ch 20 OB prep u

A nurse finds that a client is bleeding excessively after a vaginal delivery. Which assessment finding would indicate retained placental fragments as a cause of bleeding?

Large uterus with painless dark-red blood mixed with clots

An Rh-positive client vaginally delivers a 6-lb, 10-oz neonate after 17 hours of labor. Which condition puts this client at risk for infection?

Length of labor

When caring for a client with postpartum blues, which intervention would be most appropriate?

Validate the client's emotions, allowing her to express them freely

The majority of women who experience postpartal psychosis had no symptoms of mental illness before pregnancy.

false

A fundal massage is sometimes performed on a postpartum woman. The nurse would perform this procedure to address which condition?

uterine atony

A nurse is caring for a client with idiopathic thrombocytopenic purpura (ITP). Which intervention should the nurse perform first? You selected: Administration of prescribed nonsteroidal anti-inflammatory drugs (NSAIDs) Incorrect

Administration of platelet transfusions as ordered

A nurse is assessing a client with postpartal hemorrhage; the client is presently on IV oxytocin. Which interventions should the nurse perform to evaluate the efficacy of the drug treatment? Select all that apply.

Assess client's uterine tone • Monitor client's vital signs • Get a pad count

A nurse has just received a client from the surgical suite following a cesarean birth. The report given reveals the client has received magnesium sulfate for management of preeclampsia just before the emergency surgery. The nurse should monitor the client for adverse effects from the magnesium sulfate by checking which parameter?

Consistency of the fundus

The nurse is conducting a review class for a group of perinatal nurses about factors that place a pregnant woman at risk for infection in the postpartum period. The nurse determines that additional teaching is needed when the group identifies which factor?

Increased vaginal acidity leading to growth of bacteria

When assessing a postpartum patient who was diagnosed with a cervical laceration that has been repaired, what sign should the nurse report as a possible development of hypovolemic shock?

Weak and rapid pulse

Which of the following would the nurse include in the teaching plan for a postpartal client with a history of thromboembolism to reduce the risk of a recurrence?

Wear support hose or antiembolic stockings

Which clinical manifestation in a woman with deep vein thombosis (DVT) should you report immediately?

dyspnea

A nurse is assessing vital signs for a postpartum patient 48 hours after delivery. The vital signs are: Temp 101.2°F (38.4°C); HR 82 beats/min.; RR 18 breaths/min.; BP 125/78 mmHg. How will the nurse interpret the vital signs?

infection

The nurse assesses the patient who is one hour postpartum and observes a heavy steady gush of bright red blood from the vagina in the presence of a firm fundus. Select the most likely cause of the signs and symptoms.

lacerations

A nurse is caring for a client who has had an intrauterine fetal death with prolonged retention of the fetus. For which signs and symptoms should the nurse watch to assess for an increased risk of disseminated intravascular coagulation? Select all that apply.

• Bleeding gums • Tachycardia • Acute renal failure

Which of the following would lead the nurse to suspect that a postpartum woman has developed metritis? Select all that apply.

• Pain on both sides of the abdomen • Foul-smelling lochia • Leukocytosis

Two weeks after a vaginal delivery, a client presents with low-grade fever. The client also reports a loss of appetite and low energy levels. The health care provider suspects an infection of the episiotomy. What sign or symptom is most indicative of an episiotomy infection?

Foul-smelling vaginal discharge

A nurse is caring for a 38-year-old overweight client 24-hours post cesarean delivery. The client is reporting calf tenderness. Which should the nurse do first?

Have the client rest with the extremity elevated

A nurse is caring for a postpartum client diagnosed with von Willebrand disease. What should be the nurse's priority for this client?

check the lochia

Methylergonovine is ordered for a woman experiencing postpartum hemorrhage. The nurse monitors the woman closely for which of the following adverse effects?

seizure