OB exam 4

Which information is important for the nurse to provide to mothers of infants of 3 months of age regardless of the method of infant feeding?

When growth spurts and dietary increases are expected

A postpartum patient informs the nurse of a frequent urge and burning when attempting to urinate. The nurse reviews the patient's medical record and associates which risk factors related to a possible urinary tract infection (UTI)? Select all that apply.

-Urinary catheter during labor -Use of a vacuum extractor -Poor oral fluid intake -Neonatal macrosomia

The nurse is collecting information from a new mother who is bottle-feeding her infant. Which comment, made by the mother, requires the nurse to provide patient teaching?

"Sometimes I will add a little water to the formula if I am running low."

A new mother expresses severe frustration with an infant that is exhibiting symptoms of colic. Which suggestions from the nurse are aimed at infant safety?Select all that apply.

-Do simple household chores, such as vacuuming or washing the dishes. -Place the baby in a safe place and allow the baby to cry for 10 to 15 minutes.

The nurse is preparing a postpartum patient for discharge. For which reasons does the nurse instruct the patient to call the primary care provider? Select all that apply.

-Hot, red, painful breasts -Foul-smelling lochia -Frequent, painful urination

The postpartum nurse is preparing to present infant care information to a couple who expresses concern about when to bathe their newborn. Which behaviors will the nurse present as general guidelines? Select all that apply.

-Use a mild preservative-free soap with a neutral pH. -Genital and rectal areas should be cleaned at each diaper change. -Daily bathing with soap is not necessary for the newborn. -Avoid the use of soap on the face of the newborn.

A postpartum patient calls the OB office 8 days following a vaginal delivery. The patient reports concern regarding vaginal bleeding. Which patient-reported symptom causes the nurse concern?

A description of the lochia as being red in color

A patient who is 12 hours postpartum after a vaginal delivery continues to have difficulty in initiating urination. The nurse is aware that an integrative method used when a woman is unable to void is peppermint oil. In which manner will the peppermint oil be used?

A saturated cotton ball of peppermint oil is placed in a "hat" on the toilet.

A multiparous patient reports severe uterine cramps the first day after a vaginal delivery. The nurse is aware the patient is breastfeeding and associates the patient's pain primarily with which occurrence? (Think Physiologically)

An increase in oxytocin release related to the newborn suckling

The nurse is providing postpartum care to a patient 24 hours after a vaginal delivery. Which action does the nurse perform prior to assessing the patient's uterus?

Ask the patient to void.

A breastfeeding mother is planning to return to work 3 months after her baby is born. The mother is planning to use an electric breast pump and freeze some breast milk for use later. Which information does the nurse need to provide?

Breast milk can be kept in a deep freezer for 6 to 12 months.

The nurse works in a labor and delivery facility with new protocols for estimating postpartum blood loss. Which method for estimating blood loss is implemented in the delivery room?

Collect blood in calibrated, under-buttocks drapes for vaginal birth.

The nurse is providing care for a patient who is 8 hours postpartum after a vaginal delivery. The patient reports severe perineal pain unaffected by pain medication. The nurse notices a 4 cm area of discoloration on the labia that is tender to the touch. Which action does the nurse take after providing comfort measures?

Contact the primary care provider for further evaluation.

The nurse in a postpartum unit frequently teaches patients regarding breast care. Which teaching is most helpful to the breastfeeding patient? (Think Primary Engorgement)

Express milk by a breast pump or manually.

The nurse is providing education about postpartum depression. How does the nurse differentiate baby blues from postpartum depression?

Postpartum depression usually happens after discharge where a patient has more bad days than good.

The nurse is preparing a postpartum patient for discharge. Which patient teaching is most important for the nurse to provide?

The signs and symptoms of secondary hemorrhage

A mother who is breastfeeding expresses concern about whether her infant is getting enough milk. Which concrete indicator does the nurse provide to the mother?

There are at least six to eight wet diapers and several stools per day.

The nurse is palpating a patient's uterus 12 hours after a vaginal delivery. For which reason does the nurse place one hand just above the symphysis pubis?

To prevent uterine inversion

Prior to discharge from the birthing center, the nurse informs the patient that she will receive vaccines for rubella, hepatitis B, pertussis, and influenza. For which reason does the nurse explain the need for the vaccinations?

Vaccinating the mother will protect the neonate from serious illnesses.

The nurse is concerned about the number of infants in the community who die from SIDS even with teaching about "back to sleep" being provided. On which additional preventive measures will the nurse focus? Select all that apply.

-During pregnancy, women should not smoke, drink alcohol, or use illegal drugs. -Parents should not smoke or allow smoking around their baby. -Mothers need to be informed that breastfeeding reduces the risk for SIDS. -Parents need to avoid products that claim to reduce the risk of SIDS. -Infants need to be dressed to prevent infants from overheating during sleep.

The nurse is collecting information during a follow-up OB appointment with a patient who delivered 3 months ago. The patient reports her partner has become cynical, irritable, and verbally abusive. The nurse will screen for which risks related to paternal postnatal depression (PPND)? Select all that apply.

-The father is recently estranged from his parents and siblings. -he birth of this fourth child was unexpected and unplanned. -The father exhibited depression during the pregnancy.

The nurse is reviewing the medical record for a patient who is postpartum. The nurse notices the patient is rubella-nonimmune. Which information does the nurse present to the patient? Select all that apply.

-The risks to the fetuses of any future pregnancies. -Pregnancy should be avoided for 4 weeks. -The patient will need to be immunized before discharge.

The nurse is providing care for a patient who is 1 day postpartum and exhibiting symptoms of postpartum psychosis. Which medical management does the nurse expect for this patient?

Immediate hospitalization in a psychiatric unit

The nurse is preparing discharge teaching for a postpartum patient who exhibits signs and symptoms of an episiotomy infection and is on oral antibiotic therapy. Which discharge teaching will the nurse provide regarding pain management?

Information applicable to medication therapy

The nurse is assisting the primary care provider with the third stage of a vaginal delivery. The patient is multiparous, experienced a precipitous birth, and has a history of hypertension. Which medical prescription does the nurse anticipate for this patient?

Methylergonovine (Methergine)