OB Chapter 7 Notes
4. Which of the following would the nurse include when teaching women about preventing pelvic support disorders? A)Performing Kegel isometric exercises B) Consuming low-fiber diets C) Using hormone replacement D) Voiding every 2 hours
A
11. When preparing the discharge teaching plan for the woman who had surgery to correct pelvic organ prolapse, which of the following would the nurse include? A) Care of the indwelling catheter at home B) Emphasis on coughing to prevent complications C) Return to usual activity level in a few days D) Daily douching with dilute vinegar solution
A
2. To assist the woman in regaining control of the urinary sphincter for urinary incontinence, the nurse should teach the client to do which of the following? A)Perform Kegel exercises daily. B)Void every hour while awake. C) Limit her intake of fluid. D)Take a laxative every night.
A
6. A woman is scheduled for an anterior and posterior colporrhaphy as treatment for a cystocele. When the nurse is explaining this treatment to the client, which of the following descriptions would be most appropriate to include? A) This procedure helps to tighten the vaginal wall in the front and back so that your bladder and urethra are in the proper position. B) Your uterus will be removed through your vagina, helping to relieve the organ that is putting the pressure on your bladder. C) This is a series of exercises that you will learn to do so that you can strengthen your bladder muscles. D) These are plastic devices that your physician will insert into your vagina to provide support to the uterus and keep it in the proper position.
A
19. A nurse is teaching a client how to perform Kegel exercises. Which of the following would the nurse include? (Select all that apply.) A) Squeeze your rectal muscles as if you are trying to avoid passing flatus. B) Tighten your pubococcygeal muscles for a count of 10. C) Contract and relax your pubococcygeal muscles rapidly 10 times. D) Try bearing down for about 10 seconds for no more than 5 times. E) Do these exercises at least 5 times every hour.
A, C
23. A nurse is reading a journal article about care of the woman with pelvic organ prolapse. The nurse would expect to find information related to which of the following? (Select all that apply.) A) Rectocele B) Fecal incontinence C) Cystocele D) Urinary incontinence E) Enterocele
A, C, E
15. After teaching a woman with pelvic organ prolapse about dietary and lifestyle measures, which of the following statements would indicate the need for additional teaching? A) If I wear a girdle, it will help support the muscles in the area. B) I should take up jogging to make sure I exercise enough. C) I will try to drink at least 64 oz of fluid each day. D) I need to increase the amount of fiber I eat every day.
B
3. When developing the plan of care for a woman who has had an abdominal hysterectomy, which of the following would be contraindicated? A) Ambulating the client B) Massaging the clients legs C) Applying elasticized stockings D) Encouraging range-of-motion exercises
B
5. A client is diagnosed with an enterocele. The nurse interprets this condition as: A) Protrusion of the posterior bladder wall downward through the anterior vaginal wall B) Sagging of the rectum with pressure exerted against the posterior vaginal wall C) Bulging of the small intestine through the posterior vaginal wall D) Descent of the uterus through the pelvic floor into the vagina
C
9. When teaching a woman how to perform Kegel exercises, the nurse explains that these exercises are designed to strengthen which muscles? A) Gluteus B) Lower abdominal C) Pelvic floor D) Diaphragmatic
C
1. A woman is admitted for repair of cystocele and rectocele. She has nine living children. In taking her health history, which of the following would the nurse expect to find? A)Sporadic vaginal bleeding accompanied by chronic pelvic pain B) Heavy leukorrhea with vulvar pruritus C) Menstrual irregularities and hirsutism on the chin D)Stress incontinence with feeling of low abdominal pressure
D
10. A postmenopausal woman with uterine prolapse is being fitted with a pessary. The nurse would be most alert for which side effect? A) Increased vaginal discharge B) Urinary tract infection C) Vaginitis D) Vaginal ulceration
D
13. After teaching a local woman's group about incontinence, the nurse determines that the teaching was successful when the group identifies which of the following as characteristic of stress incontinence? A) Feeling a strong need to void B) Passing a large amount of urine C) Most common in women after childbirth D) Sneezing may be an initiating stimulus
D
14. A woman is being evaluated for pelvic organ prolapse. A postvoid residual urine specimen is obtained via a catheter. Which residual volume finding would lead the nurse to suspect the need for further testing? A) 50 mL B) 75 mL C) 100 mL D) 120 mL
D
20. After teaching a group of students about pelvic organ prolapse, the instructor determines that the teaching was successful when the group identifies leiomyomas as which of the following? A) Cysts B) Pelvic organ prolapse C) Fistula D) Fibroid
D
In securing a health history of a 65-year-old woman, which clinical manifestation described by the client would the nurse suspect is related to pelvic organ prolapse? a) Chronic abdominal pain b) Heavy feeling or dragging in vagina c) Uterine cramping and backache d) Weight gain and edema of ankles
The correct response is "B" because when pelvic organs prolapse into the vaginal area, most women will experience a feeling of dragging, a lump in the vagina, or something coming down. Their symptoms are related to the site and type of prolapse. Responses "A," "C," and "D" are incorrect since none of them are directly related to pelvic organ prolapse.
Conservative treatment options available for women with pelvic organ prolapse are: A) Pessaries and PFM exercises B) External pelvic fixation devices C) Weight gain and yoga D) Firm panty-and-girdle garments
The correct response is A. Both pessaries and Kegel exercises help hold up and strengthen the pelvic floor to restore the pelvic organs to their correct anatomic position. B is incorrect: an external fixation device would not be a tolerable long-term solution; it would also be invasive and would place the woman at risk for infection. C is incorrect: weight gain is not usually a healthy intervention for women as they age. Additional weight would increase the pressure on pelvic organs and exacerbate the problem. Yoga is relaxing and could reduce the woman's stress level, but it would not be therapeutic for pelvic organ prolapse. D is incorrect: wearing firm support garments might increase intra-abdominal pressure and cause further downward descent of the pelvic organs.
Which of the following dietary and lifestyle modifications might the nurse recommend to help prevent pelvic relaxation as women age? A) Eat a high-fiber diet to avoid constipation and straining. B) Avoid sitting for long periods; get up and walk around frequently. C) Limit the amount of exercise to prevent overdeveloping muscles. D) Space children a year apart to reduce wear and tear on the uterus.
The correct response is A. Preventing constipation and straining with defecation would lessen the strain on pelvic organs. B is incorrect: sitting for long periods will not affect pelvic organ movement. Gravity will create a downward pull on all organs regardless of the position, sitting or standing. C is incorrect: exercise will help to tone muscles within the body and strengthen the pelvic floor. D is incorrect: frequent childbirth contributes to pelvic organ prolapse rather than preventing it. Spacing children only a year apart would negatively influence the pelvic floor musculature and would be a contributing factor for prolapse.
When you are interviewing a client with uterine fibroids, what subjective data would you expect to find in her history? A) Cyclic migraine headaches B) Urinary tract infections C) Chronic pelvic pain D) Chronic constipation
The correct response is C. Pressure against adjacent structures and stretching of the uterine muscle with increasing growth of the fibroid create pain. A is incorrect: migraines are not caused by growing fibroids, but rather a change within the vasculature in the cranium. B is incorrect: bladder pressure to cause urinary urgency would be secondary to pelvic structure relaxation, not uterine fibroids. D is incorrect: constipation would be more common in a woman experiencing pelvic organ prolapse than in one with fibroids, since fibroids usually involve the uterus, not the rectum.
