Pregnancy, labor, childbirth, postpartum(uncomplicated) ELSEVIER

A woman at 40 weeks gestation is having contractions. Wondering whether she is in true labor, she asks " how will you know if I'm really in labor? " Which information should the nurse provide to a client at this time? 1. The cervix dilates and becomes effaced in true labor 2. Bloody show is the first sign of true labor 3. The membranes rupture at the beginning of true labor 4. Feral movements lessen and become weaker in true labor

1. The cervix dilates and becomes effaced in true labor The major difference between true and false labor is that true labor can we confirmed by the presence of dilation and Effacement of cervix.

Which information should the nurse include in the discharge teaching of a postpartum client? 1.The prenatal kegel tightening exercise should be continued 2. The a PZI to me sutures will be removed at the first postpartum visit 3. She may not have a bowel movement for up to a week after birth 4. She should schedule a postpartum checkup as soon as her menses returns

1. The prenatal kegel tightening exercises should be continued Exercises may be resumed immediately and should be done for the rest of the life because they help strengthen the muscle needed for urinary continence and may inhance sexual intercourse.

The nurse instructs a pregnant client regarding fetal growth and development which statement indicates the client needs further teaching? 1. The fetus keeps growing throughout pregnancy 2. The fetus may be underweight if it's exposed to smoke 3. The fetus gets nutrients from Amniotic fluid 4. Fetus it's oxygen from blood in the placenta

3. The fittest gets nutrients from amniotic fluid Amnionic fluid provides protection not nutrition the fetus depends on the placenta along with umbilical blood vessels for nutrients and oxygen

During her first prenatal visit the client reports that her last menstruation period began on April 15. What is expected the delivery date 1. January 8 2. January 22 3. February 8 4. February 22

2. January 22 Subtract three months from the date of the last menstruation and add seven days

What is the optimal nursing intervention to minimize perennial edema after an an episiotomy? 1. Apply ice packs 2. Offering a warm sitz bath 3. Administering aspirin as needed 4. Elevating the hips on a pillow

1 apply ice Cold causes vasoconstriction and reduces Edema by lessening the accumulation of blood and lymph at the site. it also deadens nerve endings and lessens pain.

A primigravid client Who is that 38 weeks gestation is undergoing a non-stress test. The nurse determines that the baseline fetal heart rate is 130 to 1 40 bpm. It rises to 160 on two occasions and 157 once during 20 minute period. Each of the episodes in which the heart rate is increased lasts 20 seconds. What action should the nurse take? 1. Discontinue the test because the pattern is within normal range 2. Encouraged the client to drink more fluids to decrease the fetal heart rate 3. Notify the primary health provider and prepare for an emergency birth 4. Record this nonreassuring pattern and continue the test for further evaluation

1. Discontinue because it's normal The baseline heart rate is within the expected range, accelerations meet the criteria for an increase of 15 beats that lasts 15 seconds during a 20 minute ., this is a reassuring pattern that is indicative of a fetal well-being

A client at 10 weeks gestation calls the clinic and tells the nurse that she has morning sickness and cannot control it. What should the nurse to just a promote relief? 1. "Eat dry crackers before you get out of bed" 2. " increase your fat intake before bed" 3. " drink high carb fluids with meals" 4. " eat two small meals a day and a snack at noon"

1. Eat dry crackers before you get out of bed Nausea and vomiting in the morning occur in almost 50% of pregnancies. Eating dry crackers before getting out of bed in the morning and the simple remedy that may provide relief. Increasing fat does not relieve nausea. Drinking high carb fluids is not helpful. Separating fluids from salads at nail Time is more advisable. Eating two small meals a day and a snack does not meet nutritional needs of a pregnant woman nor will it relieve the nausea. Some women find that eating 5 to 6 small meals a day instead of three large ones is helpful

During the second stage of labor the nurse discourages the client from holding her breath for longer than six seconds while pushing with each contraction what complication does this prevent? 1. Fetal hypoxia 2. Perineal lacerations 3. Carpopedal spasms 4. Maternal hypertension

1. Fetal hypoxia Prolonged breath holding at this stage of labor can result in decreased placental/fetal oxygenation which can lead to fetal hypoxia

The client in labor begins to experience contractions 2 to 3 minutes apart and lasting about 45 seconds. Between contractions the nurse identifies a fetal heart rate of 100 bpm and the internal fetal monitor. What is the priority nursing action 1. Notify the healthcare provider 2. Resume continuous fetal heart monitoring 3. Continue to monitor mother's vital signs 4. Document the fetal heart rate as an expected response to contractions

1. Notify HCP Bradycardia a baseline of less than 110 indicates the fetus might be compromised requiring medical intervention

Which statements regarding the involution process our correct? Select all that apply. 1. Begins immediately after expulsion of the placenta 2. Is this self-destruction of excess hypertrophied tissue 3. Progresses rapidly during the next few days after birth 4. Is there return of the uterus to a non-pregnant state after birth 5. May be caused by retained placental fragments in infection

1. Occurs immediately after expulsion of placenta, 3. Progresses rapidly during the next few days after birth. 4. Is the return of the uterus to a non-pregnant state Sub involution is a self-destruction of excess hypertrophied tissue, this process may be caused by retained placental fragments or infection

A client at 35 weeks gestation asked the nurse why her breathing has become more difficult. How should the nurse respond? 1. "Your lower rib cage is more restricted" 2. " your diaphragm has displaced upward" 3. " your lungs have increased in size since you've gotten pregnant" 4. " the height of your rib cage has increased since you got pregnant"

2. " your diaphragm has been displaced upward" The pressure of the enlarging fetus causes upward displacement the diaphragm which results in the thoracic breathing, this limits the decent of the diaphragm on inspiration. The lower rib cage expands but it does not become restricted. There's no change in the size of the lungs. The Thoracic cage enlarges but it does not rise

The client and her 37th week of gestation calls the nurse at the clinic and reports "my ankles are so swollen." What should the nurse recommend. 1. Limit fluid intake during the day 2. Elevate her legs more frequently during the day 3. Restricts salt intake for the remainder of the pregnancy 4. Taking a mild diuretic of the health provider will prescribe

2. Elevate her legs more frequently Dependent Edema is in the ankles is a common occurrence during pregnancy and results from increased pressure of the uterus on the pelvic veins. elevating the leg is encourages return

When a client at 39 weeks gestation arrives at the birthing suites she says "I've been having contractions for three hours, and I think my water broke." What will the nurses action be to confirm that the membranes have ruptured. 1. Take the clients oral temperate 2. Test the leaking fluid with nitrazine paper 3. Obtain a clean catch urine specimen 4. Inspect perineum for leaking fluid

2. Test the leaking fluid with nitrazine paper Paper will turn dark blue if amniotic fluid is present, it remains the same color if it's urine.

The postpartum nurse is delegating tasks to an unlicensed healthcare provider. Which tasks should the nurse delegate 1. Evaluation of a postpartum clients lochia 2. Vital signs and client four hours after delivery 3. Assessment of a postpartum client episiotomy 4 Assisting the postpartum client to breast-feed for the first time

2. Vital signs 4 hours postpartum

A 16-year-old adolescent at 24 weeks gestation visits the prenatal clinic for the first time. After the physical examination she tells the nurse I can't believe how big I am will I get much bigger? What information about adolescent growth and development does the nurse need to understand before responding. 1. Adolescents generally regain their figures two weeks after birth so size is of moderate concern 2. Adolescents are in a high-risk category so weight gain should be limited to prevent complications 3. Body image is very important to adolescents therefore pregnant teenagers are overly concerned about body size 4. Physiological growth in adolescence is more rapid than in adults so the gravid size larger than that of an adult woman

3. Body image is very important to adolescence therefore pregnant teenagers are overly concerned about body size Because of the changes in the body size the teenager may feel insecure as she struggles to establish identity

A client in active labor start screaming "the baby is coming! Do something!" What is the nurses primary action? 1. Notifying the practitioner 2. Telling the client that and it's too soon in encouraging her to pant 3. Checking the perineal area for presenting part 4. Helping the client to hold her knees together and explaining what to expect

3. Checking the perineal area The primary action should be to confirm whether the birth is eminent by checking the area to determine whether the part is emerging the nurse should remain with a client and ask a colleague to call the practitioner of birth is imminent

The nurse is teaching a client to care for her episiotomy after discharge. Which priority instruction should the nurse include in her instructions? 1. Rest with legs elevated at least two times a day 2. avoid stair climbing for several days after discharge 3. Perform perennial care after toileting until healing occurs 4. Continue sitzbaths three times a day if they provide comfort

3. Perform perennial care after toileting until healing occurs Prevention of infection is the priority.

A pregnant client is scheduled for an ultrasound at the end of her first trimester. what should the nurse instruct her to do to prep the sonogram? 1. Empty her bladder 2. Avoid eating for eight hours 3. Take a laxative the night before 4. Increase fluid for one hour before procedure

4. Increase fluid When the fluid fills the bladder the uterus is pushed up toward abdominal cavity for optimum ultrasound viewing during the first trimester

A women Who is 28 weeks pregnant call the clinic to report that she is frightened because she has begun leaking breastmilk. What is the best response? 1.She needs to come in for calcium level 2. She needs to come in for a nonstress test 3. She needs to get off her feet and rest more 4.This could be normal during pregnancy

4. Many women began to leak breast milk or colostrum during pregnancy. This may occur during the third trimester. Its completely normal, and there is no issue with her health or pregnancy. The woman just needs to purchase breast pads to absorb the milk