unit 7 maternal success book

A postoperative cesarean section woman is to receive morphine 4 mg q 3-4 h subcutaneously for pain. The morphine is available on the unit in premeasured syringes 10 mg/1 mL. Each time the nurse administers the medication, how many milliliters (mL) of morphine will be wasted? Calculate to the nearest tenth.

0.6ml

The nurse is caring for a breastfeeding mother who asks advice on foods that will provide both vitamin A and iron. Which of the following should the nurse recommend?

1 1/2 cup raw broccoli.

A breastfeeding woman has been counseled on how to prevent engorgement. Which of the following actions by the mother shows that the teaching was effective?

She feeds her baby every 2 to 3 hours.

A 3-day-postpartum client questions why she is to receive the rubella vaccine before leaving the hospital. Which of the following rationales should guide the nurse's response?

The client's obstetric status is optimal for receiving the vaccine

A client, 2 days postoperative from a cesarean section, complains to the nurse that she has yet to have a bowel movement since the surgery. Which of the following responses by the nurse would be appropriate at this time?

"Fluids and exercise often help to combat constipation. Take a stroll around the unit and drink lots of fluid."

A 2-day-postpartum breastfeeding woman states, "I am sick of being fat. When can I go on a diet?" Which of the following responses is appropriate?

"Many mothers lose weight when they breastfeed because the baby consumes about 600 calories a day."

The nurse is caring for a client who had an emergency cesarean section, with her husband in attendance, the day before. The baby's Apgar was 9/9. The woman and her partner had attended childbirth education classes and had anticipated having a water birth with family present. Which of the following comments by the nurse is appropriate?

"With all of your preparations, it must have been disappointing for you to have had a cesarean."

A breastfeeding client, 7 weeks postpartum, complains to an obstetrician's triage nurse that when she and her husband had intercourse for the first time after the delivery, "I couldn't stand it. It was so painful. The doctor must have done something terrible to my vagina." Which of the following responses by the nurse is appropriate?

"Women who breastfeed often have vaginal dryness. A vaginal lubricant may remedy your discomfort."

A 3-day-breastfeeding client who is not immune to rubella is to receive the rubella vaccine at discharge. Which of the following must the nurse include in her discharge teaching regarding the vaccine?

The woman should not become pregnant for at least 4 weeks.

The nurse is caring for a postpartum client who experienced a second-degree perineal laceration at delivery 2 hours ago. Which of the following interventions should the nurse perform at this time?

1. Apply an ice pack to the perineum.

The obstetrician has ordered that a post-op cesarean section client's patient-controlled analgesia (PCA) be discontinued. Which of the following actions by the nurse is appropriate?

1. Discard the remaining medication in the presence of another nurse.

A client is receiving an epidural infusion of a narcotic for pain relief after a cesarean section. The nurse would report to the anesthesiologist if which of the following were assessed?

1. Respiratory rate 8 rpm.

A client who is 3 days postpartum asks the nurse, "When may my husband and I begin having sexual relations again?" The nurse should encourage the couple to wait until after which of the following has occurred?

1. The client has had her six-week postpartum checkup.

The nurse is discussing the importance of doing Kegel exercises during the postpartum period. Which of the following should be included in the teaching plan?

2. She should practice by stopping the urine flow midstream every time she voids.

A breastfeeding woman, 11 /2 months postdelivery, calls the nurse in the obstetrician's office and states, "I am very embarrassed but I need help. Last night I had an orgasm when my husband and I were making love. You should have seen the milk. We were both soaking wet. What is wrong with me?" The nurse should base the response to the client on which of the following?

2. The same hormone stimulates orgasms and the milk ejection reflex.

Which of the following statements is true about breastfeeding mothers as compared to bottle-feeding mothers?

2. Breastfeeding mothers have decreased incidence of diabetes mellitus later in life.

A breastfeeding client, G10 P6408, delivered 10 minutes ago. Which of the following assessments is most important for the nurse to perform at this time?

2. Fundus.

During a home visit, the nurse assesses a client 2 weeks after delivery. Which of the following signs/symptoms should the nurse expect to see?

2. Lochia alba.

A woman is receiving patient-controlled analgesia (PCA) post-cesarean section. Which of the following must be included in the patient teaching?

2. The client should report any feelings of nausea or itching to the nurse.

A client informs the nurse that she intends to bottle feed her baby. Which of the following actions should the nurse encourage the client to perform? Select all that apply.

Wear a supportive bra 24 hours a day Stand with her back toward the shower water.

A post-cesarean section, breastfeeding client, whose subjective pain level is 2/5, requests her as needed (prn) narcotic analgesics every 3 hours. She states, "I have decided to make sure that I feel as little pain from this experience as possible." Which of the following should the nurse conclude in relation to this woman's behavior?

2. The woman is high risk for severe constipation.

The nurse is assessing the midline episiotomy on a postpartum client. Which of the following findings should the nurse expect to see?

2. Well-approximated edges.

Which of the following laboratory values would the nurse expect to see in a normal postpartum woman?

2. White blood cell count, 16,000 cells/mm3.

The nurse monitors his or her postpartum clients carefully because which of the following physiological changes occurs during the early postpartum period?

3. Decreased blood volume.

The nurse is caring for a client who had a cesarean section under spinal anesthesia less than 2 hours ago. Which of the following nursing actions is appropriate at this time?

3. Have her turn and deep breathe every 2 hours.

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

3. Inform the client that polyuria is normal.

A woman, 24 hours postpartum, is complaining of profuse diaphoresis. She has no other complaints. Which of the following actions by the nurse is appropriate?

3. Reassure the woman that this is normal.

A breastfeeding mother states that she has sore nipples. In response to the complaint, the nurse assists with "latch on" and recommends that the mother do which of the following?

3. Rotate the baby's positions at each feed.

A woman had a cesarean section yesterday. She states that she needs to cough but that she is afraid to. Which of the following is the nurse's best response?

4. "If you support your incision with a pillow, coughing should hurt less."

A 3-day-postpartum breastfeeding woman is being assessed. Her breasts are firm and warm to the touch. When asked when she last fed the baby her reply is, "I fed the baby last evening. I let the nurses feed him in the nursery last night. I needed to rest." Which of the following actions should the nurse take at this time?

Encourage the woman exclusively to breastfeed her baby.

A multigravid, postpartum woman reports severe abdominal cramping whenever she nurses her baby. Which of the following responses by the nurse is appropriate?

4. Discuss the action of breastfeeding hormones.

The nurse is evaluating the involution of a woman who is 3 days postpartum. Which of the following findings would the nurse evaluate as normal?

4. Fundus 3 cm below the umbilicus, lochia serosa.

A nurse is assessing a 1-day-postpartum woman who had her baby by cesarean section. Which of the following should the nurse report to the surgeon?

4. Pad saturation every 30 minutes.

A patient, G2 P1102, who delivered her baby 8 hours ago, now has a temperature of 100.2°F. Which of the following is the appropriate nursing intervention at this time?

Encourage intake of water and other fluids.

To prevent infection, the nurse teaches the postpartum client to perform which of the following tasks?

Change the peripad at each voiding.

The nurse in the obstetric clinic received a telephone call from a bottle-feeding mother of a 3-day-old. The client states that her breasts are firm, red, and warm to the touch. Which of the following is the best action for the nurse to advise the client to perform?

Intermittently apply ice packs to her axillae and breasts.

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?

Notify the woman's primary health care provider.