OB ch. 22

a

A nurse is caring for a postpartum client diagnosed with von Willebrand disease. What should be the nurse's priority for this client? a. Check the lochia. b. Assess the temperature. c. Monitor the pain level. d. Assess the fundal height.

d

On examining a woman who gave birth 5 hours ago, the nurse finds that the woman has completely saturated a perineal pad within 15 minutes. Which action by the nurse should be implemented first? a. Begin an IV infusion of Ringer's lactate solution. b. Assess the woman's vital signs. c. Call the woman's health care provider. d. Assess the woman's fundus.

a, b

On postpartum day 4, a client has a temperature of 101.4°F (38.6°C). Which findings would be consistent with a diagnosis of endometritis? Select all that apply. a. foul-smelling lochia b. tender uterus c. strong afterpains d. fluctuant, perineal mass e. swollen, warm breast

c

The father of a 2-week-old infant presents to the clinic with his disheveled wife for a postpartum visit. He reports his wife is acting differently, is extremely talkative and energetic, sleeping only 1 or 2 hours at a time (if at all), not eating, and appears to be totally neglecting the infant. The nurse should suspect the client is exhibiting signs and symptoms of which disorder? a. Postpartum blues b. Postpartum depression c. Postpartum psychosis d. Maladjustment

d

Upon examination of a postpartal client's perineum, the nurse notes a large hematoma. The client does not report any pain, and lochia is dark red and moderate in amount. Which factor would most likely contribute to the nurse not discovering the perineal hematoma prior to the examination? a. The client is receiving oral pain medications. b. The client had an episiotomy. c. The client has a distended bladder. d. The client has a history of epidural anesthesia.

a

What medication would the nurse administer to a client experiencing uterine atony and bleeding leading to postpartum hemorrhage? a. Oxytocin b. Magnesium sulfate c. Domperidone d. Calcium gluconate

a

A Hispanic client who gave birth several hours ago is experiencing postpartum hemorrhage. She had a cesarean birth and received deep, general anesthesia. She has a history of postpartum hemorrhage with her previous births. The blood is a dark red. Which cause of the hemorrhage is most likely in this client? a. uterine atony b. cervical laceration c. retained placental fragment d. disseminated intravascular coagulation

c

A client develops mastitis 3 weeks after giving birth. What part of client self-care is emphasized as most important? a. Administer antibiotic medication for the full 10 days even if she begins to feel better b. Use NSAIDs, warm showers, and warm compresses to relieve her discomfort c. Breastfeed or otherwise empty her breasts every 1 to 2 hours d. Increase her fluid intake to ensure that she will continue to produce adequate milk

b

A group of nurses are reviewing information about mastitis and its causes in an effort to develop a teaching program on prevention for postpartum women. The nurses demonstrate understanding of the information when they focus the teaching on ways to minimize risk of exposure to which organism? a. E. coli b. S. aureus c. Proteus d. Klebsiella

b, c

A new mother is diagnosed with a venous thromboembolism in her left calf. Which risk factor is associated with this problem? Select all that apply. a. maternal age greater than 30 b. cesarean birth c. obesity d. precipitous birth hypotension

d

A nurse is assessing a postpartum client. Which finding would the cause the nurse the greatest concern? a. leg pain on ambulation with mild ankle edema b. calf pain with dorsiflexion of the foot c. perineal pain with swelling along the episiotomy d. sharp stabbing chest pain with shortness of breath

a

A nurse is caring for a postpartum client whose most recent assessment reveals a large, purple area of edema on the left side of her perineum. What is the nurse's best action? a. Report the finding promptly to the primary care provider. b. Apply an ice pack and reassess in 30 minutes. c. Provide the client with a hot pack and analgesia as prescribed. d. Document this expected finding and reassess frequently.

d

A woman gave birth to a healthy baby girl 2 days ago. Which observation by the nurse indicates the need for additional assessment and follow up? a. The woman actively participates in the care of her baby. b. The woman comments that her baby has red hair like her grandmother. c. The woman reports that she will be happy to get home because she does not like hospital food. d. The woman tells a friend, referring to her baby, "It just cries all the time."

d

A woman is experiencing a postpartum hemorrhage due to uterine atony. Which risk factor would the nurse recognize as contributory to this specific problem? a. fetal demise b. placenta accreta c. preeclampsia d. multiparity

b

A woman presents to the clinic at 1-month postpartum and reports her left breast has a painful, reddened area. On assessment, the nurse discovers a localized red and warm area. The nurse predicts the client has developed which disorder? a. Breast yeast b. Mastitis c. Plugged milk duct d. Engorgement

d

As part of an in-service program to a group of home health care nurses who care for postpartum women, a nurse is describing postpartum depression. The nurse determines that the teaching was successful when the group identifies that this condition becomes evident at which time after birth of the newborn? a. in the first week b. within the first 2 weeks c. in approximately 1 month d. within the first 6 weeks

b

While assessing a postpartum woman, the nurse palpates a contracted uterus. Perineal inspection reveals a steady stream of bright red blood trickling out of the vagina. The woman reports mild perineal pain. She just voided 200 mL of clear yellow urine. Which condition would the nurse suspect? a. hematoma b. laceration c. uterine inversion d. uterine atony

d

The nurse is caring for a client within the first four hours after her cesarean birth. Which nursing intervention would be most appropriate to prevent thrombophlebitis? a. Roll a bath blanket or towel and place it firmly behind the knees. b. Limit oral intake of fluids for the first 24 hours to prevent nausea. c. Assist client in performing leg exercises every two hours. d. Ambulate the client as soon as her vital signs are stable.

a, c, d

The nurse is developing a discharge teaching plan for a postpartum woman who has developed a postpartum infection. Which measures would the nurse most likely include in this teaching plan? Select all that apply. a. taking the prescribed antibiotic until it is finished b. checking temperature once a week c. washing hands before and after perineal care d. handling perineal pads by the edges e. directing peribottle to flow from back to front

d

Which complication is most likely responsible for a late postpartum hemorrhage? a. cervical laceration b. clotting deficiency c. perineal laceration d. uterine subinvolution