OB Exam 2
An overt cord prolapse has been identified after artificial rupture of membranes. What actions should the nurse take? 1.Call for help 2.Minimize cord compression 3.Prepare for emergency c-section 4.instruct woman to push
Call for help Minimize cord compression Prepare for emergency c-section
It's important to provide advice to pt's who are experiencing intimate partner violence to leave the situation.
False
Postpartum depression is always easily detected by the pt or partner.
False
When the nurse is assessing a postpartum client approximately 6 hours after birth, which finding would warrant further investigation?
blood pressure 90/50 mm Hg
A nurse is caring for a client who is in labor. For which fetal response should the nurse monitor?
decrease in circulation and perfusion to the fetus
Most miscarriages are result of maternal infection
false
Pt's with active mastitis should stop breastfeeding and pumping
false
The nurse is assessing a new client who presents in early labor. The nurse determines the fetus has an acceptable heart rate if found within which range?
110 to 160 bpm
In which ways does excess blood volume resolve after pregnancy? Blood loss Diuresis Breast milk production Diaphoresis
Blood loss Diuresis Diaphoresis
The client in active labor overhears the nurse state the fetus is ROA. The nurse should explain this refers to which component when the client becomes concerned?
Fetal Position
Select all the apply: risk factors for experiencing intimate partner violence Younger than 24 Use of heroine and cocaine Earning more money than partner History of abuse in a relationship
Younger than 24 Use of heroine and cocaine History of abuse in a relationship
To give birth to her infant, a woman is asked to push with contractions. Which pushing technique is the most effective and safest?
head elevated, grasping knees, breathing out
In providing culturally competent care to a laboring woman, which is a priority?
Identify how the client expresses labor pain.
Late decelerations indicate a problem with the placenta
true
A nurse is inspecting the perineal pad of a client who gave birth vaginally to a healthy newborn 6 hours ago. The nurse observes a 5-inch stain of lochia on the pad. The nurse would document this as: light. moderate. heavy. scant.
moderate
A postpartum client comes to the clinic for her routine 6-week visit. The nurse assesses the client and suspects that she is experiencing subinvolution based on which finding? fever moderate lochia serosa bruising on arms and legs nonpalpable fundus
moderate lochia serosa
Which nursing action has a negative effect on fetal descent? walking the client in the hall using a tap water enema laying the client on the left side administering opioid pain medication
administering opioid pain medication
A nursing instructor is teaching students about the labor and delivery process and recognizes a need for further teaching when overhearing a student make which statement?
"Anxiety can speed up the labor process."
A client has just received combined spinal epidural. Which nursing assessment should be performed first?
Assess vital signs.
A breastfeeding pt reports a clogged duct, which actions should the nurse encourage? Complete emptying of the breast Avoiding breast stimulation Heat Massage
Complete emptying of the breast Heat Massage
Which fetal position is the most difficult to deliver vaginally? ROA (Right Occiput Anterior) LOA(Left Occiput Anterior) LOP (Left Occiput Posterior) ROT (Right Occiput Transverse)
LOP (Left Occiput Posterior)
The nurse is assessing a client in labor for pain and notes she is currently not doing well handling the increased pain. Which opioid can the nurse offer to the client to assist with pain control? hydroxyzine hydrochloride thiopental meperidine secobarbital
meperidine
A nurse is providing care to a postpartum woman who gave birth about 2 days ago. The client asks the nurse, "I haven't moved my bowels yet. Is this a problem?" Which response by the nurse would be most appropriate? "That's unusual. Are you making sure to eat enough?" "I'll get a laxative prescribed so that you can move your bowels." "It might take up to a week for your bowels to return to their normal pattern." "Let me call your health care provider about this problem."
"It might take up to a week for your bowels to return to their normal pattern."
A postpartum client comes to the clinic for her 6-week postpartum check up. When assessing the client's cervix, the nurse would expect the external cervical os to appear:
slit-like.
During labor, a pregnant client's doula uses therapeutic touch and massage. Which outcome indicates that these approaches have been effective?
The client is not requesting pain medication.
A nurse is preparing a presentation for a group of pregnant women about the labor experience. Which factors would the nurse include when discussing measures to promote coping for a positive labor experience? Select all that apply. 1.presence of a support partner 2.view of birth as a stressor 3.low anxiety level 4.fear of loss of control 5. participation in a pregnancy exercise program
presence of a support partner low anxiety level participation in a pregnancy exercise program
The nurse is caring for a client in labor whose fetus is in an occiput posterior position. Which intervention should the nurse use to reduce this client's discomfort?
Massage the lower back.
which statement should be included in postpartum discharge teaching? "Do not lift anything heavier than 25 lbs for 2 weeks after a c-section." "Please complete your post partum depression screening in 2-3 weeks." "Keep your perineum clean with your peri bottle. Your stitches will disolve "Please go to the OB office if you have chest pain."
"Please complete your post partum depression screening in 2-3 weeks." "Keep your perineum clean with your peri bottle. Your stitches will disolve
A client in labor has requested the administration of opioids to reduce pain. At 2 cm cervical dilation (dilatation), she says that she is managing the pain well at this point but does not want it to get ahead of her. What should the nurse do?
Advise the client to hold out a bit longer, if possible, before administration of the drug, to prevent slowing labor.
The licensed practical nurse is evaluating the tracings on the fetal heart monitor. The nurse is concerned that there is a change in the tracings. What should the LPN do first?
Assess and reposition the woman.
A gravida 1 client is admitted in the active phase of stage 1 labor with the fetus in the LOA position. The nurse anticipates noting which finding when the membranes rupture?
Clear to straw-colored fluid
The nursing instructor is preparing a class discussing the role of the nurse during the labor and birthing process. Which intervention should the instructor point out has the greatest effect on relieving anxiety for the client? Massage therapy Continuous labor support Prenatal classes Pharmacologic pain management
Continuous labor support
Which finding is more concerning to the nurse? Lochia rubra saturating a pad in 20 minutes 1 day post partum BP 125/82 after ambulation Temp 37.2 6 hours post partum Small amount of bloody drainage from c-section incision
Lochia rubra saturating a pad in 20 minutes 1 day post partum
A nurse is auscultating the fetal heart rate of a woman in labor. To ensure that the nurse is assessing the FHR and not the mother's heart rate, which action would be most appropriate for the nurse to do?
Palpate the mother's radial pulse at the same time.
Which is not a "P" of labor? Power Passenger Psyche Pitocin
Pitocin
A client has presented in the early phase of labor, experiencing abdominal pain and signs of growing anxiety about the pain. Which pain management technique should the nurse prioritize at this stage?
Practicing effleurage on the abdomen
A woman arrives at the office for her 4-week postpartum visit. Her uterus is still enlarged and soft, and lochial discharge is still present. Which nursing diagnosis is most likely for this client? Risk for fatigue related to chronic bleeding due to subinvolution Risk for infection related to microorganism invasion of episiotomy Risk for impaired breastfeeding related to development of mastitis Ineffective peripheral tissue perfusion related to interference with circulation secondary to development of thrombophlebitis
Risk for fatigue related to chronic bleeding due to subinvolution
The community health nurse is conducting a presentation on labor and delivery. When illustrating the birth process, the nurse should point out "0 station" refers to which sign? "The presenting part is at the true pelvis and is engaged." "This means +1 and the baby is entering the true pelvis." "This is just a way of determining your progress in labor." "This indicates that you start labor within the next 24 hours."
The presenting part is at the true pelvis and is engaged."
If the monitor pattern of uteroplacental insufficiency were present, which action would the nurse do first?
Turn her or ask her to turn to her side.
A nurse is assessing a full-term client in labor and determines the fetus is occiput posterior. The client states that all her discomfort is in her lower back. What intervention can the nurse provide that will help alleviate this discomfort?
Use a fist to apply counterpressure to the lower back.
A nurse is assigned to conduct an admission assessment on the phone for a pregnant client. Which information should the nurse obtain from the client? Select all that apply. appearance of vaginal blood characteristics of contractions estimated due date history of substance use history of drug allergy
appearance of vaginal blood characteristics of contractions estimated due date
Seven hours ago, a multigravida woman gave birth to a male infant weighing 4,133 g. She has voided once and calls for a nurse to check because she states that she feels "really wet" now. Upon examination, her perineal pad is saturated. The immediate nursing action is to:
assess and massage the fundus.
A nurse is working with a group of new parents, assisting them in transitioning to parenthood. The nurse explains that this transition may take 4 to 6 months and involves four stages. Place the stages below in the order in which the nurse would explain them to the group. All options must be used.
commitment, attachment, and preparation for an infant acquaintance with and increasing attachment to the infant moving toward a new normal routine achievement of the parental role
A labor and delivery nurse knows that when assessing a woman's contraction pattern, it is important to include which of the following? Select all that apply. frequency duration status of membranes intensity activity of fetus
frequency duration intensity
the nurse in the labor and delivery unit is performing a focused assessment on a client who is 2 hours postpartum. Assessment reveals a headache 3 out of 10 on a scale of 0 to 10. Vital signs: temperature, 99.1°F (37.3°C); heart rate, 101 beats/min; blood pressure, 87/58 mm Hg; capillary refill time, less than 3 seconds. Client reports a small gush of blood the first time out of bed to ambulate to the bathroom. Three perineal pads have been saturated since birth.
he client is at highest risk for developing postpartum hemorrhage as evidenced by three perineal pads saturated since birth and blood pressure 87/58 mm Hg
A nurse is providing care to a client in labor. A pelvic exam reveals a vertex presentation with the presenting part tilted toward the left side of the mother's pelvis and directed toward the anterior portion of the pelvis. When developing this client's plan of care, which intervention would the nurse include?
implementing measures for a vaginal birth
Breastfeeding decreases the risk of breast and ovarian cancer
true
A woman comes to the clinic. She gave birth about 2 months ago to a healthy term male newborn. During the visit, the woman tells the nurse, "I've noticed that I'm a bit uncomfortable now when we have sexual intercourse. Is there anything that I can do?" The woman's menstrual period has not yet resumed. Which suggestion by the nurse would be most appropriate? "Try doing Kegel exercises to get your pelvic muscles back in shape." "This is entirely normal, and many women go through it. It just takes time." "It takes a while to get your body back to its normal function after having a baby." "You might try using a water-soluble lubricant to ease the discomfort.
You might try using a water-soluble lubricant to ease the discomfort.
