test 4 pp
Woman who is 2 weeks postpartum from a vaginal delivery, calls the obstetric office to state that she had a whitish discharge for 1 wk and today saturated a pad every half hour. Which of the following responses by the nurse is appropriate?
"Physician should see you, please go to ER"
The RN is caring for a woman on postpartum day one. The RN should notify the physician concerning which of the following:
+3 proteinuria
A G2P2002, who is postpartum 6 hours from a spontaneous vaginal delivery, is assessed. The nurse notes that the fundus is firm at the umbilicus, there is heavy lochia, and perineal sutures are intact. Which of the following actions should the nurse take at this time?
Notify the woman's primary health care provider.
Select all about mastitis and cracked nipples with fissures?? What would prevent these complications?
Allow nipples exposed to air part of day, Wash hands, Change breast pads frequently
What physiological factor is NOT a reliable indicator of impending shock
Blood Pressure
To prevent infection, the nurse teaches the postpartum client to perform which of the following tasks?
Change the peripad at each voiding.
Your patient is of the muslim culture. Which meal would be appropriate?
Chicken and dumplings
The nurse is developing a plan of care for the postpartum client during the "taking in" phase. Which of the following should the nurse include in the plan?
Discuss the labor and birth with the mother.
Korean woman?
Don't believe in giving colostrum to newborn
Client will NOT develop thrombophlebitis, how will you achieve this goal?
Early ambulation
A client has just received Hemabate (carboprost) because of uterine atony not controlled by IV oxytocin. For which of the following side effects of the medication will the nurse monitor this patient?
Hyperthermia, vomiting, and diarrhea.
Which of the following is true related to postpartum blues?
It only lasts a week or 2
The nurse should suspect puerperal infection when a client exhibits which of the following?
Malodorous lochial discharge.
Client day 1 PP, monitored closely after a significant postpartum hemorrhage, what should you report to the doctor?
Urine output of 200ml for last 8 hrs
Client discharged on Warfarin (coumadin), what do you include in discharge teaching?
Use a reliable form of contraception
Breast feeding client is unable to maintain her milk supply, instruction?
Empty breasts frequently, Take cold baths, Apply ice packs (I put this and it's wrong), Perform kegels
New parents are concerned w/ not being able to bond w/ their baby immediately due to birth complications
Explain attachment/bonding is a process that occurs over time
Experiencing thoughts & behaviors of "Taking Hold Phase", which is characteristic of this phase?
Expresses a strong interest in taking care of her child
PP unit, who do you assess FIRST
Had vacuum delivery w/ hemoglobin 7.2g/dL
A breastfeeding woman has been counseled on how to prevent engorgement. Which of the following actions by the mother shows that the teaching was effective?
She feeds her baby every 2 to 3 hours.
Select all which patients monitor for PPH?
Placenta previa, Prolonged first stage of labor, Delivered vaginally w/ forceps
Asigan woman. Select all the foods she would most likely avoid??
Raw carrots, Ice cream, Orange slices
How does the Rhogam injection work?
Inhibit the mother's active immune response
The nurse informs a postpartum woman that ibuprofen (Advil) is especially effective for afterbirth pains. What is the scientific rationale for this?
Ibuprofen has an antiprostaglandin effect.
The day after delivery a woman,whose fundus is firm at 1cm below the umbilicus and who has moderate lochia, tells the nurse that something must be wrong, "All I do is go to the bathroom." Which of the following is an appropriate nursing response?
Inform the client that polyuria is normal.
The nurse is examining a 2-day postpartum client whose fundus is 2 cm below the umbilicus and whose bright red lochia saturates about 4 inches of a pad in 1 hour. What should the nurse document in the nursing record?
Normal involution, lochia rubra moderate.
Breastfeeding mom post- c section asks advice for breastfeeding
Use the football position to feed baby so it doesn't effect incision
Client wants to bottle feed, what should you encourage?
Wear a supportive bra for 24 hrs a day & Stand with your back to the water in the shower
G2P2002, PP 6 hrs from sponateous vag delivery, fundus firm & at umbilicus, heavy lochia rubra, sutures intact, nursing action at this time?
Notify healthcare provider
Gave birth 12 hrs ago, says she's been voiding small amounts of urine frequently, uterus is displaced to the right, what should the nurse do next?
Notify provider (I put this and got it wrong), Urinary cath, Insert 20 gauge IV, Admin oxytocin IV
Select all about uneventful vag delivery, not immune to rubella, what education is vital to include r/t rubella vaccine:
Breastfeeding mothers can receive vaccines, Do not get pregnant for 28 days: Other options- Breastfeeding should be discouraged, Breast milk production will decrease until vaccines effectiveness reaches its peak ,Transient joint pain & lymphadenopathy
The nurse monitors his or her postpartum clients carefully because which of the following physiological changes occurs during the early postpartum period?
Decreased blood volume.
A woman, 26 weeks' gestation, has just delivered a fetal demise. Which of the following nursing actions is appropriate at this time?
Dress the baby in a tee shirt and swaddle the baby in a receiving blanket.
A client is 10 minutes postpartum from a forceps delivery of a 4500-gram Down syndrome neonate over a right mediolateral episiotomy. The client is at risk for each of the following nursing diagnoses. Which of the diagnoses is highest priority at this time?
Fluid volume deficit.
Examining a woman who gave birth 5 hrs ago, & saturates a peri pad every 15 minutes, priority?
Massage the fundus
A postoperative cesarean client, who was diagnosed with severe preeclampsia in labor and delivery, is transferred to the postpartum unit. The nurse is reviewing the client's doctor's orders. Which of the following medications that were ordered by the doctor should the nurse question?
Methergine (methylergonovine).
A client delivered her 3rd baby via cesarean delivery. The RN's assessment of the woman reveals an elevated temperature along with severe chills, nausea, and increased abdominal pain. The RN notifies the PCP and receives the following orders: Ampicillin 500mg IVPB Q6, Ultrasound of the pelvis, Culture and sensitivity of lochia, Chest x-ray, & Maintain RL @ 125ml/hr
Obtain culture and sensitivity
One nursing diagnosis that a nurse has identified for a postpartum client is: Risk for intrauterine infection r/t vaginal delivery. During the postpartum period, which of the following goals should the nurse include in the care plan in relation to this diagnosis? Select all that apply.
The client will drink sufficient quantities of fluid.,The client will have a stable white blood cell count, The client will have a normal temperature, The client will have normal-smelling vaginal discharge,The client will take two or three sitz baths each day.
A nurse has administered Methergine (methylergonovine) 0.2 mg po to a grand multipara who delivered vaginally 30 minutes earlier. Which of the following outcomes indicates that the medication is effective?
Fundus firm at umbilicus.
