Nokea
When teaching a new mother how to perform perineal care, which instruction should be included?
- A. Use a front-to-back motion when cleaning the perineal area
- B. Use a peri-bottle filled with warm water after each voiding
- C. Avoid using any cleansing solution on the perineal area
- D. Apply powder to the perineal area to keep it dry
Correct Answer: B
Rationale: Using a peri-bottle filled with warm water after each voiding is essential for proper perineal care as it helps cleanse the area without causing irritation and promotes healing. It is important to avoid using a back-to-front motion to prevent introducing bacteria into the urethra, and using powder may increase the risk of infection. Cleansing solutions specifically formulated for perineal care may be recommended but should be used under healthcare provider guidance.
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The healthcare provider is assessing a newborn for signs of hypoglycemia. Which finding is consistent with hypoglycemia?
- A. Jitteriness
- B. Flushed skin
- C. Quiet alert state
- D. Strong cry
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
The healthcare provider is preparing to administer Rh immune globulin (RhoGAM) to a postpartum client. This medication is indicated for:
- A. Rh-negative individuals with Rh-positive infants
- B. Rh-positive individuals with Rh-negative infants
- C. All individuals regardless of Rh status
- D. Individuals with a history of Rh incompatibility
Correct Answer: A
Rationale: Rh immune globulin (RhoGAM) is administered to Rh-negative individuals who have given birth to Rh-positive infants to prevent Rh sensitization. When an Rh-negative individual gives birth to an Rh-positive infant, there is a risk of the mother developing antibodies against the Rh-positive blood cells, which can lead to hemolytic disease of the newborn in subsequent pregnancies. Rh immune globulin is given to prevent this sensitization in Rh-negative individuals who deliver Rh-positive infants.
The healthcare provider assesses a postpartum client who is 1 day post-delivery. Which finding would require immediate intervention?
- A. Lochia rubra with a few small clots
- B. Fundus firm and midline
- C. Temperature of 100.4°F (38°C)
- D. Saturated perineal pad in 15 minutes
Correct Answer: D
Rationale: A saturated perineal pad in 15 minutes indicates excessive bleeding, which is abnormal postpartum. This finding could suggest hemorrhage, requiring immediate intervention to prevent further complications like hypovolemic shock. Monitoring and managing postpartum bleeding are crucial to ensure the client's safety and prevent serious consequences.
The nurse is preparing to administer erythromycin eye ointment to a newborn. The mother asks why this is necessary. What is the nurse's best response?
- A. It helps to prevent eye infections caused by bacteria in the birth canal.
- B. It protects the baby's eyes from bright lights in the delivery room.
- C. It prevents the development of jaundice.
- D. It helps the baby see more clearly after birth.
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A breastfeeding mother is experiencing nipple pain. What should the nurse instruct her to do?
- A. Use soap and water to clean her nipples
- B. Apply warm compresses to her breasts
- C. Ensure the baby is latching on properly
- D. Limit breastfeeding to every 4 hours
Correct Answer: C
Rationale: When a breastfeeding mother experiences nipple pain, ensuring the baby latches on properly is essential. Proper latch-on technique can help prevent and alleviate nipple pain by ensuring the baby is effectively extracting milk and not causing undue pressure or friction on the nipple. This guidance can promote a more comfortable breastfeeding experience for the mother and improve milk transfer for the baby.