Test #2 406

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A nurse has provided instructions to a breastfeeding mother who has been diagnosed with mastitis. Which of the following statements if made by the mother indicates the mother has gained an understanding?

"I will continue to breastfeeding until this condition resolves."

A postpartum client is 24 hours post delivery. Where would the nurse expect to locate her fundus?

1 fingerbreadth below the umbilicus

Preeclampsia signs and symptoms

1. Sudden weight gain 2. Face and hands swollen because they are losing protein so fluid will not stay in the vascular space 3. Headache 4. Blurred vision and seeing spots 5. HYPER-Reflexia 6. Clonus -> SEIZURES

Physiological jaundice occurs when?

After the first 24 hours after birth

An abnormal finding in a recently delivered newborn would be which of the following?

Babinski reflex not present

A nurse is assisting with the delivery of a newborn infant. After the delivery, the nurse prepares to prevent heat loss in the newborn resulting from evaporation by:

Drying the infant in a warm blanket- Evaporation of moisture from a wet body dissipates heat along with the moisture. Keeping the newborn dry by drying the wet newborn infant will prevent hypothermia via evaporation

A mom expresses concern that her baby quits breathing for 10 seconds and then breathes real fast. The nurse should do which of the following?

Explain to the mom this is normal and called periodic breathing.

Which condition is sometimes associated with severe preeclampsia and may cause epigastric pain?

HELLP syndrome

Which condition is the most reassuring that the lungs will be mature in a newborn?

L/S ration more than 2:1 Lecithin and sphingomyelin are phospholipids that help compose surfactant in the lungs; lecithin peaks at 36 weeks and sphingomyelin concentrations remain stable.

The nurse caring for a postpartum woman within the first 24 hours would expect to find which of the following?

Lochia rubra

Your patient who is 34 weeks pregnant is diagnosed with total placenta previa. The patient is A positive. What nursing interventions below will you include in the patient's care?

Monitor pad count

Mother-fetus Rh blood type incompatibility problems can occur if the mother is _____ and her fetus is _____ .

Rh negative, Rh positive

The cervix is considered to be closed after delivery when which of the following is true?

The client no longer has lochia.

The primary observation and most critical with APGAR scoring is which of the following?

The heart rate is the most critical observation in Apgar scoring.

What is the term for the white, cheese like substance that newborns are born with?

Vernix caseosa

When should neonates born to HIV and HBV (hepatitis B) infection be given their first dose of HBV vaccine series?

Within 12 hours after birth

A new mom is concerned about her baby's rash which is pink and slightly raised. The nurse would instruct the mom that:

a newborn rash is normal and she does not need to treat it

clonus

an abnormal finding- is present if the foot jerks or taps the examiners hand. The presence of clonus indicates a more pronounced hyperreflexia and indicates CNS irritability. This assessment is done in women with preeclampsia.

A pregnant woman with sharp, one-sided pain, syncope, and referred right shoulder pain may be experiencing which condition?

ectopic pregnancy

Insulin requirements generally ______ significantly during the postpartum period.

fall

A client received magnesium sulfate during labor, which condition would the nurse anticipate as a potential problem in the baby?

hypotonia- Magnesium sulfate crosses the placenta and can result in neonatal respiratory depression, hypotonia, and bradycardia.

The four cardinal signs and symptoms of diabetes mellitus include:

polyuria polydipsia polyphagia weight loss

A client is 2 hours postpartum. Her blood pressure 112/82, her heart rate is 59, respiratory rate 16, temp is 100.5, O2 sat is 98%. She has moderate blood loss with several small clots. Her fundus is halfway between the symphysis pubis and the umbilicus, firm, and midline. The client states she feels cramping. The nurse would be most concerned about which of the following assessments?

temperature - needs to be under 100.4 in first 24 hours


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