Please help with Maternal/newborn Assessment Questions?

[MomtoP]

Hi All,

I am working on a class assignment, and have most of it finished, but there are a few questions that I am unsure of ..I have a good idea of the right answers, but I wanted to see if anyone could offer up some better answers than I have...

2. What procedures should the nurse anticipate the physician would do to minimize fetal and maternal injury immedietely before and during delivery? Describe.

...Not sure what they mean here

10. If you find something abnormal for the newborn during the apgar assessment, what are your nursing interventions?

....Of course i would want to treat the baby anyway I can with suctioning or applying oxygen and reporting status to the MD, but what more should I be doing?

11. What interventions must be taken to ensure the safety of the infant?

...again, making sure baby is getting enough O2, wrapping in blanket to preserve heat, but what else?

17. If You come across an obviously pregnant woman who is leaning over the hood of her car and yelling, "The baby's coming, please help me! I feel the baby's head coming out." No one is available except you! How will you help her?

..This is just a fun question here, that I will throw back at my classmates when I present the case study. I'd call 911 and pray they would get their fast, haha..but really I would check to see if the baby was crowning, and ask mom how far apart contractions are , when they started etc.. but is there more specifics I should get into that would be very important?

Thank you if you read this far, I appreciate any and all help. :)

[suzers26]

2. What procedures should the nurse anticipate the physician would do to minimize fetal and maternal injury immedietely before and during delivery? Describe.

This makes me think of things like an episiotomy, comfort measures - pain control, assess positioning of both the mother and baby, control bleeding, possible forceps or vacuum use, hemodynamic change monitoring, etc

10. If you find something abnormal for the newborn during the apgar assessment, what are your nursing interventions?

This I feel really depends on what the abnormality is. We would definitely suction, keep warm, O2, notify pediatrician, etc. But it may be a situation that requires CPR. Frequent monitoring is a big intervention. Apgar should be done in 5 minute intervals until the newborn's condition is stable. Perhaps think up a couple common examples to help answer this

11. What interventions must be taken to ensure the safety of the infant?

I think of basics such as: don't leave unattended, alarm & name bands should be on, proper assessments, proper meds, if they are on a warmer safety measures apply, most facilities want infants in their bassinets when going through the halls instead of carried, feedings - don't lay flat, etc.

17. If You come across an obviously pregnant woman who is leaning over the hood of her car and yelling, "The baby's coming, please help me! I feel the baby's head coming out." No one is available except you! How will you help her?

Well, definitely need an assessment: water broke? crowning?dilation? baby positioning?due date?contractions? other pain? medical problems? meds?. I would think getting her off the hood of the car would decrease risk of injury related to falls. Support, try to calm her. Note what materials are available if that baby is coming. hopefully a call can get into 911. if need be catch the baby, wrap the baby, clear airway, etc

I'm still in school, but that's what came to mind when I read your post...good luck!

[MomtoP]

suzers26 thanks so much for your replies. I had several interventions that you listed already, but you pointed out a few more that make perfect sense, and I should definitely add to my answer sheet. Thank You so much for taking the time to help out. I just hit a wall yesterday, and couldn't think anymore...funny how that happens in school sometimes!

[turnforthenurse, MSN, NP]

suzers26 mentioned don't lay flat....don't lay the infant in a PRONE position, because that increases the risk of SIDS.

[DolceVita, ADN, BSN, RN]

Hmmm I don't like doing people's homework for them. I know I am being a fuddy duddy.

[solneeshka, BSN, RN]

The one thing I remember about what to do if you have to deliver a baby in an emergency is that once the baby is born, set it to the mother's breast asap because the suckling with stimulate the release of oxytocin, which will stimulate uterine contractions, which will help stop uterine bleeding.