Mom Baby PrepU #1

A 2-day old newborn is crying after being circumcised and the mother is attempting to comfort the infant but he continues to be fussy. Which statement by the nurse would best support the mother's actions? "Maybe you your husband will have better luck calming him down. Why don't you let him hold him?" "You would probably be more successful if you wrapped him in on a warm blanket." "Let me show you how to calm him down. I've been doing this for many years." "Many mothers find that offering a nipple dipped in sugar water helps soothe a baby after a painful procedure."

"Many mothers find that offering a nipple dipped in sugar water helps soothe a baby after a painful procedure." Parents need support when trying to care for their newborn infants. By offering positive phrases and encouraging the mother in her caretaking, the nurse conveys acceptance and confirms the mother's abilities.

Two days after giving birth, a client is to receive Rho(D) immune globulin. The client asks the nurse why this is necessary. The most appropriate response from the nurse is: "Rho(D) immune globulin suppresses antibody formation in a woman with Rh-positive blood who gave birth to a baby with Rh-positive blood." "Rho(D) immune globulin suppresses antibody formation in a woman with Rh-negative blood who gave birth to a baby with Rh-positive blood." "Rho(D) immune globulin suppresses antibody formation in a woman with Rh-negative blood who gave birth to a baby with Rh-negative blood." "Rho(D) immune globulin suppresses antibody formation in a woman with Rh-positive blood who gave birth to a baby with Rh-negative blood."

"Rho(D) immune globulin suppresses antibody formation in a woman with Rh-negative blood who gave birth to a baby with Rh-positive blood." Rho(D) immune globulin is indicated to suppress antibody formation in women with Rh-negative blood who gave birth to babies with Rh-positive blood. Rho(D) immune globulin is also given to women with Rh-negative blood after miscarriage/pregnancy termination, abdominal trauma, ectopic pregnancy, and amniocentesis.

A nurse is examining a client who underwent a vaginal birth 24 hours ago. The client asks the nurse why her discharge is such a deep red color. What explanation is most accurate for the nurse to give to the client? "The discharge consists of mucus, tissue debris, and blood; this gives it the deep red color." "The discharge at this point in the postpartum period consists of RBCs and leukocytes." "It is normal for the discharge to be deep red since it consists of leukocytes, decidual tissue, RBCs, and serous fluid." "This discharge is called lochia, and it consists of leukocytes and decidual tissue."

"The discharge consists of mucus, tissue debris, and blood; this gives it the deep red color." Lochia serosa = leukocytes, decidual tissue, RBCs & serous fluid.Only RBCs & leukocytes = bloodleukocytes and decidual tissue = lochia alba

The nurse educates a client who is confused about her ovarian cycle. Which client statement would best validate her understanding of the education? "When I ovulate, there is a follicle on my uterus that forms showing that an ova was released." "My menstrual cycles are controlled by progesterone production." "Two hormones control my ovulation, follicle-stimulating hormone (FSH) and luteinizing hormone (LH)." "I will ovulate every month on Day 21 of my cycle."

"Two hormones control my ovulation, follicle-stimulating hormone (FSH) and luteinizing hormone (LH). Explanation:Ovulation is controlled by FSH and LH, with the follicle-stimulating hormone encompassing days 1 to 14 of a 28-day cycle and the luteinizing hormone controlling the luteal phase, which is days 15 to 28. The follicle forms only in the ovary, not the uterus. Ovulation should occur on Day 14 of a normal 28 -day cycle. Both estrogen and progesterone are necessary to the menstrual cycle, not just progesterone.

A nurse is discussing menstruation with a female client. The nurse describes a normal amount of blood loss is approximately: 5 to 20 mL. 10 to 80 mL. 75 to 100 mL. 120 to 150 mL.

10 to 80 mL.

On a routine home visit, the nurse is asking the new mother about her breastfeeding and personal eating habits. How many additional calories should the nurse encourage the new mother to eat daily? 1,000 additional calories per day 750 additional calories per day 250 additional calories per day 500 additional calories per day

500 additional calories per day The breast-feeding mother's nutritional needs are higher than they were during pregnancy. The mother's diet and nutritional status influence the quantity and quality of breast milk. To meet the needs for milk production, the woman should eat an additional 500 calories per day, 20 grams of protein per day, 400 mg of calcium per day, and 2 to 3 quarts of fluid per day.

The nurse is noting a collection of blood under the scalp on a newborn being discharged to home. The nurse is correct to prepare teaching instructions of which topic? Wrapping of the head Developmental delay A cephalohematoma A caput succedaneum

A cephalohematoma Blood collection under the scalp of the newborn from birth trauma is called a cephalohematoma. Instructions for care include simple observation of the area. The cephalohematoma will subside in a couple of weeks and may take a couple of months to completely go away. There is no brain damage associated with a cephalohematoma. A caput succedaneum is swelling, without blood collection, of the soft tissue of the head.

Which finding would lead the nurse to suspect that a woman is developing a postpartum complication? lochia that is the color of menstrual blood red-colored lochia for the first 24 hours lochia appearing pinkish-brown on the fourth day an absence of lochia

An absence of lochia Explanation: Women should have a lochia flow following childbirth. Absence of a flow is abnormal; it suggests dehydration from infection and fever.

A nurse is caring for a client who gave birth about 10 hours earlier. The nurse observes perineal edema in the client. What intervention should the nurse perform to decrease the swelling caused by perineal edema? Apply moist heat. Apply ice. Use ointments locally. Use a warm sitz bath or tub bath.

Apply ice Explanation: Ice is applied to perineal edema within 24 hours after delivery. Use of ointments is not advised for perineal edema. Moist heat and a sitz or tub bath are encouraged if edema continues 24 hours after delivery.

Which intervention would be helpful to a client who is bottle feeding her infant and experiencing hard, engorged breasts? restricting fluids applying warm compresses applying ice administering bromocriptine

Applying ice Explanation: Ice promotes comfort by decreasing blood flow (vasoconstriction), numbing the area, and discouraging further letdown of milk. Restricting fluids doesn't reduce engorgement and shouldn't be encouraged. Warm compresses will promote blood flow and hence, milk production, worsening the problem of engorgement. Bromocriptine has been removed from the market for lactation suppression.

A woman gave birth vaginally approximately 12 hours ago, and her temperature is now 100° F (37.8° C). Which action would be most appropriate? Continue to monitor the woman's temperature every 4 hours; this finding is normal. Inspect the perineum for hematoma formation. Obtain a urine culture; the woman most likely has a urinary tract infection. Notify the health care provider about this elevation; this finding reflects infection.

Continue to monitor the woman's temperature every 4 hours; this finding is normal. Rationale: A temperature of 100.4 degrees F or less during the first 24 hours postpartum is normal and may be the result of dehydration due to fluid loss during labor. There is no need to notify the physician, obtain a urine culture, or inspect the perineum (other than the routine assessment of the perineum), because this finding is normal.

An episiotomy or a cesarean incision requires assessment. Which assessment criterion for skin integrity is not initially noted? redness edema drainage temperature

Temperature Explanation:The temperature of an incision would be determined only if the other parameters require this. A sterile glove would be used to assess skin temperature.

A 1-day-old newborn is being examined by the nurse practitioner, who makes the following notation: face and sclera appear mildly jaundiced. What causes this finding? The breakdown of RBCs release bilirubin, which the liver cannot excrete. The GI tract is immature, so the bilirubin remains in the intestines. The newborn's Vitamin K levels are low. Feedings are not adequate to eliminate the build-up of bilirubin.

The breakdown of RBCs release bilirubin, which the liver cannot excrete. After birth, the newborn's hematocrit is about 45% to 65%, which is not needed after birth for oxygenation. The cells then die and are broken down, releasing bilirubin. The liver normally breaks down the bilirubin and eliminates it but since the liver is immature, it becomes overwhelmed and the bilirubin builds up in the bloodstream. Vitamin K levels have no effect on bilirubin levels. The immaturity of the GI tract does not cause the bilirubin to increase and feedings do not directly affect bilirubin levels.

A nurse is assessing a pregnant client. The nurse understands that hormonal changes occur during pregnancy. Which hormones would the nurse most likely identify as being inhibited during the pregnancy? FSH and LH FSH and T4 T4 and GH LH and MSH

FSH and LH

A multigravida client is pregnant for the third time. Her previous two pregnancies ended in an abortion in the first and third month of pregnancy. How will the nurse classify her pregnancy history? G2 P1020 G3 P0020 G3 P0021 G2 P0020

G3 P0020

A nurse is performing an assessment on a female client who gave birth 24 hours ago. On assessment, the nurse finds that the fundus is 2 cm above the umbilicus and boggy. Which intervention is a priority? Assess a full set of vital signs. Check and inspect the lochia, and document all findings. Have the client void, and then massage the fundus until it is firm. Notify the primary care provider, and document the findings.

Have the client void, and then massage the fundus until it is firm. The fundus in a postpartum client should decrease 1 cm below the umbilicus each day. The fundus should also be firm to decrease the risk of postpartum hemorrhage. All of the listed interventions are appropriate, but a firm fundus is the priority.

The nursing instructor is leading a discussion on the physical changes to a woman's body after the birth of the baby. The instructor determines the session is successful after the students correctly point out which process results in the return of nonpregnant size and function of the female organs? Evolution Involution Decrement Progression

Involution

A couple wants to start a family. They are concerned that their child will be at risk for cystic fibrosis because they each have a cousin with cystic fibrosis. They are seeing a nurse practitioner for preconceptual counseling. What would the nurse practitioner tell them about cystic fibrosis? It is an autosomal dominant disorder. It is passed by mitochondrial inheritance. It is an X-linked inherited disorder. It is an autosomal recessive disorder.

It is an autosomal recessive disorder.

A nurse helps a postpartum woman out of bed for the first time postpartum and notices that she has a very heavy lochia flow. Which assessment finding would best help the nurse decide that the flow is within normal limits? The flow is over 500 mL. The color of the flow is red. Her uterus is soft to your touch. The flow contains large clots.

The color of the flow is red. Explanation:A typical lochia flow on the first day postpartally is red; it contains no large clots; the uterus is firm, indicating that it is well contracted.

The nurse is used to working on the postpartum floor taking care of women who have had normal vaginal births. Today, however, the nurse has been assigned to help care for women who are less than 24 hours post cesarean birth. The nurse realizes that some areas will not be assessed. What would the nurse leave out of the client assessments? Lower extremities Perineum Breasts Respiratory status

Perineum Usually a woman who experiences cesarean birth does not have an episiotomy, although rarely this may be the case.

What should the nurse expect for a full-term newborn's weight during the first few days of life? There is an increase in 3% to 5% of birth weight by day 3 in formula-fed babies. A formula-fed newborn should gain 3% to 5% of the initial birth weight in the first 48 hours, but a breastfed newborn may lose up to 3%. There is a loss of 5% to 10% of the birth weight in the first few days in breastfed infants only. There is a loss of 5% to 10% of birth weight in formula-fed and breastfed newborns.

There is a loss of 5% to 10% of birth weight in formula-fed and breastfed newborns.

The nurse is teaching a couple trying to conceive about the changes in the cervical mucus near the time of ovulation. The nurse determines the session is successful when the couple correctly choose mucus in which form as indicating ovulation has occurred? Scant amount Thick and tacky Thin and copious Mucus is not visible at ovulation

Thin and copious Women can analyze cervical mucus changes to help plan coitus so it coincides with ovulation if they want to increase their chance of becoming pregnant or plan to avoid coitus at the time of ovulation to prevent pregnancy by analyzing how thick or thin is cervical mucus. At the beginning of each cycle, when estrogen secretion from the ovary is low, cervical mucus is thick and scant. Sperm survival in this type of mucus is poor. At the time of ovulation, when the estrogen level has risen to a high point, cervical mucus becomes thin, stretchy (Spinnbarkeit), and copious. Sperm penetration and survival in this thin mucus are both excellent. Fernlike patterns on a microscope slide of cervical mucus do indicate ovulation, but this method is not nearly as practical as examining the consistency of the cervical mucus. The beginning of the cycle, just after the end of menstruation, is before ovulation, and thus not the best time to have coitus if the goal is conception.

A woman states that she still feels exhausted on her second postpartum day. The nurse's best advice for her would be to do which action? Avoid getting out of bed for another 2 days. Avoid elevating her feet when she rests in a chair. Walk the length of the hallway to regain her strength. Walk with the nurse the length of her room.

Walk with you the length of her room Explanation: Most women report feeling exhausted following childbirth. Ambulation is important, however, so a small amount, such as walking across a room, should be encouraged.

A postpartum woman with an episiotomy asks the nurse about perineal care. Which recommendation would the nurse give? Avoid using soap for any perineal care. Use an alcohol wipe to wash her episiotomy line. Wash her perineum with her daily shower. Refrain from washing lochia from the suture line.

Wash her perineum with her daily shower. Explanation: A suture line should be kept free of lochia to discourage infection. Washing with soap and water at the time of a shower will help to do this

The nurse is examining a woman who came to the clinic because she thinks she is pregnant. Which data collected by the nurse are presumptive signs of her pregnancy? Select all that apply. a. fetal heartbeat b. ultrasound pictures c. morning sickness d. breast changes e. amenorrhea f. hydatidiform mole

breast changes amenorrhea morning sickness Explanation: Presumptive signs are possible signs of pregnancy that appear in the first trimester, often only noted subjectively by the mother (e.g., breast changes, amenorrhea, morning sickness). Probable signs are signs that appear in the first and early second trimesters, seen via objective criteria, but can also be indicators of other conditions (e.g., hydatidiform mole). Positive signs affirm that proof exists that there is a developing fetus in any trimester and are objective criteria seen by a trained observer or diagnostic study, (e.g., ultrasound.)

A postpartum client has a fourth-degree perineal laceration. The nurse would expect which medication to be prescribed? methylergonovine docusate ferrous sulfate bromocriptine

docusate

Some chromosomal abnormalities of number often result because of the failure of the chromosome pair to correctly separate during cell division. One type is referred to as polyploidy. The nurse recognizes that this type usually results in: early spontaneous abortion. Patau syndrome. Down syndrome. Edward syndrome.

early spontaneous abortion.

A nurse is assessing a woman who has come into the clinic. The nurse obtains a sample of the client's cervical mucus and notes ferning. The nurse interprets this finding to indicate high levels of which hormone? follicle-stimulating hormone progesterone estrogen oxytocin

estrogen

The Apgar score is based on which 5 parameters? heart rate, muscle tone, reflex irritability, respiratory effort, and color heart rate, breaths per minute, irritability, reflexes, and color heart rate, respiratory effort, temperature, tone, and color heart rate, breaths per minute, irritability, tone, and color

heart rate, muscle tone, reflex irritability, respiratory effort, and color

A nurse is observing a postpartum woman and her partner interact with the their newborn. The nurse determines that the parents are developing parental attachment with their newborn when they demonstrate which behavior? Select all that apply. identify common features between themselves and the newborn frequently ask for the newborn to be taken from the room make direct eye contact with the newborn refrain from checking out the newborn's features refer to the newborn as having a monkey-face

identify common features between themselves and the newborn make direct eye contact with the newborn Positive behaviors that indicate attachment include identifying common features and making direct eye contact with the newborn. Asking for the newborn to be taken out of the room, referring to the newborn as having a monkey-face and refraining from checking out the newborn's features are negative attachment behaviors.

The nurse is developing a teaching plan for a client who has decided to bottle-feed her newborn. Which information would the nurse include in the teaching plan to facilitate suppression of lactation? instructing her to apply ice packs to both breasts every other hour telling her to limit the amount of fluids that she drinks encouraging the woman to manually express milk suggesting that she take frequent warm showers to soothe her breasts

instructing her to apply ice packs to both breasts every other hour

A nurse is visiting a postpartum woman who gave birth to a healthy newborn 5 days ago. Which finding would the nurse expect? bright red discharge pinkish brown discharge deep red mucus-like discharge creamy white discharge

pinkish brown discharge

A nurse is teaching newborn care to students. The nurse correctly identifies which mechanism as the predominant form of heat loss in the newborn? nonshivering thermogenesis lack of brown adipose tissue sweating and peripheral vasoconstriction radiation, convection, and conduction

radiation, convection, and conduction Heat loss in the newborn occurs primarily through radiation, convection, and conduction because of the newborn's large ratio of body surface to weight and because of the marked difference between core and skin temperatures. Nonshivering thermogenesis is a mechanism of heat production in the newborn. Lack of brown adipose tissue contributes to heat loss, particularly in premature infants, but it is not the predominant form of heat loss. Peripheral vasoconstriction is a method to increase heat production.

A school nurse is talking to an adolescent who asks about why she has monthly menstrual cycles. The best explanation that the nurse can offer regarding the menstrual phase is to tell her that: her uterus fills up with blood each month and is passed during the menstrual cycle. her hormones cause her to accumulate blood in the uterus from ovulation. each month, her uterine lining thins out and vessels close to the surface begin to fill with blood. the uterine lining is being shed due to lowering of hormone levels.

the uterine lining is being shed due to lowering of hormone levels.

A postpartum woman is experiencing subinvolution. When reviewing the client's history for factors that might contribute to this condition, which factors would the nurse identify? Select all that apply. breastfeeding early ambulation hydramnios prolonged labor empty bladder uterine infection

• Uterine infection • Hydramnios • Prolonged labor Factors that inhibit involution include prolonged labor and difficult birth, uterine infection, overdistention of the uterine muscles such as from hydramnios, a full bladder, close childbirth spacing, and incomplete expulsion of amniotic membranes and placenta. Breast-feeding, early ambulation, and an empty bladder would facilitate uterine involution.