Nursing Bullets: Medical-Surgical Nursing Part V

  1. Chlorpromazine (Thorazine) is used to treat neonates who are addicted to narcotics.
  2. The nurse should provide a dark, quiet environment for a neonate who is experiencing narcotic withdrawal.
  3. In a premature neonate, signs of respiratory distress include nostril flaring, substernal retractions, and inspiratory grunting.
  4. Respiratory distress syndrome (hyaline membrane disease) develops in premature infants because their pulmonary alveoli lack surfactant.
  5. Whenever an infant is being put down to sleep, the parent or caregiver should position the infant on the back. (Remember back to sleep.)
  6. The male sperm contributes an X or a Y chromosome; the female ovum contributes an X chromosome.
  7. Fertilization produces a total of 46 chromosomes, including an XY combination (male) or an XX combination (female).
  8. The percentage of water in a neonate’s body is about 78% to 80%.
  9. To perform nasotracheal suctioning in an infant, the nurse positions the infant with his neck slightly hyperextended in a “sniffing” position, with his chin up and his head tilted back slightly.
  10. Organogenesis occurs during the first trimester of pregnancy, specifically, days 14 to 56 of gestation.
  11. After birth, the neonate’s umbilical cord is tied 1″ (2.5 cm) from the abdominal wall with a cotton cord, plastic clamp, or rubber band.
  12. Gravida is the number of pregnancies a woman has had, regardless of outcome.
  13. Para is the number of pregnancies that reached viability, regardless of whether the fetus was delivered alive or stillborn. A fetus is considered viable at 20 weeks’ gestation.
  14. An ectopic pregnancy is one that implants abnormally, outside the uterus.
  15. The first stage of labor begins with the onset of labor and ends with full cervical dilation at 10 cm.
  16. The second stage of labor begins with full cervical dilation and ends with the neonate’s birth.
  17. The third stage of labor begins after the neonate’s birth and ends with expulsion of the placenta.
  18. In a full-term neonate, skin creases appear over two-thirds of the neonate’s feet. Preterm neonates have heel creases that cover less than two-thirds of the feet.
  19. The fourth stage of labor (postpartum stabilization) lasts up to 4 hours after the placenta is delivered. This time is needed to stabilize the mother’s physical and emotional state after the stress of childbirth.
  20. At 20 weeks’ gestation, the fundus is at the level of the umbilicus.
  21. At 36 weeks’ gestation, the fundus is at the lower border of the rib cage.
  22. A premature neonate is one born before the end of the 37th week of gestation.
  23. Pregnancy-induced hypertension is a leading cause of maternal death in the United States.
  24. A habitual aborter is a woman who has had three or more consecutive spontaneous abortions.
  25. Threatened abortion occurs when bleeding is present without cervical dilation.
  26. A complete abortion occurs when all products of conception are expelled.
  27. Hydramnios (polyhydramnios) is excessive amniotic fluid (more than 2,000 ml in the third trimester).
  28. Stress, dehydration, and fatigue may reduce a breast-feeding mother’s milk supply.
  29. During the transition phase of the first stage of labor, the cervix is dilated 8 to 10 cm and contractions usually occur 2 to 3 minutes apart and last for 60 seconds.
  30. A nonstress test is considered nonreactive (positive) if fewer than two fetal heart rate accelerations of at least 15 beats/minute occur in 20 minutes.
  31. A nonstress test is considered reactive (negative) if two or more fetal heart rate accelerations of 15 beats/minute above baseline occur in 20 minutes.
  32. A nonstress test is usually performed to assess fetal well-being in a pregnant patient with a prolonged pregnancy (42 weeks or more), diabetes, a history of poor pregnancy outcomes, or pregnancy-induced hypertension.
  33. A pregnant woman should drink at least eight 8-oz glasses (about 2,000 ml) of water daily.
  34. When both breasts are used for breast-feeding, the infant usually doesn’t empty the second breast. Therefore, the second breast should be used first at the next feeding.
  35. A low-birth-weight neonate weighs 2,500 g (5 lb 8 oz) or less at birth.
  36. A very-low-birth-weight neonate weighs 1,500 g (3 lb 5 oz) or less at birth.
  37. When teaching parents to provide umbilical cord care, the nurse should teach them to clean the umbilical area with a cotton ball saturated with alcohol after every diaper change to prevent infection and promote drying.
  38. Teenage mothers are more likely to have low-birth-weight neonates because they seek prenatal care late in pregnancy (as a result of denial) and are more likely than older mothers to have nutritional deficiencies.
  39. Linea nigra, a dark line that extends from the umbilicus to the mons pubis, commonly appears during pregnancy and disappears after pregnancy.
  40. Implantation in the uterus occurs 6 to 10 days after ovum fertilization.
  41. Placenta previa is abnormally low implantation of the placenta so that it encroaches on or covers the cervical os.
  42. In complete (total) placenta previa, the placenta completely covers the cervical os.
  43. In partial (incomplete or marginal) placenta previa, the placenta covers only a portion of the cervical os.
  44. Abruptio placentae is premature separation of a normally implanted placenta. It may be partial or complete, and usually causes abdominal pain, vaginal bleeding, and a boardlike abdomen.
  45. Cutis marmorata is mottling or purple discoloration of the skin. It’s a transient vasomotor response that occurs primarily in the arms and legs of infants who are exposed to cold.
  46. The classic triad of symptoms of preeclampsia are hypertension, edema, and proteinuria. Additional symptoms of severe preeclampsia include hyperreflexia, cerebral and vision disturbances, and epigastric pain.
  47. Ortolani’s sign (an audible click or palpable jerk that occurs with thigh abduction) confirms congenital hip dislocation in a neonate.
  48. The first immunization for a neonate is the hepatitis B vaccine, which is administered in the nursery shortly after birth.
  49. If a patient misses a menstrual period while taking an oral contraceptive exactly as prescribed, she should continue taking the contraceptive.
  50. If a patient misses two consecutive menstrual periods while taking an oral contraceptive, she should discontinue the contraceptive and take a pregnancy test.