OB

During a prenatal visit a client who is at 36 weeks' gestation states that she is having uncomfortable, irregular contractions. How should the nurse respond?

Walk around until they subside.

The prenatal nurse palpates the uterus of a client who is at 12 weeks' gestation. The uterus is enlarged as expected. What else should the nurse expect to observe when assessing the uterus?

At 12 weeks' gestation the enlarging uterus begins to rise out of the pelvis and is palpable just above the symphysis pubis.

What is the priority nursing action during a client's second stage of labor?

Assessing the perineum for bulging A bulging perineum is caused by the pressure of the fetal head against the perineal area and usually signifies imminent birth. Pain medication is not administered this close to the birth; it crosses the placental barrier and can cause respiratory distress in the newborn. During the second stage of labor the client is encouraged to push, not pant, with each contraction. Catheterization may be indicated earlier in labor so uterine contractions are not impeded; voiding will occur spontaneously as the client pushes.

Braxton Hicks contractions

After the fourth month of pregnancy, irregular, painless uterine contractions, felt through the abdominal wall

The nurse determines that a newborn has a cephalhematoma. What did the nurse note?

Bleeding between the parietal bone and periosteum confined within the suture line

A 37-year-old woman agrees to have a prenatal test done in order to diagnose fetal defects. There is a history of Down syndrome in her family. Which invasive prenatal test provides the earliest diagnosis and rapid test results?

Chorionic villus sampling -which may be performed between 10 and 12 weeks' gestation.

A client in labor is experiencing discomfort because her fetus is in the occiput posterior position. Which nursing action will help relieve this discomfort?

Counterpressure over the sacral area helps relieve the pain caused by the pressure of the fetal head in the posterior position.

A client at 35 weeks' gestation calls the prenatal clinic, concerned that she has "not felt the baby move as much as usual." The most appropriate recommendation by the nurse is to have the client call the clinic with the results after she has done what?

Drunk a glass of orange juice and timed 10 fetal movements

A client in her second trimester is at the prenatal clinic for a routine visit. While listening to the fetal heart, the nurse hears a heartbeat at the rate of 136 in the right upper quadrant and also at the midline below the umbilicus. What are the sources of these two sounds?

Funic souffle and fetal heart rate

The nurse must meet the hydration needs of a preterm infant. What should the nurse consider carefully regarding the preterm infant's kidney function?

Large amounts of urine are excreted.

Which interventions are included in the care plan of a postpartum client with a fourth-degree laceration? Select all that apply. Pain management with oral analgesics Continuous application of a warm pack Assessment of the site every 15 minutes Gentle cleansing with antibacterial cleanser Application of an ice pack for 20-minute intervals Instructing the client in how to promote normal bowel function

Pain management with oral analgesics Assessment of the site every 15 minutes Application of an ice pack for 20-minute intervals Providing pain management will prevent the client's pain from reaching an unmanageable level. Assessment of the site will identify any abnormal changes. Application of ice will decrease pain and edema. Warmth applied to newly traumatized tissue will increase pain and edema. Antibacterial cleanser would be caustic and painful to the laceration. Teaching regarding bowel function would be more appropriately presented after the client has completed the fourth stage and resumed normal intake.

A nurse is caring for a preterm neonate with physiologic jaundice who requires phototherapy. What is the physiologic mechanism of this therapy?

Phototherapy changes unconjugated bilirubin in the skin to conjugated bilirubin bound to protein, permitting excretion in the urine and feces.

While performing Leopold maneuvers on a client who has been admitted to the birthing room, the nurse identifies a firm, round prominence over the symphysis pubis; a smooth, convex structure along her right side; irregular lumps along her left side; and a soft roundness in the fundus. What is the fetal position?

ROA

While assessing a neonate, the nurse observes ecchymotic-appearing areas on the buttocks and sacrum. What does the nurse conclude that this discoloration is probably related to?

Skin color These bluish discolorations are known as Mongolian spots, which are commonly found on the back and buttocks of dark-skinned newborns. These spots are unrelated to gestational age. Bluish spots on the buttocks are not areas of ecchymosis caused by bleeding. The buttocks and genitals of infants who are born vaginally in the breech presentation are usually edematous.

Chadwick's sign

deepened violet-bluish color of cervix and vaginal mucosa

Goodell's sign

softening of the cervix

Hegar's sign

softening of the lower uterine segment

funic souffle

sound made by blood rushing through the umbilical vessels and synchronous with the fetal heart rate