ob 415 exam 4 review
two hours after the vaginal birth under epidural anesthesia, a client with a midline episiotomy ambulates to the bathroom to void. after voiding, the nurse assesses the client's bladder, finding it distended. the nurse interprets this finding based on the understanding that the client's bladder distention is most likely caused by which factor?
edema in the lower urine tract area
what is the appropriate nursing action for a c/s patient that is 24 hours post delivery? -keep NPO for 36 hours -encourage early ambulation -keep on bedrest the first 24 hours -monitor hourly for clonus
encourage early ambulation
the breastfeeding woman is experiencing breast engorgement. nursing education includes? -offer infant formula -stop feeding and use pump every 4 hours -encourage feedings every 2-3 hours -place hot packs on breasts
encourage feedings every 2-3 hours
the nurse is assessing a client at her postpartum checkup 6 weeks after a vaginal birth. the mother is bottle feeding her baby. which client finding indicates a problem at this time? -firm fundus at the symphysis -white, thick vaginal discharge -striae that are silver in color -soft breasts without milk
firm fundus at the symphysis (should not be palpable after 10 days, should be back in the pelvis)
medication commonly used to treat afterpains? -tylenol -tums -aspirin -ibuprofen
ibuprofen
the nurse assesses heavy lochia with clots on assessment. what is the next nursing action? -massage fundus and assess for bladder distention -insert indwelling catheter and monitor urine -run for help -administer oxytocin bolus over 15 minutes
massage fundus and assess for bladder distention
a breastfeeding mom complains of a reddened area on one of her breasts, what does she most likely have? -endometriosis -mastitis
mastitis
which is not an expected finding for someone who had a c/s? -indwelling catheter for 12-24 hours -decreased lochia initially -delayed bowel movement -walking 6 hours postpartum
walking 6 hours postpartum
methylprostaglandin is ordered. the hx and assessment are reviewed. waht information should the nurse be aware? -woman with tachycardia -woman with preeclampsia -woman with drug addiction -woman with asthma
woman with asthma
where would the nurse expect to find the fundus of a woman 24 hours postpartum? -2 finger breadths below umbilicus -1 finger breadth above umbilicus -1 finger breadth below umbilicus -4 finger breadths below umbilicus
1 finger breadth below umbilicus
a G5P5 woman complains of frequent cramping. why is this? -multiparas have more blood loss -multiparas experience afterpains -multiparas require extra doses of oxytocin -multiparas should not experience this
multiparas experience afterpains
a nurse obtains VS for a new PP woman. the pulse is 60. what will the nurse do? -notify the MD immediately -administer atropine IV -place in trandelenburg -nothing this is normal
nothing this is normal
a PP woman that delivered 2 hours ago has a temp of 100.2. what is the first nursing action? -nothing, this is normal -administer tylenol every 4 hours -have woman take a tepid tub bath -call the MD immediately
nothing, this is normal
a nurse finds the fundus at the umbilicus 12 hours PP. what will the nurse do next? -massage and start oxytocin -notify the MD immediately -monitor closely for hemorrhage -nothing, this is normal
nothing, this is normal
the pt is bleeding heavy. her pad weighs 275 gms. what is the blood loss in mls? -550 mls -345 mls -275 mls -135.5 mls
275 mls (1 gm=1ml)
a PP woman is having heavy bleeding. what medication will the nurse give initially? -tylenol 250 mg PO -misoprostol 100 mg PO -oxytocin
oxytocin
on the first postpartum day, the primiparous client reports perineal pain of 5 on a scale of 1-10 that was unrelieved by ibuprofen 800 mg 2 hours ago. the nurse should further assess the client for? -puerperal infection -vaginal lacerations -hx of drug abuse -perineal hematoma
perineal hematoma
a nurse assessment finds the woman's leg is cool to touch and pulse is weak. what should the nurse do next? -have woman ambulate to increase circulation -place on bedrest and notify MD -perform active ROM exercises and massage area -do nothing as this sometimes happens
place on bedrest and notify MD
a 26yo primiparous client is seen in the urgent care clinic 2 weeks acter giving birth to a viable female neonate. the client, who is breastfeeding is diagnosed with mastitis on the right
A
a multigravida pt gave birth vaginally 2 hours ago. a family member notifies the nurse that the pt is pale and diaphoretic
D
a client gave birth vaginally 2 hours ago and has 3rd degree laceration. there is ice in place on her perineum. the perineum is slightly edematous and the client is having pain rate 6 on a scale of 1-10. which nursing intervention would be the MOST appropriate? -begin sitz baths -administer pain medication per prescription -
administer pain medication per prescription
a woman who is bottlefeeding asks about comfort measures for engorgement. the nurse educates? -wear a snug fitting bra 24-7 -apply cabbage leaves inside the bra cups -ice packs to axilla three to four times a day -all of the above
all of the above
which one is not a normal finding after immediate delivery? -tremors -decreased BP -small to moderate bleeding -slowed pulse rate
decreased BP
a client is in the 1st hour of recovery after a vaginal birth. during an assessment, the lochia is moderate, is bright red, and is trickling from the vagina. the nurse locates the fundus at the umbilicus; it is firm and midline who no palpable bladder. the client's VS remain at their baseline. based on this information, the nurse would implement which action? -increase IV rate -recheck the admission H&H -report the findings to the health care provider -document the findings as normal
report the findings to the HCP (tricking indicates laceration)
a woman with 4th degree laceration complains of constipation. appropriate measures include? -stool softeners and increase fluids -cleansing enema and prune juice -suppositories TID -nothing, give her time
stool softeners and increase fluids
a woman receives a rubella injection. what is important education? -she will need a 2nd rubella in 30 days -tell her not to get pregnant for 28 days -nothing additional is needed -she will need a rubella booster in 1 year
tell her not to get pregnant for 28 days (do not want her pregnant while live vaccine is active)
a woman complains of leg pain. the nurse palpates a hard cord-like area of the calf. what does this indicate? -this is a normal PP finding -this is a DVT -this is likely a SVT -massage until the area softens
this is likely a SVT
a woman is 5 days postpartum and states that she cannot stop crying even though she loves her baby and is so happy to be a mother. what education should the nurse give the mother? -this is normal and will subside, evaluate if she has help and getting rest. -you need to see you physician
this is normal and will subside, evaluate if she has help and getting rest.
a patient calls 9 days PP and states sudden onset of heavy bleeding. the nurse suspects? -nothing, this is normal at 9 days postpartum -this may be a retained fragment -this may be her menstrual cycle -this may be a fundal sufflation
this may be a retained fragment
a breastfeeding woman asks about resuming sexual relations. the nurse educates to? -douche after each encounter -use water soluble lubricant -no sex while breastfeeding -nothing special is needed
use water soluble lubricant