OB exam 1

The nurse administers Rho (D) immune Globulin to an RH-negative client after delivery of an RH-positive newborn based on the understanding that this drug will prevent her from:

Developing our RH sensitivity

A deviated fundus to the right side of the ad abdomen would indicate____________.

Distended bladder

Immediately after childbirth in the recovery area, the nurse observes the mothers partners fascination an interest in their son. This behavior is often termed?

Engrossment

Fathers or partners go through three stages in their development process: __________, reality, and transition to mastery.

Expectations

A woman typically experiences tachycardia after delivery. True or false

False

During the first 24 hours postpartum, he does use to provide perineal comfort. True or false

False

Intravenous Anticoagulant therapy to treat thrombotic conditions involves the use of warfare and true or false

False

Lochia typically begins as lochia serosa. True or false

False

The most common cause of postpartum hemorrhage is retained placental fragments true or false

False

The postpartum period begins with the birth of the newborn true or false

False

Thromboembolism leads to thrombophlebitis. True or false

False

cardiac output Quickly returns to non-pregnant values after birth. True or false

False

The day after delivery, a woman, whose fundus is firm at 1 cm below umbilicus and who has moderate lochia, tells the nurse that something is wrong: all I do is go to the bathroom. Which of the following is an appropriate nursing response?

Informed the client that polyuria is normal

A nurse is discussing breast-feeding with a post partum client. Which of the following statements should the nurse include?

Initiate breast-feeding within the first hour of birth for a newborn who is stable. The client in the newborn should be allowed to continue skin to skin contact until the newborn has breast-fed

A prolapse of the uterine fundus to or through the cervix so that the uterus is turned inside out after birth is called uterine ________.

Inversion

A nurse is providing discharge instructions to a postpartum client following a cesarean birth. The client reports leaking urine every time they sneeze or cough. Which interventions should the nurse suggest?

Kegel exercises

A nurse is caring for a client who is eight hour postpartum and begins to hemorrhage. Which of the following actions should the nurse take first?

Massage the clients fundus. The greatest risk to this client is injury from hemorrhage. The nurse is priority intervention is to prevent excessive bleeding. The nurse should massage the uterus to expel clots to allow the uterus to contract. Uterine massage facilitate improved uterine tone.

________ Is an infectious condition involving the endometrium, decidua, and myometrium.

Metritis

A nurse is performing a fundal assessment for a client who is 2 days postpartum and observes the perineal pad for lochia. The pad is saturated approximately 12 cm with lochia that is bright red and contains small clots. Which of the following should the nurse document?

Moderate lochia rubra

A nurse is discussing proper positioning techniques with a post partum client who is breast-feeding. Which of the following information should the nurse include

Nose cheeks and chin should touch the breast during the feeding

Lochia serosa

Pink, serous, and blood-tinged vaginal discharge that follows lochia rubra and lasts until the 7th to 10th day after birth.

A nurse in the delivery room is planning to promote parent-infant bonding for a client who just delivered. Which of the following is the priority action by the nurse?

Position the neonate skin-to-skin

The nurse is preparing to place a Perry pad on the perineum of a client who delivered her baby 10 minutes earlier. The client states I don't wear those. I always use tampons. Which of the following action by the nurse is appropriate at this time?

State that it is unsafe to place anything into the vagina until involution is complete

_________ Or swelling of the breast tissue occurs usually 2 to 4 days after birth.

engorgement

A nurse is discussing risks factors for urinary tract infections with a newly licensed nurse. which of the following conditions should the nurse include in the teaching?

epidural anesthesia urinary bladder catheterization frequent pelvic examinations history of UTIs

A nurse is caring for a postpartum client who delivered their third infant 2 days ago. Which of the following manifestations could indicate postpartum depression?

fatigue insomnia flat affect

A nurse is completing postpartum discharge teaching to a client who had no immunity to varicella and was given the varicella vaccine. Which statement by the client indicates understanding of teaching?

"I need a second vaccination at my postpartum visit."

A nurse is reviewing discharge teaching with a client who has a urinary tract infection. Which of the following statements by the client indicates understaNDING OF THE TEACHING?

"I will drink large amounts of fluids to flush the bacteria from my urinary tract" "I will take Tylenol for any discomfort"

A nurse is conducting a home visit for a client who is 1 week postpartum and breastfeeding. The client reports breast engorgement. Which of the following recommendations should the nurse make?

"apply cold compresses between feedings."

A nurse is teaching a client who is breastfeeding and has mastitis. Which of the following responses should the nurse make?

"completely empty each breast at each feeding or use a pump"

A nurse is providing discharge teaching for a nonlactating client. Which instructions should the nurse include in the teaching?

"wear a supportive bra continuously for the first 72 hrs"

A nurse is caring for a clie t who is 2 days postpartum. The client states, "My 4-year old son was toilet trained and now he is frequently wetting himself." Which statements should the nurse provide to the client?

"your son is showing an adverse sibling response"

Postpartum hemorrhage is defined as a blood loss of greater than ___________ milliliters after a cesarean birth.

1000

A client informed the nurse that she intends to bottlefeed her baby. Which of the following actions should the nurse encourage the client to perform? Select all that apply 1. Increase her fluid intake for a few days. 2. I'll play heat to her axillae 3. Stand with your back towards the shower. 4. Where is supportive bra 24 hours a day. 5. Massage your breast every 4 hours

3. Stand with your back towards the shower. 4. Where is supportive bra 24 hours a day.

A G2 P2002, who is postpartum 6 hours from a spontaneous vaginal delivery, is assessed. The nurse notes that the fundus is firm at the umbilicus, there is heavy lochia rubra, and perineal sutures are intact. Which of the following actions should the nurse take at this time? 1. Do nothing. This is a normal finding. 2. Massage the woman's fundus. 3. Take the woman to the bathroom to void. 4. Notify the woman's primary health care provider.

4. Notify the woman's primary health care provider.

After a clients placenta is birth, the obstetrician states, please add 20 units of oxytocin to the intravenous and increase the drip rate to 250 mL/hr. The client has 750 mL in her IV and the IV tubing delivers fluid at the rate of 10 gtt/mL. To what drip rate should the nurse said the intravenous?

42 gtt/min

During ambulation to the bathroom, a postpartum client experiences a gush of dark red blood that soon stops. On assessment, a RN finds the clients uterus to be firm, midline & at the level of the umbilicus. The nurse interprets this finding as?

A normal postural discharge of lochia

When assessing a post partum woman, which of the following would lead you to suspect postpartum blues?

Periodic crying and insomnia

A client who is breast-feeding her newborn tells the nurse, I noticed that when I feed him, I feel fairly strong contractions like pain. Labor is over. Why am I having contractions now? Which response by the nurse would be most appropriate?

The baby sucking release is a hormone that causes the uterus to contract

A slight temperature elevation is normal during the first 24 hours after delivery. True or false

True

______ Refers to uterine contractions that occur after birth.

afterpains

The uterus returns to its normal size through a process called __________.

involution

A nurse is planning care for a client who is postpartum and has thrombophlebitis. Which of the following nursing interventions should the nurse include in the plan of care?

measure leg circumferences

A nurse is assessing a postpartum client who is exhibiting tearfulness, insomnia, lack of appetite, and a feeling of letdown. Which of the following conditions are associated with these manifestations?

postpartum blues

A nurse is caring for a client who has disseminated intravascular coagulation (DIC). Which of the following antepartum complications should the nurse understand is a risk factor for this condition?

preeclampsia

A nurse is caring for a client who has mastitis. Which of the following is the typical causative agent of mastitis?

staphylococcus aureus escherichia coli streptococcus

lochia

the postpartum vaginal discharge that typically continues for 4-6 weeks after childbirth

A nurse is assessing postpartum client for fundal height, location, and consistency. The fundus is noted to be displaced laterally to the right, and there is uterine atony. The nurse should identify which of the following conditions as the cause of the uterine atony.

urine retention

A nurse is caring for a client who is 1 day postpartum. The nurse is assessing for maternal adaptation and parent-infant bonding. Which of the following behaviors by the client indicates a NEED FOR THE NURSE TO INTERVENE?

~Demonstrates apathy when the newborn cries ~Views the newborn's behavior as uncooperative during diaper changing

A nurse on the postpartum unit is assessing a client who is being admitted with a suspected deep-vein thrombosis (DVT). Which of the following clinical findings should the nurse expect?

~calf tenderness to palpation ~elevated temperature ~area of warmth

A client is suspected of having a ruptured ectopic pregnancy. Which assessment with the nurse identify as a priority?

Hemorrhage

On admission to the labor and delivery unit, a clients hemoglobin was assessed at 11g/dL and her hematocrit at 33%. Which of the following values with the nurse expect to see two days after a normal spontaneous vaginal delivery Hgb 12.5 g/dL; Hct 37% Hgb 11 g/dL; Hct 33% Hgb 10.5 g/dL; Hct 31% Hgb 9 g/dL; Hct 27%

Hgb 10.5 g/dL; Hct 31%

_____ Exercises help to strengthen the pelvic floor muscles.

Kegel

A nurse is caring for a client who is to our postpartum. Which of the following factors should the nurse identify as a risk factor for postpartum hemorrhage?

Prolonged labor is a risk factor for the development of postpartum hemorrhage. Prolong labor results and stimulation of the uterine muscle for an extended amount of time, which may cause you're in atony and possible hemorrhage.

A nurse concludes that the parent of a newborn is not showing positive indications of parent-infant bonding. The parent appears very anxious and nervous when asked to bring the newborn to the other parent. Which of the following actions should the nurse use to promote parent-infant bonding?

Provide education about infant care when the parent is present

The nurse is assessing a post partum woman. Which finding would lead the nurse to suspect that a postpartum woman is having a problem?

Pulse rate of 110 BPM

A nurse is assessing a client who is postpartum and has saturated for pads in one hour. Which of the following findings is a manifestation of hemorrhage shock?

Rapid shallow respirations is a manifestation of hemorrhage shock. Other clinical findings include rapid, weak, irregular pulse, decreased urinary output, cool pill, clammy skin, hypotension, lethargic, anxiety.

A nurse is discussing the benefits of breast-feeding with a post partum client. Which of the following benefits to the newborn should the nurse include?

Reduces the risk of otitis media sudden infant death syndrome obesity lower respiratory tract infections type one and two diabetes Celiac disease asthma eczema non-specific gastrointestinal infections.

The nurse would expect the post partum woman to demonstrate lochia in which sequence? Rubra, serosa, alba Alba, serosa, rubra Rubra, Alba, serosa Serosa, Alba, rubra

Rubra, serosa, Alba

A nurse is providing discharge instructions for a client. At 4 weeks postpartum, the client should contact the provider for which of the following client findings?

Sore nipple with cracks and fissures

Post partum wound infections are usually not identified until the woman has been discharged from the hospital. True or false

True

Profuse diaphoresis is common during the early postpartum period. True or false

True

Pulmonary embolism is a major cause of maternal mortality. True or false

True

The post partum woman's bladder should be non-palpable. True or false

True

The postpartum woman commonly exhibits bradycardia. True or false

True

A nurse is providing care to a postpartum woman. The nurse determines that the client is in the taking in phase based on Which finding?

Client states, he has my eyes and nose

After teaching parents about their newborn, the nurse determines that the teaching was successful when they identify which concept as reflecting the enduring nature of the relationship involving place in the infant at the center of their lives and finding their own way to assume the parental identity

Commitment

_________ Refers to the enduring nature of the attachment relationship.

Commitment

A nurse is providing care to four clients on the postpartum unit. Which of the following clients is at greatest risk for developing a postpartum infection?

A client who does not wash their hands between perineal care and breastfeeding

A client who has just given birth to a healthy newborn required and episiotomy. Which action would the nurse implement immediately after birth to decrease the clients pain from the procedure?

Applying ice pack to the site

A nurse is caring for a client who is eight hour postpartum. The nurse palpates the fundus at two fingerbreadths above the umbilicus and deviated to the right. Which of the following actions should the nurse take?

Assist the client to void Bladder distention may cause you to run to Tony and excessive bleeding therefore, the priority action is to assist the client to void to facilitate emptying of the bladder.

The development of strong affectional ties between an infant and significant other defines the process of ______ .

Attachment

A nurse is performing postpartum assessment on a client who delivered by cesarean section. Which of the following actions will the nurse perform select all that apply Auscultate the abdomen assess nipple integrity palpate the fundus assess the central venous pressure auscultate the lung fields

Auscultate the abdomen assess nipple integrity palpate the fundus auscultate the lung fields

A primipara client gave birth vaginally to a healthy newborn girl 12 hours ago. The nurse palpates the client's fundus, expecting it to be: A) Two fingerbreadths above the umbilicus B) At the level of the umbilicus C) Two fingerbreadths below the umbilicus D) Four fingerbreadths below the umbilicus

B At the level of the umbilicus

Postpartum ________ Are usually self-limiting and required no formal treatment other than support and reassurance.

Blues

a nurse is caring for a client who Is experiencing hemorrhage postpartum hemorrhage and has a prescription for methylergonovine. Which condition is a contra indication with this medication?

The nurse should identify preeclampsia as a contraindication for methylergonovine. Other contraindications include hypertension and cardiac disease. Methylergonovine is a uterotonic medication to manage postpartum hemorrhage. The nurse should notify the provider of the contraindication.

Is soft, boggy uterus that deviates from the midline suggest a full bladder interfering with your router and involution. True or false

True

And inflammation of the breast is termed ________.

Mastitis

Lochia _______ occurs from postpartum days 10 to 14.

alba

A nurse is assisting a post partum client who had a cesarean birth with breast-feeding her newborn. Which of the following breast-feeding positions should the nurse suggest for this client?

Football hold clutch hold

The nurse is evaluating the involution of a woman who is three days postpartum. Which of the following findings with the nurse evaluate as normal?

Fundus 3 cm below the umbilicus, lochia serosa

A nurse on the postpartum unit is caring for four clients. Which of the following clients should the nurse recognize as the greatest risk for development of a postpartum infection?

a client who had premature rupture of membranes and prolonged labor

A client in the early postpartum period is very excited and talkative. They repeatedly tell the nurse every detail of the labor and birth. Because the client will not stop talking, the nurse is having difficulty completing the postpartum assessments. Which of the following action should the nurse take?

Give the client time to express feelings

A nurse is caring for a newborn immediately following birth. Which of the following actions should the nurse take first?

Greatest risk to the newborn injury from hypothermia, therefore, the priority action is to place the newborn skin to skin with the client immediately following birthday.

Upon entering the room of a client who has had a spontaneous abortion, the nurse observes the client crying. Which response by the nurse would be most appropriate?

I'm sorry you lost your baby

A woman who is bottlefeeding should use _______ packs to alleviate the discomfort of engorgement.

Ice

A post operative cesarean section woman is to receive morphine 4 mg q 3-4 h subcutaneous for pain. The morphine is available on the unit in premeasured syringes 10 mg per 1 mL. Each time the nurse administer the medication, how many milliliters of morphine will be wasted? Calculate to the nearest 10th

0.6mL

A mother choosing to breast-feed or lactate requires an additional ______ calories per day.

500

A nurse is caring for a client who is postpartum. The nurse should identify which of the following findings as an early indicator of hypovolemia caused by hemorrhage?

Increasing pulse and decreasing blood pressure

A woman just had a macrosomic baby after a 12 hour labor. For which of the following complications shut the woman be carefully monitored?

Urine atony

During a postpartum assessment, the nurse assesses the calves of a clients legs. The nurse is checking for which of the following signs/symptoms? Select all that apply Ecchymosis Warmth Redness Pain Discharge

Warmth Redness Pain

A nurse is caring for a client who has postpartum psychosis. Which of the following actions is the nurse's priority?

ask the client if they have thoughts of harming themselves or their infant

A nurse is providing education to a client who is 2 hr postpartum and has perineal laceration. Which of the following information should the nurse include?

~Use a perineal squeeze bottle to cleanse the perineum ~Apply a topical anesthetic cream or spray to the perineum ~Apply cold or ice packs to the perineum

A nurse is assessing a client who has postpartum depression. The nurse should expect which of the following manifestations?

~concerns about lack of income to pay bills ~anxiety about assuming a new role as a parent ~rapid decline in estrogen and progesterone ~feeling of inadequacy with the new role as a parent

A nurse educator on the postpartum unit is reviewing risk factors for postpartum hemorrhage with a group of nurses. Which of the following factors should the nurse include in the teaching?

~precipitous delivery ~inversion of the uterus ~retained placental fragments