Women's Health/Disorders and Childbearing Health Promotion (level 2)

A client with endometriosis asks the nurse what side effects to expect from leuprolide (Lupron). What should the nurse include in the response? Weight gain Increased libido Frequent urination Heavy menstrual bleeding

Weight gain Endometriosis (A disorder in which tissue that normally lines the uterus grows outside the uterus.) The nurse should teach the client that the side effects of leuprolide (Lupron) include edema, which causes an increase in weight. Leuprolide decreases libido. Frequent urination is not a side effect of leuprolide. Clients who take leuprolide do not experience menstrual periods, because follicle-stimulating hormone and luteinizing hormone are suppressed.

A client at 16 weeks' gestation is being treated for Trichomonas vaginalis. Which statement best indicates to the nurse that the client has learned measures to prevent a recurrence? "After having sex I'll insert a vaginal suppository." "My partner has to get treated before we have sex again." "I need to urinate immediately after having sexual intercourse." "Douching immediately after sexual intercourse will help protect me."

"My partner has to get treated before we have sex again." The male partner should be treated to prevent the infection from passing back and forth between him and his sexual partner. Inserting a vaginal suppository after having sex is an ineffective remedy and will not prevent a recurrence. The organism is usually present in the partner's urogenital tract; voiding will not prevent a recurrence. A douche is not recommended either during pregnancy or in the nonpregnant state.

A primipara who had a prolonged labor states that she is very tired and asks the nurse to place her newborn son in the nursery while she sleeps. After awakening and having the infant brought back to her, she asks whether she may undress him. How should the nurse respond? "I'll help you undress the baby." "This is important for you. Of course you can undress your baby." "You should wait a few hours, until your baby's temperature has stabilized." "Let's walk back to the nursery. We'll put the baby in a heated crib so you can undress him."

"This is important for you. Of course you can undress your baby." One aspect of the attachment or bonding process is the parents' need to touch, hold, and observe their newborn; this is facilitated by encouraging the mother to undress, gaze at, and hold her newborn. If not asked for help, the nurse should honor the mother's request and encourage her to undress, touch, and hold her baby. A healthy naked newborn can withstand the temperature variation in the mother's room.

On the third postpartum day a client who is breastfeeding calls the clinic complaining of hot, hard, aching breasts. What recommendation should the nurse include in the response? Use ice packs throughout the day. Limit the number of feedings to six per day. Air-dry the breasts for 20 minutes after nursing. Apply warm, moist cloths to both breasts before nursing.

Apply warm, moist cloths to both breasts before nursing. The client is experiencing breast engorgement; warmth is soothing, causes vasodilation, and increases circulation to the breasts, thus promoting easier emptying of the breasts. Ice packs cause vasoconstriction, inhibit circulation, and decrease emptying of the breasts, thus contributing to breast pain. Frequent, not limited, breastfeeding keeps the breasts emptied, increases circulation to the breasts, and helps remove the fluid that causes engorgement. Air-drying is done to toughen the nipples to limit cracking, but it does not help relieve engorgement.

What is the priority nursing intervention during the 2 hours after a cesarean birth? Evaluating fluid needs to maintain optimum hydration Monitoring the incision to help prevent the onset of infection Encouraging bonding to promote mother-infant interaction Assessing the lochia to identify the complication of hemorrhage

Assessing the lochia to identify the complication of hemorrhage The amount and character of the lochia must be checked after a cesarean birth just as they are after a vaginal birth. Although it is important to maintain hydration, preventing hemorrhage is the priority. Although the area of the incision is monitored for signs of hemorrhage, it is too early for evidence of infection. Bonding is an important consideration after the conditions of both mother and newborn have stabilized.

A 25-year-old woman comes to the clinic complaining of increased vaginal discharge, milky gray in color with a "fishy" odor that both she and her husband have noticed. A wet smear is performed and the presence of "clue cells" confirmed. Which type of infection does the nurse suspect? Candidiasis Trichomoniasis Bacterial vaginosis Group B Streptococcus

Bacterial vaginosis Signs of bacterial vaginosis include a milky gray vaginal discharge that has a characteristic fishy odor. "Clue cells" noted on wet smear are indicative of BV. Candidiasis is a yeast infection caused by the organism Candida albicans. The most common symptom of a yeast infection is vulvar and vaginal pruritus. Vaginal discharge in a candidal infection is thick, white, and lumpy. A woman with a trichomoniasis infection may present with a frothy yellowish-green vaginal discharge. Vulvar irritation, pruritus, and dyspareunia are usually present. Group B Streptococcus may be considered part of the normal vaginal flora in a woman who is not pregnant, and no treatment is necessary.

A nurse is teaching a class of expectant parents about changes that are to be expected during pregnancy. What changes does the nurse explain result from the melanocyte-stimulating hormone? Select all that apply. Chloasma Linea nigra Effacement Morning sickness Cervical softening Urinary frequency

Chloasma Linea nigra Melanocyte-stimulating hormone during pregnancy causes pigmentation over the bridge of the nose and cheeks (chloasma, mask of pregnancy). The concentration of melanocyte-stimulating hormone increases from the end of the second month of pregnancy until term, causing in some women a line of pigmentation on the abdomen from the umbilicus to the symphysis pubis (linea nigra). Effacement of the cervix is a result of increased mucoidal secretion and the effects of labor. A high level of chorionic gonadotropin, secreted by the placental chorion, is associated with the nausea and vomiting that may occur early in pregnancy. Cervical softening of the cervix occurs as a result of increased mucoidal secretions and the effects of labor. Urinary frequency is related to advancing growth and pressure of the uterus on the bladder.

After a modified radical mastectomy a client has two portable wound drainage systems in place. What is an important intervention as the nurse cares for these drainage systems? Irrigating the tubes with normal saline to ensure patency Attaching the tubes to straight drainage to monitor the output Leaving the drains open to the air to ensure maximum drainage Compressing the drainage receptacles after emptying them to maintain suction

Compressing the drainage receptacles after emptying them to maintain suction Portable wound drainage systems are self-contained and may be emptied and compressed to reestablish negative pressure, which promotes drainage. Portable wound drainage systems are not irrigated; they drain by way of negative pressure. Portable wound drainage systems have collection chambers, so another drainage system is not needed. Portable wound drainage systems are self-contained closed systems.

The nurse should explain to the newly pregnant primigravida that the fetal heartbeat will first be heard with: A fetoscope around 8 weeks A fetoscope at 12 to 14 weeks Electronic Doppler ultrasonography after 17 weeks Electronic Doppler ultrasonography at 10 to 12 weeks

Electronic Doppler ultrasonography at 10 to 12 weeks The fetal heartbeat can be heard on electronic Doppler ultrasound between 10 and 12 weeks' gestation. Around 8 weeks is too early for the heartbeat to be heard with a fetoscope; a fetoscope can pick up the fetal heartbeat around the 20th week, not at 12 to 14 weeks or before the 17th week. The fetal heartbeat can be heard at least 5 weeks earlier with the use of electronic Doppler ultrasound.

A pregnant client asks the nurse for information about toxoplasmosis during pregnancy. What should the nurse teach the client? Pork and beef should be cooked thoroughly. Toxoplasmosis is a disease that is most prevalent in foreign countries. Raw shellfish are intermediary hosts and should be avoided during pregnancy. Salad dressings made with mayonnaise should be avoided during the summer months.

Pork and beef should be cooked thoroughly. Thorough cooking of pork and beef thoroughly before consumption helps prevent ingestion of the cyst stage of the Toxoplasma protozoa. Even though toxoplasmosis is more prevalent in foreign countries, it occurs in the United States and its prevention should be addressed. Raw shellfish is not related to toxoplasmosis. Salad dressings made with mayonnaise are not linked to toxoplasmosis.

When performing a routine physical assessment on a client who is postmenopausal the nurse determines that the client has enlarged breasts with galactorrhea. For what blood hormone level does the nurse expect the client to be tested? Prolactin Estrogen Oxytocin Progesterone

Prolactin Prolactin is a hormone that is produced and secreted by the anterior pituitary. A pituitary tumor is the most probable cause of an increased prolactin level that results in lactation not associated with childbirth or nursing (galactorrhea). If the client is taking oral contraceptives the estrogen level will increase, causing galactorrhea in some women; this client is postmenopausal. The production of oxytocin is not related to the occurrence of galactorrhea. The production of progesterone is not related to the occurrence of galactorrhea.

A client who is pregnant for the first time and is carrying twins is scheduled for a cesarean birth. What should the nurse tell the client to expect? "We'll give you an enema before the surgery." "We'll be encouraging you to walk early after surgery." "You'll be discharged from the hospital in a week." "You should take sponge baths until the incision is healed."

"We'll be encouraging you to walk early after surgery." Early postoperative ambulation helps prevent such postpartum complications as thrombophlebitis and constipation. An enema is not necessary. Clients who have had uncomplicated cesarean births are generally discharged by the third postpartum day. Clients are permitted to shower after 48 hours or even sooner.

A nurse is caring for a postpartum client. Where does the nurse expect the fundus to be located if involution is progressing as expected 12 hours after birth? 2 cm below the umbilicus 3 cm above the umbilicus 1 cm above the umbilicus 3 cm below the umbilicus

1 cm above the umbilicus Twelve hours after birth the uterus is 1 cm above the umbilicus, and each succeeding day it descends one fingerbreadth. Therefore the uterus should be 2 cm below the umbilicus on the second postpartum day. A uterus 3 cm above the umbilicus indicates that the bladder is full. The uterus is 3 cm below the umbilicus on the fourth postpartum day because the uterus descends one fingerbreadth per day.

A pregnant client tells the nurse that her nose is often so congested that she must breathe through her mouth. How should the nurse respond? "It's common for women to develop allergies during pregnancy." "Increased hormones in your body are responsible for the congestion." "Have you ever had sinusitis? I can take a nasal smear to have it analyzed." "Do you have a sore throat, too? I'll get a tongue blade so I can examine it."

"Increased hormones in your body are responsible for the congestion." Estrogen and progesterone cause increased vascularization and resultant congestion of mucous membranes. It is common for women, including those with allergies, to be relatively allergy free during pregnancy. The nasal congestion is benign. Further intervention is unnecessary unless there are signs of infection.

During a prenatal visit a nurse explains to a client who is Rh negative when Rho(D) immune globulin (RhoGAM) will be administered to her. When is the best time to administer RhoGAM? Within 72 hours of birth if the infant is Rh positive Weekly during the ninth month if the mother is a multipara Immediately after birth if the infant's Coombs test result is positive During the second trimester if an amniocentesis indicates a problem

Within 72 hours of birth if the infant is Rh positive Rho(D) immune globulin (RhoGAM) is given to an Rh-negative mother after birth if the infant is Rh positive and the mother was not previously sensitized. RhoGAM is administered once after birth if the mother was not previously sensitized. The infant's Coombs test result does not influence the timing of the RhoGAM administration. A small dose of RhoGAM may be given prophylactically in the 28th week of gestation if there is a minimal increase in the antibody titer. If there is a significant increase in the antibody titer, amniocentesis is performed. Treatment of the fetus depends on the results of the amniocentesis.

A client seeking advice about contraception asks a nurse about how an intrauterine device (IUD) prevents pregnancy. How should the nurse respond? "It covers the entrance to the cervical os." "The openings to the fallopian tubes are blocked." "The sperm are kept from reaching the vagina." "It produces a spermicidal intrauterine environment."

"It produces a spermicidal intrauterine environment." Intrauterine devices produce a spermicidal intrauterine environment. A copper IUD (ParaGard T380A) inflames the endometrium, damaging or killing sperm and preventing fertilization and/or implantation; a Mirena IUD (LNG-IUS) releases levonorgestrel, damaging sperm and causing the endometrium to atrophy, thus preventing fertilization and/implantation. A diaphragm blocks the cervical os. The IUD does not act by blocking the openings to the fallopian tubes.Preventing sperm from reaching the vagina is the function of a condom.

After the removal of a hydatidiform mole, the nurse assesses the client's laboratory data during a follow-up visit. The nurse notes that a prolonged increase of the serum human chorionic gonadotropin (hCG) level is a danger sign. What condition is a possible outcome? Uterine rupture Choriocarcinoma Hyperemesis gravidarum Disseminated intravascular coagulation (DIC)

Choriocarcinoma hCG increases shortly after the onset of pregnancy, peaks at the end of the second month, then decreases and is sustained at a lower level until the end of pregnancy; a continued increase indicates retained trophoblastic tissue and possible choriocarcinoma. Uterine rupture is characterized by persistent, localized abdominal pain; it does not have a higher incidence in women with hydatidiform mole. Hyperemesis gravidarum cannot occur after termination of a pregnancy. DIC is manifested by shock, bleeding, a low platelet count, and elevated prothrombin time and partial thromboplastin time; it does not have a higher incidence in women with hydatidiform mole.

A nurse discusses breast engorgement with a new mother who is formula feeding her infant. She has remained on the unit because she had a cesarean birth. Which statement causes the nurse to realize that the client needs further teaching? "I know that the pain will go away in a few days." "I'll wear my new bra to help put a stop to the pain." "I'll take some pain medicine if my breasts start to hurt." "I should apply heat to my breasts to ease the discomfort."

"I should apply heat to my breasts to ease the discomfort." Although heat application may help ease the discomfort, it also increases milk flow, which is an undesired outcome; the application of cold is recommended to limit engorgement and ease the discomfort. Engorgement lasts about 48 hours; stating that the pain will go away in a few days indicates that the client requires no further teaching. A supportive brassiere will help suppress milk production; the client's statement that she plans to wear one indicates that no further teaching is needed. Analgesics will help lessen the discomfort of engorgement; the client's statement that she plans to use pain medication to ease the pain indicates that no further teaching is needed.

What is dyspareunia?

Difficult or painful sexual intercourse.

A client who wishes to postpone having children until she and her husband are financially sound tells the nurse she has been taking oral contraceptive pills for several years. What finding indicates a potential risk in regard to continued use of birth control pills? Dysmenorrhea Lack of ovulation Midcycle bleeding Increased blood pressure

Increased blood pressure The estrogen and/or progesterone in birth control pills increases the amount of renin produced in the kidneys. Increased renin will stimulate the production of angiotensin, a potent pressor substance, resulting in hypertension. Dysmenorrhea does not occur. Anovulation is the desired effect of oral contraceptives. Midcycle bleeding may indicate a low hormone level; it is corrected by changes in the type of medication prescribed.

A nurse watches as a new mother timidly approaches her critically ill preterm son for the first time in the neonatal intensive care unit. Which statement by the nurse would best foster the bonding process between the mother and her baby? "I'll teach you how to take care of him." "He'll gain weight gradually, and it won't be long till he'll start to look better." "I know it's hard for you to see him like this, hooked up to so many machines, and you don't know what to expect." "Many mothers are shocked when they first see their babies; you'll see him grow."

"I know it's hard for you to see him like this, hooked up to so many machines, and you don't know what to expect." Focusing on the client's feelings permits her to work through her fears, which she must do before she can focus on her son and his care. Telling the client that the infant will gain weight and look better gradually or that that she will see her baby grow is false reassurance; the focus should be on the mother's feelings at this time, not her infant's future.

A client who is visiting the family planning clinic is prescribed an oral contraceptive. As part of teaching, the nurse plans to inform the client of the possibility of: Cervicitis Ovarian cysts Fibrocystic disease Breakthrough bleeding

Breakthrough bleeding Breakthrough bleeding, or midcycle bleeding, commonly occurs when women start using oral contraceptives. If it persists, the dosage should be changed. There is no evidence that cervicitis, ovarian cysts, or fibrocystic disease is related to the use of oral contraceptives.

A nurse is reviewing a postmenopausal client's history, which reveals that the client previously received hormonal replacement therapy (HRT) as treatment for osteoporosis. For which problem does HRT increase the client's risk? Breast cancer Rapid weight loss Accelerated bone loss Vaginal tissue atrophy

Breast cancer There is a relationship between HRT that combines estrogen and progesterone compounds and an increased incidence of invasive breast cancer. One side effect of HRT is weight gain with ankle and foot edema. Bone loss is retarded with HRT. Vaginal tissue maintains turgor and lubrication with HRT.

The clinic nurse is planning care for a client found to have Chlamydia. Which treatment should the nurse plan to implement? Administration of acyclovir (Zovirax) 250 mg orally in a single dose Administration of azithromycin (Zithromax) 1 g orally in a single dose Administration of ceftriaxone (Rocephin) 250 mg intramuscularly in a single dose Administration of Benzathine penicillin G 2.4 million units intramuscularly in a single dose

Administration of azithromycin (Zithromax) 1 g orally in a single dose The treatment of choice for chlamydial infection is azithromycin (Zithromax) 1 g orally in a single dose. The one-dose course is preferred because of its ease of completion. Acyclovir (Zovirax) may be prescribed in a 7-day course for a genital herpes outbreak. Ceftriaxone (Rocephin) 250 mg intramuscularly in a single dose is the drug therapy recommended for gonorrhea. Benzathine penicillin G given intramuscularly as a single 2.4 million unit dose is the treatment for primary, secondary, and early latent syphilis.

A client who has been breastfeeding her newborn every 3 hours experiences sore nipples. What should the nurse teach her about easing nipple soreness? Use breast shields at each feeding. Wash with mild soap when cleansing the nipples. Change the baby's breastfeeding position for each feeding. Allow just the edge of the nipple to be placed in the baby's mouth.

Change the baby's breastfeeding position for each feeding. If the infant's position is changed for each feeding, the infant will exert pressure on different areas of the nipples while suckling, thereby decreasing the possibility of soreness from constant pressure on one site. Persistent use of nipple shields does not foster effective breastfeeding; the rubber nipple of the shield may cause infant "nipple confusion." The nipples should not be washed with soap, which can cause further irritation. The entire nipple and surrounding areolar tissue should be in the infant's mouth.

A practitioner orders doxycycline (Vibramycin) for a sexually active woman with a history of a mucopurulent discharge and bleeding associated with cervical dysplasia, dysuria, and dyspareunia. With which sexually transmitted infection are these clinical findings and medication therapy commonly associated? Herpes simplex 2 Chlamydial infection Treponema pallidum Neisseria gonorrhoeae

Chlamydial infection The signs and symptoms listed and the treatment ordered (doxycycline or azithromycin) indicate that the client has a chlamydial infection. Painful blisters on the genitalia, fever, malaise, dysuria, and dyspareunia are signs of herpes simplex virus 2 infection. Chancre formation is a sign of primary syphilis; a symmetrical rash accompanied by malaise, fever, anorexia, and headache is indicative of secondary syphilis. Dysuria, heavy greenish-yellow purulent discharge, and swollen Bartholin glands are signs of gonorrhea.

A client in labor is receiving an oxytocin (Pitocin) infusion. What should the nurse do first when repetitive late decelerations of the fetal heart rate are observed? Administer oxygen. Place the client on the left side. Discontinue the oxytocin infusion. Check the client's blood pressure.

Discontinue the oxytocin infusion. The infusion should be stopped because it is the likely source of fetal compromise. Administering oxygen may not be necessary if late decelerations cease with other interventions. Placing the client on the left side should be done after the oxytocin infusion is discontinued. The client's blood pressure may be checked, but this is not the priority.

What should the nurse emphasize in a class about childbirth? Birth as a family experience Labor without the use of analgesics Education, exercise, and breathing techniques Hydration, relaxation, and pain control during labor

Education, exercise, and breathing techniques The objective of childbirth classes is to adequately prepare parents for childbearing. Birth as a family experience is only part of the class content. Labor without the use of analgesics is not an absolute; in most childbirth methods parents are informed that analgesics are available if necessary. Hydration, relaxation, and pain control during labor is only part of the class content.

At 22 weeks' gestation a client visits the prenatal clinic for the first time. As part of the prenatal workup, the client has blood work performed. The nurse concludes that further assessment is indicated when the laboratory findings show a: Hemoglobin of 10 g/dL Sedimentation rate of 15 mm/hr Blood glucose level of 115 mg/dL White blood cell (WBC) count of 9000/mm3

Hemoglobin of 10 g/dL (he normal range for hemoglobin is: For men, 13.5 to 17.5 grams per deciliter. For women, 12.0 to 15.5 grams per deciliter.) A hemoglobin reading below 11 g/dL suggests true anemia rather than physiologic anemia; this occurs because the plasma volume increases more than the red blood cell count during pregnancy, especially during the second trimester. The sedimentation rate in women is up to 20 mm/hr; no further assessment is necessary, because this is an expected value. The normal blood glucose level ranges from 70 to 105 mg/dL; a slightly increased level is common during pregnancy. A WBC count of 5000 to 10,000/mm3 is within expected limits; no further assessment is necessary.

A nurse is teaching a female client how to use a diaphragm to prevent pregnancy. What information should the nurse include? The dome must be facing down to maximize its effectiveness. Spermicidal lubricants are unnecessary for the diaphragm to be effective. It should remain in place for at least 6 hours after intercourse to be effective. Puckering on the surface of the diaphragm does not interfere with its effectiveness.

It should remain in place for at least 6 hours after intercourse to be effective. The diaphragm should remain in place for at least 6 hours after intercourse; if coitus occurs within those 6 hours, additional spermicide should be added, after which the 6-hour time frame begins again. The diaphragm may be inserted with the dome facing up or down and still will be effective. The diaphragm must always be used with a spermicide to be effective, because the diaphragm may be displaced in some positions. Puckering, especially near the rim, may indicate thin spots that can rupture during intercourse; the diaphragm should not be used if puckering is present.

Contraceptives that contain estrogen-like and/or progesterone-like compounds are prepared in a variety of forms. Which contraceptives should the nurse tell clients have a hormonal component? Select all that apply. Oral drugs Diaphragm Cervical cap Female condoms Foam spermicide Transdermal agents

Oral drugs Transdermal agents Oral agents have a hormonal component. Transdermal agents have a hormonal component. The diaphragm acts as a barrier. The cervical cap acts as a barrier. The female condom acts as a barrier. Foam spermicides kill the sperm; there is no hormonal effect.

A left modified radical mastectomy is performed on a client with breast cancer. What is the most important measure to be included in the care plan for the first postoperative day? Having someone from Reach to Recovery visit the client Emptying the portable wound drainage system after each shift Keeping the left arm and shoulder immobile until drainage ceases Placing the client in the semi-Fowler position with the left arm and hand elevated

Placing the client in the semi-Fowler position with the left arm and hand elevated Placing the client in the semi-Fowler position with the left arm and hand elevated promotes drainage from the operative site by means of gravity, thereby preventing edema. Basic physiologic needs must be met first; because of shortened hospital stays, Reach to Recovery visits may be made in the home. The portable wound drainage system is emptied as necessary, usually when it becomes half full. Arm mobility should be encouraged. Using the arm for activities of daily living helps prevent lymphedema. Initially abduction of the arm on the affected side should be limited to prevent tension on the suture line.

The nurse is taking the health history of a client who has been admitted for repair of a cystocele and rectocele. What signs or symptoms would the nurse expect the client to report? White vaginal discharge and itching Sporadic bleeding and abdominal pain Increased temperature and intractable diarrhea Stress incontinence and low abdominal pressure

Stress incontinence and low abdominal pressure As the uterus drops, the vaginal wall relaxes. When the bladder herniates into the vagina (cystocele) and the rectal wall herniates into the vagina (rectocele), the individual feels pressure or pain in the lower back and/or pelvis. When there is an increase in intraabdominal pressure in the presence of a cystocele, incontinence results. A white vaginal discharge (leukorrhea) and vaginal itching (pruritus) do not indicate cystocele and rectocele; they are common with a vaginal infection. Sporadic bleeding is not expected with cystocele and rectocele. Increased temperature and intractable diarrhea are not expected with cystocele and rectocele; a fever would indicate an infection; constipation, not diarrhea, is more likely to occur.

A nurse is evaluating a client's understanding regarding postoperative concerns after mastectomy. Which development near and around the incision noted by the client should be reported to her practitioner? Persistent itching Decreased sensation Swelling with erythema Irregular-appearing skin

Swelling with erythema Swelling and erythema are signs of infection and should be reported to the health care provider. Itching is a sign of healing that is expected. Decreased sensation results from the severing of nerves and formation of scar tissue and is expected. There is little subcutaneous fat in the thoracic area, and the skin may be taut at the operative site, appearing irregular; this commonly occurs.

After a client undergoes a biopsy for suspected cervical cancer, the laboratory report reveals a stage 0 lesion. What does a nurse conclude about this client's stage of cancer? The lesion is carcinoma in situ. There is early stromal invasion. There is parametrial involvement. The cancer is confined to the cervix.

The lesion is carcinoma in situ. According to the International Federation of Gynecology and Obstetrics, stage 0 is indicative of preinvasive cancer. When cancerous cells are completely confined within the epithelium of the cervix without stromal invasion, it is deemed stage 0 and called carcinoma in situ. Early stromal invasion is stage IA; there is minimal stromal invasion. Parametrial involvement, stage II, involves the area around the broad ligaments but not the pelvic wall; there is extension to the corpus of the uterus. Cancer confined to the cervix is classified as stage I.

Before discharge, what suggestion should the nurse give to a non-nursing mother to help limit breast engorgement? Wear a supportive bra. Stop drinking milk for 1 week. Take an analgesic every 4 hours. Apply warm compresses to the breasts.

Wear a supportive bra. Wear a tightly fitted brassiere. (other question) Wearing a supportive brassiere provides greater comfort when engorgement occurs 36 hours after birth; engorgement lasts about 1 to 2 days. Milk and fluids should not be restricted during the postpartum period. Medication will ease pain but will not limit further engorgement. Cold, not warm, compresses will limit further engorgement in the non-nursing mother.