustion or fetal distress; ONLY
if baby is crowing
Two main risks for uterine rupture? ✅TOLAC (Trial of Labor After C-section) and
VBAC (Vaginal Birth After C-section)
What kind of c-section scare is best? ✅transverse or horizontal
What causes shoulder dystocia? ✅GDM or small maternal pelvis
Interventions for shoulder dystocia? ✅McRobert's position (needs hyper flexed
towards shoulders) and suprapubic pressure
What is a prolapsed cord? ✅cord lies below the presenting part of the fetus
What is the first clue of a prolapsed cord? ✅change in FHR, repetitive variable decels
(from cord compression)
Interventions for a prolapsed cord? ✅hands and knees position
What is the risk of meconium aspiration syndrome? ✅infection
, BUBBLE-LE ✅PP assessment; breasts, uterus, bladder, bowel, lochia, episiotomy-
legs, emotions
REEDA ✅perineum assessment; redness, edema, ecchymosis, discharge,
approximation of edges
Where do we want fundus upon assessment? ✅midline at umbilicus, firm
What helps uterus contract back to normal? ✅uterine massage, oxytocin (IV Pitocin),
and breastfeeding
When should you start massaging fundus? ✅right after placenta is born, every 15
minutes for first hour, then every 30 minutes
Reva Rubin's Model ✅Taking in, taking hold, letting go
Taking in phase includes: ✅-focus on self and meeting basic needs
-excited and talkative
-wants to relive birth
Taking hold phased includes: ✅focus on role and desire to take charge, optimal for
TEACHING
Letting go phase includes: ✅fully incorporating mothering role, reassertion of
relationship w/ partner
What is the definition of postpartum hemorrhage? ✅loss of >500mL of blood for
vaginal birth, >1,000mL for c-section
Four T's for PPH ✅tone, trauma, tissue, thrombin
Tone ✅-most common cause of PPH
-marked by hypotonia of uterus associated with high parity, hydramnios, macrosomic
fetus, and multifetal gestation
Trauma ✅-20% of PPH
-lacerations from episiotomy, tears, hematoma
Tissue ✅-10% of PPH
-retained placenta (accreta-slight penetration of myometrium, then incretta, and
percreta- complete perforation)
Why do we want to make sure placenta is complete after birth? ✅retained placenta
prevents uterus from contracting
