Unit 3 OB
The nurse is caring for a couple during their initial visit to a fertility clinic after being unable to conceive for 2 years. Which assessment questions would be appropriate to determine an alternate cause of infertility? A. "Do you use any lubrication during intercourse?" B. "Can both of you reach orgasm at the same time?" C. "What type of birth control did you use in the past?" D. "Are you consistent in the manner in which you have intercourse?"
A. "Do you use any lubrication during intercourse?" Some lubricants act as a spermicide; they should be avoided, or only a recommended lubricant should be used. A female orgasm is not necessary for conception; asking about simultaneous orgasms is not a relevant question. The type of birth control before the couple began trying to conceive 2 years ago is not relevant at this time. Consistency in the manner of intercourse usually is not relevant to conception, although a change in position may be recommended.
The nurse in the birthing room is assessing a newborn. Which characteristic would be assigned an Apgar value of 2? A. A strong cry B. A heart rate of 90 beats/min C. Slight flexion of legs and arms D. Pink body and blue extremities
A. A strong cry A strong cry indicates effective respiratory function and is assigned a value of 2. The heart rate should be more than 100 beats/min; therefore a pulse of 90 beats/min is assigned a value of 1. If flexion of the arms and legs is slight and movement is diminished, a value of 1 is assigned. A value of 1 is assigned when the body is pink and the extremities are blue
An Rh-negative, 30-year-old gravida 1 para 0 experiences a miscarriage at 10 weeks' gestation. Which action would the nurse anticipate regarding the administration of Rho(D) immune globulin A. Administration of one intramuscular microdose (50 mcg) of Rho(D) immune globulin B. Administration of one intramuscular standard dose (300 mcg) of Rho(D) immune globulin C. A prescription for one subcutaneous standard dose (300 mcg) of Rho(D) immune globulin D. A prescription of Rho(D) immune globulin will not be administered because of pregnancy ending during first trimester
A. Administration of one intramuscular microdose (50 mcg) of Rho(D) immune globulin To prevent production of anti-Rho(D) antibodies in an Rh-negative woman who has been exposed to Rh-positive blood, a microdose of Rho(D) immune globulin (RhoGAM) must be administered intramuscularly because the pregnancy ended in the first trimester. Had the pregnancy ended at 13 weeks' gestation or later, a standard dose of Rho(D) immune globulin would be administered intramuscularly. Rho(D) immune globulin is not administered subcutaneously.
A pregnant client has two children at home, the first born at 38 weeks' gestation and the second born at 34 weeks' gestation. She has also had one miscarriage, at 18 weeks, and an elective abortion. Which is the correct summary of her obstetric history using the GTPAL system? A. G5 T1 P1 A2 L2 B. G4 T2 P2 A1 L4 C. G2 T3 P3 A2 L1 D. G3 T2 P1 A3 L3
A. G5 T1 P1 A2 L2 G (gravida) stands for the total number of pregnancies a client has had. Gravida 5 indicates that this is the client's fifth pregnancy. T (term) stands for the number of neonates born at the expected date of birth. The neonate born at 38 weeks' gestation was born at term. P (preterm) stands for the number of neonates born before the expected date of birth. The neonate born at 34 weeks' gestation was born preterm. An abortion or miscarriage describes the birth of a fetus before 20 weeks' gestation. Both the miscarriage and elective abortion are considered abortions. L (living) stands for the number of living children at the time of assessment. The client has two living children.
The nurse is planning to teach the parents of a preterm infant about the infant's nutritional needs. Which nutrients are required in greater quantities in a preterm infant than a full-term one? A. Proteins B. Carbohydrates C. Vitamins A, D, E, and K D. Calcium and phosphorus
A. Proteins Proteins are needed for tissue building; therefore the preterm infant's need for protein is greater than the full-term infant's. Carbohydrates are not needed in greater quantities by the preterm infant than by the full-term infant. Vitamins A, D, E, and K are fat-soluble vitamins; all of these vitamins are needed, but the B vitamins, found in proteins, are most important for the preterm infant. Although minerals are needed for electrolyte balance, they are not the priority nutrient for a preterm newborn.
Which activity would help prepare a client to care for her preterm infant who is in the neonatal intensive care unit? A. She will be encouraged to participate in the infant's care as much as possible. B. She may watch the care to familiarize herself with the specific routines. C. She should find someone with preterm care training to help at home for the first week. D. She will be able to care for the infant in a special nursery for a few days before discharge.
A. She will be encouraged to participate in the infant's care as much as possible. By participating in her infant's care, the mother will gain confidence in her own ability to meet her infant's needs. Watching the provision of care by others may only increase the client's sense of inadequacy. There is no need for a specialist to care for the infant after discharge. The mother should be involved with infant care as early as possible, not just a few days before discharge.
A client with hypertension has labor pains before the 35th week of gestation. Which pharmacological intervention would the nurse anticipate to be beneficial for this client? A. Administer terbutaline. B. Administer magnesium sulfate. C. Prepare the client for an abortion. D. Administer sedatives and maintain hydration.
B. Administer magnesium sulfate Magnesium sulfate is the medication of choice for maintaining pregnancy in preterm labor in hypertensive clients. Terbutaline is used to maintain pregnancy in preterm labor by relaxing the uterine smooth muscle. An abortion is advisable if the preterm labor starts before the 20th week of gestation because the fetus may be nonviable. The use of sedatives and body hydration measures are nonpharmacological interventions to maintain pregnancy in preterm labor
The parent of a preterm infant asks the nurse in the neonatal intensive care unit why the baby is in a bed with a radiant warmer. How would the nurse explain the increased risk for hypothermia in preterm infants? A. Have a smaller body surface area than full-term newborns B. Lack the subcutaneous fat that usually provides insulation C. Perspire excessively, causing a constant loss of body heat D. Have a limited ability to produce antibodies against infections
B. Lack the subcutaneous fat that usually provides insulation Much of a full-term infant's birth weight (almost a third) is gained during the last month of gestation, and most of this final spurt is related to an increase in subcutaneous fat, which serves as insulation; the preterm infant did not have enough time to grow in the uterus and has little of this insulating layer. The preterm infant has a relatively larger surface area per body weight than does a term infant. Preterm infants do not shiver or perspire. Depressed antibody production is unrelated to maintenance of body temperature.
The primary health care provider instructs the nurse to apply an emollient to an infant. During assessment, the nurse finds that the neonate is a preterm infant and has a body weight of 900 g. Which is the appropriate nursing intervention in this situation? A. Administer intravenous fluids before applying emollient. B. Monitor for coagulase-negative staphylococcal infection. C. Avoid applying emollient to dry, flaking, and fissured areas on the skin. D. Hold applying emollient and recheck with the primary health care provider.
B. Monitor for coagulase-negative staphylococcal infection. Emollients can cause coagulase-negative staphylococcal infection in a preterm infant who weighs 900 g or less. Intravenous fluids do not increase the effectiveness of the emollients, so there is no need to administer intravenous fluids before applying the emollient. Emollients effectively reduce dry, flaking, and fissured areas on the infant's skin. Emollients are not contraindicated in preterm infants, so there is no need to hold application or recheck with the primary health care provider.
A client who is 25 weeks' pregnant and who is being treated with atenolol reports labor pain. Which medication would the nurse anticipate incorporating into the plan of care? A. Sucralfate B. Nifedipine C. Indomethacin D. Dexamethasone
B. Nifedipine Nifedipine inhibits myometrial activity by blocking calcium reflux. This action helps reduce preterm labor. Indomethacin is commonly used to treat preterm labor. However, concomitant use of atenolol and indomethacin may increase maternal and fetal risk. Dexamethasone is administered if neither indomethacin nor nifedipine is effective. Sucralfate is used to protect the stomach from gastrointestinal issues associated with indomethacin.
A client is being shown her preterm infant in the neonatal intensive care unit (NICU) for the first time. The client immediately starts to cry and refuses to touch her baby. Which situation would this behavior represent? A. A typical detachment behavior B. An incomplete bonding behavior C. An expected reaction to the situation D. A negative reaction to the NICU environment
C. An expected reaction to the situation Crying in this situation is a typical response. It is not unusual to be frightened about touching a small preterm infant, and the nurse would provide support while encouraging the mother to do so. Bonding does not involve a detachment behavior phase; the behavior indicates apprehension in a difficult situation. An incomplete bonding behavior is not incomplete bonding but an expression of fear in a difficult situation. The negative reaction to the NICU environment is more complex than mere fear of the NICU.
Which criterion would the nurse use when assessing the gestational age of a preterm infant? A. Reflex stability B. Simian creases C. Breast bud size D. Fingernail length
C. Breast bud size The size of the breast buds is an indication of gestational age. Small, underdeveloped nipples reflect prematurity. Reflex stability is not a reliable indicator of gestational age; also, reflexes may be impaired in full-term infants. The simian crease is a single palm crease that is a clinical manifestation of Down syndrome, not of prematurity. Although the nails may be longer in a postterm infant, nail length is not a reliable indicator in a preterm infant.
A pregnant client has labor pains; however, upon assessment, the nurse finds that the cervix is not dilated. Which medication would the nurse identify that could be used to promote labor? A. Oxytocin B. Nifedipine C. Dinoprostone D. Methylergonovine
C. Dinoprostone Dinoprostone induces cervical ripening. This action helps in the induction of labor at term. Oxytocin enhances labor when uterine contractions are weak and ineffective. Nifedipine is a calcium channel blocker used to maintain pregnancy during preterm labor. Methylergonovine reduces postpartum hemorrhage
A woman who is infertile is diagnosed with primary ovarian failure. Which fertility medication regimen would the nurse identify as being used to treat infertility? A. Clomiphene B. Menotropins C. Estrogens D. Choriogonadotropin alfa
C. Estrogens Exogenous administration of estrogens or progestins is used to treat infertility associated with primary ovarian failure. The administration of clomiphene, menotropins, and choriogonadotropin alfa cannot stimulate the ovaries to increase the levels of estrogens or progestins.
A client with frank vaginal bleeding is admitted to the birthing unit at 30 weeks' gestation. The admission data include blood pressure of 110/70 mm Hg, pulse of 90 beats/min, respiratory rate of 22 breaths/min, and fetal heart rate of 132 beats/min. The uterus is nontender, the client is reporting no contractions, and the membranes are intact. In light of this information, which problem would the nurse suspect? A. Preterm labor B. Uterine inertia C. Placenta previa D. Abruptio placentae
C. Placenta previa A nontender uterus and bright-red bleeding are classic signs of placenta previa; as the cervix dilates, the overlying placenta separates from the uterus and begins to bleed. There is no information to indicate that the client is in labor. There is no indication that the client was having contractions that have now ceased. The classic adaptations to abruptio placentae are pain and a rigid boardlike abdomen; dark-red blood may or may not be present.
Before administering a nasogastric feeding to a preterm infant, the nurse aspirates a small amount of residual fluid from the stomach. Which action would the nurse take next? A. Return the aspirate and withhold the feeding. B. Discard the aspirate and administer the full feeding. C. Return the aspirate and administer the full feeding. D. Discard the aspirate and add an equal amount of normal saline solution to the feeding.
C. Return the aspirate and administer the full feeding. The aspirate should be returned to ensure that the gastric enzymes and acid-base balance are maintained. Recent evidence indicates that aspirates should not be subtracted from the feeding volume, as this reduces energy intake. Withholding the feeding will compromise the infant's fluid and electrolyte balance, as will discarding the aspirate from the full feeding. Discarding the aspirate and adding an equal amount of normal saline solution to the feeding will compromise the infant's fluid and electrolyte balance.
A female client who is undergoing infertility testing is taught how to examine her cervical mucus. After listening to the instructions, the client says, "That sounds gross. I don't think I can do it." Which conclusion would the nurse make from this statement? A. The client is unduly fastidious. B. The client feels that having a baby is not that important. C. The client may be uncomfortable with performing manual examination of the genitals. D. The client is afraid that she is the cause of the infertility
C. The client may be uncomfortable with performing manual examination of the genitals. Some women find it emotionally stressful to handle their genitals and discharges. The nurse would need to question the client further to determine if this is the case. The nurse does not have data to support whether the client is unduly fastidious. The nurse would not pass judgment on whether or not the client desires having a baby. Although many women in this situation feel that they are the cause of infertility, this has no bearing on either the nurse's instruction or the client's response.
Which question is most important to ask a client who arrives in the birthing unit with birth imminent? A. "Is this your first baby?" B. "Have your membranes ruptured?" C. "When did your contractions begin?" D. "When is your baby's expected date of birth?"
D. "When is your baby's expected date of birth?" It is most important to know whether this is a preterm or full-term pregnancy so appropriate preparations may be made for the neonate, so the first question is about the baby's expected date of birth. Asking whether this is the client's first baby is irrelevant at this time. Although the client may be asked whether her membranes have ruptured, it is not the priority when a birth is imminent, and prematurity must be known to enable appropriate preparations. The birth is imminent, so asking when her contractions began is also irrelevant at this time.
As part of an infertility workup involving both partners, a male client is to have a semen analysis. Which instruction would the nurse give him? A. Obtain the specimen upon awakening. B. Use a condom to collect the semen specimen. C. Ejaculate at least 4 hours before collection to ensure a pure specimen. D. Deliver the specimen to the laboratory within 2 hours of obtaining it
D. Deliver the specimen to the laboratory within 2 hours of obtaining it Delivering the specimen within 2 hours is necessary to keep the sperm viable for determining sperm count and viability. The specimen can be collected at any time. Rubber solvents, preservatives, or spermicides in a condom may affect the semen specimen. Usual instructions are to not ejaculate for 2 to 3 days before the collection.
A female client is undergoing treatment for infertility. Therapy with clomiphene has been unsuccessful. The nurse anticipates that which treatment will be prescribed next? A. Estrogen B. Progesterone C. Human growth hormone D. Human chorionic gonadotropin
D. Human chorionic gonadotropin Clomiphene is used to induce pregnancy by triggering ovulation. If the desired result is not obtained, the second alternative is to administer human chorionic gonadotropin and gonadotropin-releasing hormone to stimulate ovulation. A combination of estrogen and progesterone is generally administered to treat female clients who have a gonadotropin deficiency. Human growth hormone injections are administered to treat adults with growth hormone deficiency.
The nurse is caring for preterm infants with respiratory distress in the neonatal intensive care unit. Which is the priority nursing action? A. Limiting caloric intake to decrease metabolic rate B. Maintaining the prone position to prevent aspiration C. Limiting oxygen concentration to prevent eye damage D. Maintaining a high-humidity environment to promote gas exchange
D. Maintaining a high-humidity environment to promote gas exchange The moisture provided by the humidity liquefies the tenacious secretions, making gas exchange possible. Caloric intake is increased; the amount, number, and type of feedings are related to the metabolic rate. Infants should be placed in a side-lying rather than a prone position; the prone position is associated with apnea and sudden infant death syndrome. Limiting oxygen concentration to prevent eye damage is not a routine action; the concentration of oxygen depends on the oxygen concentration of the neonate's blood gases.
Which complication of prematurity would the nurse monitor for in a 6-day-old preterm infant in the neonatal intensive care unit? A. Meconium ileus B. Duodenal atresia C. Imperforate anus D. Necrotizing enterocolitis
D. Necrotizing enterocolitis Necrotizing enterocolitis (NEC) is an inflammatory disease of the gastrointestinal mucosa related to several factors (e.g., prematurity, hypoxemia, high-solute feedings); it involves shunting of blood from the gastrointestinal tract, decreased secretion of mucus, greater permeability of the mucosa, and increased growth of gas-forming bacteria, eventually resulting in obstruction. NEC usually manifests 4 to 10 days after birth. Meconium ileus occurs within the first 24 hours when the newborn cannot pass any stool. It is not related to the development of NEC; it is a complication of cystic fibrosis. Duodenal atresia is a congenital defect that occurs early in gestation and is present at birth. Imperforate anus is an anorectal malformation that results in the absence of an external anal opening; it is present at birth
A 41-year-old woman is being seen for an initial visit in the infertility clinic after 3 years of trying to become pregnant. Which test or treatment would the nurse advise her would be done first? A. A laparoscopy B. The start of fertility medication C. A hysteroscopy D. Semen analysis
D. Semen analysis Semen analysis is painless, is less costly than other interventions, and provides important information regarding the male partner's fertility. It can be done at the same time that laboratory tests are being done on the female partner to assess her ovulatory function. Fertility medication would not be initiated until an evaluation of ovulatory function had been completed. Simpler evaluations and therapies are completed before more complex efforts such as surgical procedures like laparoscopy and hysteroscopy are performed.
A client starts to cry and will not touch her infant when she enters the neonatal intensive care unit (NICU) and sees her preterm infant for the first time. Which interpretation of this behavior would most likely be correct? A. Incomplete attachment B. Reaction to the environment C. Expected detachment behavior D. Typical reaction to the situation
D. Typical reaction to the situation Crying in this situation is a typical response; it is expected that the mother will be frightened about touching her small preterm infant. The nurse would provide support and encourage the mother to seek contact with the infant. This is not incomplete attachment but fear in a difficult situation. The reaction to the infant is more complex than merely fear of the NICU. This behavior indicates apprehension in a difficult situation; it is not a detachment behavior.
Which is prevented by providing warm, humidified oxygen to a preterm infant? A. Apnea B. Cold stress C. Respiratory distress D. Bronchopulmonary dysplasia
B. Cold stress By warming and humidifying oxygen, the nurse will prevent cold stress and drying of the mucosa. Apnea and bronchopulmonary dysplasia are not associated with the administration of oxygen that is not warmed or humidified. Respiratory distress can develop in a preterm infant as a result of the cold stress.
Which statement by a new mother observing her preterm infant in the neonatal intensive care nursery indicates that she has not yet begun the bonding process? A. "It's such a tiny baby." B. "Do you think he'll make it?" C. "Why does he need to be in an incubator?" D. "My baby looks so much like my husband."
A. "It's such a tiny baby." By failing to acknowledge the infant as a person, the client indicates that she has not released her fantasy baby and accepted the real baby. Acknowledging the infant by using the word "he" denotes a relationship. Saying that the baby looks like her husband indicates that the mother has incorporated the infant into the family.
A client is crying after undergoing dilation and curettage after an early miscarriage (spontaneous abortion). Which response would the nurse give? A. "This must be a very difficult experience for you to deal with." B. "You'll have other children to take the place of the child you lost." C. "Of course you're sad now, but at least you know you can get pregnant." D. "I know how you feel, but when a woman miscarries, it's usually for the best."
A. "This must be a very difficult experience for you to deal with." Saying that this must be a difficult experience acknowledges the validity of the client's grief and provides the client an opportunity to talk if she wishes. Other children cannot and should not be substituted for a lost fetus. Getting pregnant is not the issue; this statement belittles the lost fetus. The nurse cannot know how the client feels. Stating that a miscarriage is for the best is patronizing and diminishes the significance of the lost fetus.
A client reports irregular menses, weight gain, and difficulty in conceiving. The client is found to have low hormone levels and is prescribed infertility medications. Which nursing interventions would be beneficial to this client? Select all that apply. One, some, or all responses may be correct. A. Monitor vital signs. B. Recommend the self-administration of oral medications. C. Recommend the long-term use of indomethacin orally. D. Encourage the client to track her medications in a journal. E. Administer oral medications to the client when the client wakes up, along with six glasses of water.
A. Monitor vital signs. B. Recommend the self-administration of oral medications. D. Encourage the client to track her medications in a journal. The nurse would monitor the client's vital signs to minimize the risk of hypotension. Journal tracking of medication helps ensure the regular administration of medications. Self-administration of oral medications at home should be encouraged, and proper instructions regarding the administration should be provided to ensure rational use of the medications. The nurse would not advise the long-term oral use of indomethacin because it may cause birth defects. The administration of oral medications upon rising with six glasses of water is the nursing intervention for administration of oral bisphosphonates in the treatment of osteoporosis.
The nurse is teaching a client who has decreased production of estrogen because of menopause about self-management and prevention of complications. Which actions performed by the client would help reduce the complications? Select all that apply. One, some, or all responses may be correct. A. Walking for 30 minutes per day B. Performing weight-bearing activities C. Dressing warmly in cool or cold weather D. Urinating immediately after sexual intercourse E. Keeping within 10 pounds of ideal body weight
A. Walking for 30 minutes per day B. Performing weight-bearing activities D. Urinating immediately after sexual intercourse Because decreased ovarian production of estrogen leads to low bone density, regular exercises are advised, such as walking for 30 minutes per day and performing weight-bearing activities. Decreased ovarian production of estrogen increases the risk of cystitis; therefore, female clients are advised to reduce the risk by urinating immediately after sexual intercourse. Dressing warmly in cool weather would be beneficial to a client with decreased general metabolism because they may have less tolerance to cold. Maintaining body weight within 10 pounds of ideal would be beneficial to a client with decreased glucose tolerance.
A primigravida who is at 40 weeks' gestation arrives at the birthing center with abdominal cramping and a bloody show. Her membranes ruptured 30 minutes before arrival. A vaginal examination reveals 1 cm of dilation and the presenting part at -1 station. Which action would the nurse take after obtaining the fetal heart rate and maternal vital signs? A. Teach the client how to push with each contraction. B. Provide the client with comfort measures for relaxation. C. Prepare to have the client's blood typed and cross-matched. D. Encourage the client to perform patterned, paced breathing.
B. Provide the client with comfort measures for relaxation. The client is experiencing the expected discomforts of labor; the nurse should initiate measures that will promote relaxation. The client is in early first-stage labor; pushing commences during the second stage. There is no evidence that the client's bleeding is excessive or unexpected and that a transfusion will be needed. Patterned, paced breathing should be used in the transition phase, not the early phase of the first stage of labor.
Which medication would the nurse identify as aiding in uterine evacuation in cases of miscarriage? A. Oxytocin B. Misoprostol C. Dinoprostone D. Methylergonovine
C. Dinoprostone Dinoprostone is a prostaglandin E 2 abortifacient that causes uterine evacuation in cases of miscarriage. Oxytocin induces labor by enhancing uterine contractions and promotes milk ejection during lactation. Misoprostol is a stomach protectant that helps in cervical ripening. Methylergonovine is an oxytocic ergot alkaloid used to treat postpartum uterine atony and hemorrhage.
The nurse is teaching a student about adhesives to be used for preterm infants. Which statement by the student indicates effective learning? A. "I should remove the adhesive with solvents or bonding agents." B. "I should remove the adhesive within 24 hours after application." C. "I should avoid semipermeable dressings to secure intravenous lines." D. "I should secure pulse oximeter probes with elasticized dressing material."
D. "I should secure pulse oximeter probes with elasticized dressing material." Elasticized dressing material can effectively secure pulse oximeter probes or electrodes with minimal skin irritation in preterm infants. Adhesive removers, solvents, or bonding agents may result in skin damage in a preterm neonate. The adhesives are removed using water, mineral oil, or petrolatum. The adhesive should not be removed for at least 24 hours after application. Semipermeable dressings can be used to secure intravenous lines and silicone catheters in a preterm neonate.
After a hysterosalpingo-oophorectomy, a client wants to know whether it would be wise for her to take hormones right away to prevent symptoms of menopause. Which response would the nurse give? A. "It's best to wait until a few months after surgery because you may not have any symptoms." B. "Hormone replacement therapy has been associated with increased risk of breast cancer, so it would not be recommended." C. "You have to wait until symptoms are severe; otherwise the hormones will have no effect." D. "There are pros and cons to hormone replacement therapy. I will let your primary health care provider know you would like to discuss this."
D. "There are pros and cons to hormone replacement therapy. I will let your primary health care provider know you would like to discuss this." The use of hormone replacement therapy (HRT) can have benefit to a client who has undergone an oophorectomy. It can prevent menopausal symptoms such as hot flashes and vaginal dryness. It can also increase bone strength. The risks of HRT include an increased risk of breast cancer. The decision to use HRT would involve review of the client's age, medical conditions, and symptoms. The health care provider and client would engage in shared decision-making regarding initiation of HRT. If a client is going to begin HRT, the timing of initiation might depend on the reason it is being used. Stating the HRT will have no effect unless the symptoms are severe is not a true statement.
A 45-year-old client is scheduled to undergo a hysterectomy and expresses concern because she has heard from friends that she will experience severe symptoms of menopause after surgery. Which response would the nurse give? A. "You're right, but there are medicines you can take that will ease the symptoms." B. "Sometimes that happens in women of your age, but you don't need to worry about it right now." C. "You should probably talk to your surgeon, because I am not allowed to discuss this with you." D. "Women may experience symptoms of menopause if their ovaries are removed with their uterus."
D. "Women may experience symptoms of menopause if their ovaries are removed with their uterus." A hysterectomy involves only removal of the uterus. The ovaries, which secrete estrogen and progesterone, are not removed. Menopause will not be precipitated but will occur naturally. Surgical menopause is precipitated by the removal of the ovaries, not the uterus. It would be incorrect to state that there are medicines to help with menopause because menopause would not be caused by the surgery the client will have. When the ovaries are removed, an older woman might have less severe symptoms than a younger woman; however, in this instance the ovaries are not removed. Telling the client that she needs to talk to her surgeon does not answer the question. The nurse should serve as a resource.
The nurse is caring for a preterm infant who is receiving oxygen therapy. Which would the nurse do to prevent retinopathy of prematurity (ROP)? A. Cover the neonate's eyes with a shield. B. Place the neonate in an elevated side-lying position. C. Assess the neonate every hour with a pulse oximeter. D. Support the neonate's oxygen saturation while providing minimal FiO 2.
D. Support the neonate's oxygen saturation while providing minimal FiO 2. ROP is a complex disease of the preterm infant; hyperoxemia is one of the numerous causes implicated. Oxygen therapy is maintained at the lowest level necessary to support respiratory status. If the oxygen concentration needs to be increased to maintain life, ROP may not be preventable. Using a shield over the neonate's eyes will not prevent the development of ROP, nor does positioning or assessment of the neonate every hour with a pulse oximeter alone. If the pulse oximetry results are within an acceptable range, the oxygen concentration may be reduced.