NUR 2513 / NUR2513 Maternal Child

Nursing Final Exam Review | Rated A

Complete Guide| Latest 2021 / 2022 |

Rasmussen College

OB/Newborn

1. What does GTPAL mean? In a case scenario, how will you number a woman’s

pregnancy/birth history?

- Gravida: how many times she eve been pregnant

- Term: after 37wks

- Preterm: prior to 38wks

- Abortions: elective/miscarriage prior to 20wks

- Living

2. How is a due date calculated by Naegele’s rule?

- LPM – 3 months + 7 days + 1y

- Ex: 10/01/19

 EDD: 07/08/20

3. If Leopold’s maneuvers help us determine how baby laying/presenting so we know

where the head and back are to monitor baby’s heart tones best, what part of the

abdomen would the best place be to hear if the baby is vertex versus breech?

- Breech: monitor will be above the belly button of the mom, either LUQ or RUQ

- Head down: monitor will go over the back, located in either the LLQ or RLQ

4. What are the differences between placenta previa and placental abruption? How

will each manifest/what signs will you notice with each?

» Previa: placenta is covering the cervix

- no pain, bright red blood, soft uterus, nontender w/ normal tone, VS WNL

» Abruption: placenta is separating from the uterine wall

- pain, dark blood, rigid uterus

5. What are the assessment criteria for each component of the Apgar score? pp. 436-

437

Appearance – Pulse – Grimace – Activity – Respiration, 1 and 5min after birth

APGAR 0 1 2

Heart Rate Absent Slow > 100/min < 100/min

Respiratory

Rate

Absent Slow, weak Good cry

Muscle Tone Flaccid Some flexion Well-flexed

Reflex

Irritability

None Grimace Cry

Color Blue/Pale Pink +

Acrocyanosis

Completely Pink

6. If the purpose of the infant’s fontanelle (3-4 cm anterior opening) and cranial bones

is to be movable for the birthing process, when does the anterior fontanelle close? p.

445

- Anterior: 12-18mo

- Posterior: triangular shape, closes at 2-3mo

7. What is the Moro reflex? How is it elicited and how long before it fades (as

neuromuscular maturity increases)? p. 434

- Involuntary motor response that infant splays arms and move their legs before bringing

their arms in fronto of the body

- Should go away around 4-5mo

8. If a mother is using a substance (either Rx or illicit), what are the risks to baby?

Besides the need to assess toxicology on mom and baby, what other

assessments/cares are necessary? pp. 584, 709-710.

- Congenital anomalies

- Growth restriction

- Hep B, HIV

- Assess for NAS: irritability, disturbed sleep pattern, constant movement, tremors, highpitched cry, frequent sneezing, tremors, tachypnea, hyperreflexia and clonus, vomiting,

diarrhea

9. What are risk factors for postpartum hemorrhage? Think of reasons that make the

uterus have to work harder to contract back down to size.

- Multiple pregnancies, macrosomic baby, polyhydramnios

- Long labor, fast delivery (precipituous delivery

- Twins/triplets etc (over stretch the uterus)

- Uterine tachysystole / atony / ruptured uterus

10. What are signs of respiratory distress in a newborn? Is acrocyanosis a normal

finding? Why?

- Acrocyanosis is normal for 24h

- S/S of distress: nasal flaring, retractions, tachypnea/cardia, grunting, head bobbing

11. Pitocin (oxytocin) can be used to induce (or augment) labor. If too much is given,

little rest time between contractions (we like at least 1 minute) means baby will have

less circulation since a contraction really slows blood flow through the uterus. It’s

like baby is holding their breath during the contraction. Think back to your

discussion on Pitocin. What are safe ways to use this high-risk medication? pp. 603-

604 (Note: Hyperstimulation is now called tachysystole, and in real life, laying to the

right or left side helps uteroplacental circulation/prevent supine hypotension…not

just the left side).

- If contractions occur close to 2min or less, STOP infusion

- Late decels , STOP infusion

- Titrate based on baby’s tolerance

- 1min of rest between contractions is the goal