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A nurse is caring for a postpartum person who is at risk for postpartum hemorrhage. What is the most important nursing action to reduce the risk?
- A. administer oxytocin
- B. administer IV fluids
- C. administer an epidural
- D. perform fundal massage
Correct Answer: B
Rationale: The correct answer is B: administer IV fluids. IV fluids help maintain adequate circulating volume, preventing hypovolemia which is a major risk factor for postpartum hemorrhage. This action supports blood pressure and perfusion to reduce the risk of excessive bleeding. Administering oxytocin (A) helps with uterine contraction but does not address the underlying issue of hypovolemia. Administering an epidural (C) is not directly related to preventing postpartum hemorrhage. Fundal massage (D) is important but not the most critical action in reducing the risk of postpartum hemorrhage.
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What is the primary nursing action when a laboring person experiences a ruptured uterus?
- A. prepare for an emergency cesarean section
- B. provide immediate pain relief
- C. apply oxygen via mask
- D. apply pressure to the abdomen
Correct Answer: C
Rationale: The correct answer is C: apply oxygen via mask. This is the primary nursing action for a ruptured uterus because it helps improve oxygenation to the laboring person and the fetus. Ruptured uterus can lead to a significant decrease in oxygen supply, so providing oxygen is crucial.
Incorrect choices:
A: preparing for an emergency cesarean section is important but not the primary action in this situation.
B: providing pain relief is important, but ensuring oxygenation is a higher priority.
D: applying pressure to the abdomen is not recommended as it can worsen the condition.
A pregnant patient at 28 weeks gestation reports lower back pain. What should the nurse do first?
- A. Administer pain medication and encourage rest.
- B. Assess the patient's posture and recommend appropriate exercises.
- C. Instruct the patient to lie flat on her back to relieve pain.
- D. Perform a pelvic exam to check for any underlying complications.
Correct Answer: B
Rationale: The correct answer is B because assessing the patient's posture and recommending appropriate exercises can help alleviate lower back pain during pregnancy. Poor posture and lack of exercise are common causes of back pain in pregnancy. Administering pain medication as in choice A may not address the root cause. Instructing the patient to lie flat on her back (choice C) can actually worsen back pain and pose risks during pregnancy. Performing a pelvic exam (choice D) is not necessary unless there are specific indications for it related to the patient's complaint. Therefore, choice B is the most appropriate initial action to address the lower back pain in this pregnant patient.
A nurse is assessing a laboring person who is receiving oxytocin for labor induction. What is the most important intervention to prevent uterine hyperstimulation?
- A. monitor fetal heart rate
- B. increase fetal monitoring
- C. administer an epidural
- D. monitor contractions
Correct Answer: B
Rationale: The correct answer is B: increase fetal monitoring. Monitoring the fetus closely is crucial to detect signs of uterine hyperstimulation, such as non-reassuring fetal heart rate patterns. This allows for timely interventions to prevent fetal distress or hypoxia. Monitoring contractions (choice D) is important but does not directly address fetal well-being. Administering an epidural (choice C) may help manage pain but does not prevent uterine hyperstimulation. While monitoring fetal heart rate (choice A) is important, increasing the frequency of monitoring (choice B) is more specific to detecting complications related to oxytocin-induced uterine hyperstimulation.
The nurse is caring for a pregnant patient who is 30 weeks gestation and has a BMI of 32. Which of the following complications should the nurse monitor for more closely?
- A. Gestational diabetes and preeclampsia
- B. Hyperemesis gravidarum and miscarriage
- C. Iron-deficiency anemia and urinary tract infections
- D. Gestational hypertension and placenta previa
Correct Answer: A
Rationale: The correct answer is A: Gestational diabetes and preeclampsia. A pregnant patient with a BMI of 32 is considered obese, which increases the risk of developing gestational diabetes and preeclampsia. Gestational diabetes is more likely in overweight women and can lead to complications for both the mother and baby. Preeclampsia is also more common in obese women and can result in high blood pressure and organ damage. Monitoring for these complications is crucial to ensure the well-being of both the mother and baby.
Incorrect choices:
B: Hyperemesis gravidarum and miscarriage - These complications are not directly related to the patient's weight or BMI.
C: Iron-deficiency anemia and urinary tract infections - While these complications can occur in pregnancy, they are not specifically associated with the patient's BMI.
D: Gestational hypertension and placenta previa - While gestational hypertension can be a concern in obese patients, placenta previa is not directly linked to
A nurse is caring for a laboring person who is experiencing irregular fetal heart rate patterns. What is the most appropriate intervention?
- A. increase oxygen flow
- B. increase fetal monitoring
- C. administer an analgesic
- D. increase fluid intake
Correct Answer: B
Rationale: The correct answer is B, to increase fetal monitoring. This is crucial to assess the fetal well-being and identify any potential distress or complications early on. Monitoring allows for timely interventions to be implemented to optimize outcomes. Increasing oxygen flow (A) may be necessary in some cases, but it is not the initial priority. Administering an analgesic (C) may help with pain management but does not address the fetal heart rate patterns. Increasing fluid intake (D) is important for hydration but is not directly related to managing fetal heart rate patterns.