Nokea
A nurse is assessing a newborn whose mother had gestational diabetes mellitus. The nurse should monitor for which of the following findings as a manifestation of hypoglycemia?
- A. Abdominal distention
- B. Petechiae
- C. Increased muscle tone
- D. Jitteriness
Correct Answer: D
Rationale: The correct answer is D: Jitteriness. In newborns of mothers with gestational diabetes mellitus, hypoglycemia can occur due to the abrupt cessation of the maternal glucose supply. Jitteriness is a common manifestation of hypoglycemia in newborns. This is because the brain is highly dependent on glucose for energy, and low blood sugar levels can affect neurological function, leading to symptoms like jitteriness. Abdominal distention, petechiae, and increased muscle tone are not typical manifestations of hypoglycemia in newborns with a history of maternal gestational diabetes mellitus.
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Which of the following is a potential benefit of patient-centered care in maternal and newborn healthcare?
- A. Increased patient satisfaction
- B. Improved health outcomes
- C. Decreased healthcare costs
- D. All of the above
Correct Answer: D
Rationale: Patient-centered care can improve satisfaction, health outcomes, and reduce costs.
A nurse is caring for a client who is 12 hr postpartum and has a fourth-degree laceration of the perineum. Which of the following actions should the nurse take?
- A. Apply a moist, warm compress to the perineum.
- B. Provide the client with a cool sitz bath.
- C. Administer methylergonovine 0.2 mg IM.
- D. Apply povidone-iodine to the client’s perineum after she voids.
Correct Answer: A
Rationale: The correct answer is A: Apply a moist, warm compress to the perineum. This action helps to promote healing and reduce discomfort for the client with a fourth-degree perineal laceration. Warmth can increase blood flow to the area, aiding in the healing process. Moisture can also help with wound healing and provide comfort.
Choice B is incorrect as a cool sitz bath may not be suitable for a fourth-degree laceration as it can cause vasoconstriction and slow down the healing process. Choice C, administering methylergonovine, is not indicated for perineal lacerations. Choice D, applying povidone-iodine after voiding, can be irritating to the wound and delay healing.
In summary, applying a warm, moist compress is the best option to promote healing and comfort for the client with a fourth-degree perineal laceration.
A nurse is assessing a client who is 3 days postpartum. Which of the following findings should the nurse report to the provider?
- A. Cool, clammy skin
- B. Moderate lochia serosa
- C. Heart rate 89/min
- D. BP 120/70 mm Hg
Correct Answer: A
Rationale: The correct answer is A: Cool, clammy skin. This finding could indicate hypovolemic shock, a serious complication postpartum. The nurse should report this to the provider immediately for further assessment and intervention. Choice B, moderate lochia serosa, is a normal finding 3 days postpartum. Choice C, heart rate 89/min, and choice D, BP 120/70 mm Hg, are within normal limits for a postpartum client and do not require immediate reporting.
A nurse is caring for a client who is 12 hr postpartum and has a third-degree perineal laceration. The client reports not having a bowel movement for 4 days. Which of the following medications should the nurse administer?
- A. Bisacodyl 10 mg rectal suppository
- B. Magnesium hydroxide 30 mL PO
- C. Famotidine 20 mg PO
- D. Loperamide 4 mg PO
Correct Answer: A
Rationale: A rectal suppository like bisacodyl is appropriate for relieving constipation in a postpartum client with a perineal laceration, as it avoids straining. Loperamide is an antidiarrheal and not indicated here.
Which of the following is a potential complication of a postpartum infection?
- A. Septicemia
- B. Anemia
- C. Thrombocytopenia
- D. All of the above
Correct Answer: A
Rationale: Correct Answer: A (Septicemia)
Rationale:
1. Postpartum infection can lead to septicemia, a severe systemic infection caused by bacteria entering the bloodstream.
2. Septicemia can result in life-threatening complications such as septic shock and organ failure.
3. Anemia is not a direct complication of postpartum infection but can occur secondarily due to blood loss.
4. Thrombocytopenia is a separate condition characterized by low platelet levels and is not directly caused by postpartum infection.
5. "All of the above" is incorrect as not all listed complications are potential consequences of postpartum infection.
Summary: Septicemia is the correct answer as it is a serious complication directly associated with postpartum infection, while anemia and thrombocytopenia are not typically direct consequences of this condition.