Maternity

A mom two days post delivery reports abdominal pain while breast feeding her newborn. What should the nurse tell the client? 1. "You are getting a surge of oxytocin when you breast feed." 2. "I need to let the doctor know that you need a pelvic exam." 3. "Lie down so I can massasge your fundus." 4. "You cannot have pain medication while you are breast feeding."

1 This is normal and we just need to educate on why it is normal. It is nothing to worry about or contact the doctor about.

A client in her third trimester comes to the clinic for a routine prenatal visit. The nurse notes a weight gain of 4 pounds (1.8 kg) in a week. What action should the nurse take? 1. Check urine for protein. 2. Educate on proper weight gain during pregnancy. 3. Notify the primary healthcare provider. 4. Send client to the labor and delivery unit.

1 We are worried about pre-eclampsia. If things are okay then we just need to educate on proper weight gain.

The nurse is teaching a client diagnosed with mastitis about treatment. The client states she wants to continue breast feeding. What interventions should the nurse include? 1. Get plenty of bed rest. 2. Wear a support bra. 3. Place chilled cabbage leaves on breasts. 4. Take antibiotic prior to breast feeding. 5. Offer the unaffected breast first at each feeding. 6. Take cool showers to relieve breast discomfort.

1,2 The antibiotic should be taken AFTER. Cabbage leaves will stop production of milk and should be avoided if she wants to keep breast feeding.

What interventions should the nurse provide when caring for a client prescribed oxytocin IV? 1. Label IV bag and IV tubing with oxytocin sticker. 2. Monitor for late decelerations. 3. Position client supine. 4. Piggyback oxytocin at the lowest primary IV site. 5. Provide one on one care.

1,2,4,5 They can be placed in any position except for flat on their back. Review oxytocin

The nurse is teaching couples in their final weeks of pregnancy about "Kangaroo Care". What points should the nurse include in this session? 1. Trust in the newborn is an emotional and physiologic need fulfilled through "Kangaroo Care". 2. "Kangaroo Care" requires skin to skin contact between the newborn and parent. 3. The newborn is held quietly for an hour at least 4 times a day. 4. "Kangaroo Care" will only be encouraged if your newborn is premature. 5. Research shows that skin to skin bonding stabilizes the newborn's heart rate.

1,2,5 Review why kangaroo care is good. it is at least 4 times a week and should be done with all babies not just premature ones.

A client in her first trimester of pregnancy has been attending educational sessions on pregnancy. What statements by the client would indicate to the nurse that client teaching has been successful? 1. "Good food sources of iron includes spinach, raisins, and dark chocolate." 2. "I will eat at least 40 grams of protein a day." 3. "Taking folic acid will help prevent heart defects from occurring." 4. "Swimming is an acceptable exercise for me while I am pregnant." 5. "I can gain 2 pounds (0.9 kg) per week during my first trimester." 6. "I need to stay out of hot tubs while pregnant."

1,4,6 Should increase protein to 60grams a day. Folic acid is taken for neural tube defects, and you should only gain 4 pounds the entire first trimester.

The nurse is preparing to perform Leopold maneuvers on a newly admitted laboring client. What should the nurse remember when performing this procedure? 1. Ask the client to drink water prior to the procedure. 2. Perform procedure between contractions. 3. Monitor for heart beat acceleration with fetal movement. 4. Connect client to fetal heart monitor.

2 Doing it between contractions means that you will be able to feel the baby and not just a hard belly. Have them urinate before hand and the others don't have anything to do with leopolds.

A client comes to the clinic and states that she believes she is pregnant. What probable signs of pregnancy does the nurse expect to see? 1. Amenorrhea 2. Facial chloasma 3. Fetal movement 4. Breast tenderness 5. Positive pregnancy test 6. Urinary frequency

2,5 Review what probable and positive signs are.

What medication, given to help mature fetal lungs, does the nurse anticipate giving after admitting a client in preterm labor? 1. Magnesium sulfate 2. Terbutaline 3. Betamethasone 4. Nifedipine

3 Steroids help with fetal lung development. All the others are given to stop contractions by relaxing the uterus.

The nurse has presented information regarding true versus false labor to a woman in her third trimester of pregnancy. Which statement by the woman would indicate to the nurse that the client understands the information provided? 1. "With false labor the discomfort starts in the back and radiates to the abdomen." 2. "I will experience irregular contractions with both true and false labor." 3. "Contractions during true labor will increase in duration but will decrease in frequency." 4. "Pain increases with a change in activity if I am having true labor."

4 Review the difference between true and false labor.