Nokea
A nurse is checking postpartum orders, the doctor prescribed bed rest for 6-12 h. The nurse knows this is an appropriate order if the patient had which type of anesthesia?
- A. Spinal
- B. Pudendal
- C. Epidural
- D. General
Correct Answer: C
Rationale: The correct answer is C: Epidural. The rationale for this is that epidural anesthesia is a regional anesthesia that numbs the lower half of the body while allowing the patient to remain conscious. Therefore, prescribing bed rest for 6-12 hours after receiving an epidural is appropriate to ensure the anesthesia wears off gradually and the patient does not experience any complications while regaining sensation and mobility.
Summary of Incorrect Choices:
A: Spinal anesthesia also numbs the lower half of the body, but it typically wears off faster than an epidural, so bed rest may not be necessary for as long.
B: Pudendal anesthesia is specific to numbing the perineum area and does not affect mobility in the same way as epidural anesthesia.
D: General anesthesia does not target a specific area of the body and does not require bed rest for 6-12 hours postpartum.
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Probable signs of pregnancy
- A. Ballottement (rebounding of the fetus against the examiner's fingers on palpation)
- B. Chadwicks sign (violet coloration of mucous membranes of cervix, vagina, and vulva @4 wks)
- C. Uterine enlargement
- D. Hegar's sign (compressibility and softening of lower uterine segment @6 wks)
Correct Answer: A
Rationale: The correct answer is A: Ballottement. This is a probable sign of pregnancy because it involves the rebounding of the fetus against the examiner's fingers on palpation. This occurs when the examiner pushes against the uterus and feels a bouncing back, indicating the presence of a fetus.
Choice B, Chadwick's sign, is actually the violet coloration of mucous membranes of cervix, vagina, and vulva at around 6-8 weeks, not 4 weeks as stated.
Choice C, uterine enlargement, is a presumptive sign of pregnancy as it can be caused by factors other than pregnancy, such as fibroids.
Choice D, Hegar's sign, involves the compressibility and softening of the lower uterine segment at around 6 weeks, but it is a probable sign rather than a definitive one like Ballottement.
Which nursing diagnoses may apply to the childbearing family with special needs? (Select all that apply.)
- A. Risk for spiritual distress
- B. Risk for injury
- C. Readiness for enhanced nutrition
- D. Ineffective breathing pattern
Correct Answer: B
Rationale: The correct answer is B: Risk for injury. This is because families with special needs in childbearing may face unique challenges leading to potential risks of injury, such as physical limitations or difficulties in providing adequate care. Option A is incorrect as spiritual distress is not directly related to physical safety. Option C is incorrect as enhanced nutrition readiness does not directly address safety concerns. Option D is incorrect as ineffective breathing pattern is a specific health issue not necessarily related to the family's safety. Therefore, B is the most appropriate nursing diagnosis for addressing safety concerns in the childbearing family with special needs.
A patient has just been admitted to labor and delivery. She is having mild contractions lasting 30 seconds every 15 minutes. The patient wants to have a mediation free birth. When discussing medication alternatives, the nurse should be sure the patient understands that:
- A. maternal pain and stress can have a more adverse effect on the fetus than a small amount of analgesia
- B. In order to respect her wishes no pain medication will be given
- C. the use of medication allows the patient to rest and be less fatigued
- D. pain relief will allow a more enjoyable birth experience
Correct Answer: A
Rationale: The correct answer is A because maternal pain and stress can lead to increased levels of stress hormones, which can negatively affect the fetus. By providing a small amount of analgesia, the patient can experience relief from pain and stress without compromising the well-being of the fetus.
Option B is incorrect because it disregards the potential benefits of providing some pain relief to the patient while still respecting her desire for a medication-free birth.
Option C is incorrect because while medication may provide some rest and alleviate fatigue, the primary concern in this scenario is the impact on the fetus rather than the patient's comfort.
Option D is incorrect because the main focus should be on ensuring the safety and well-being of both the mother and the fetus, rather than solely on the mother's enjoyment of the birth experience.
A nurse is reviewing signs of effective breathing with a client who is 5 days postpartum. Which of the following information should the nurse include in the teaching?
- A. "You should feel a tugging sensation when the baby is sucking.
- B. You should expect your baby to have two to three wet diapers in 24hour period
- C. "Your baby's urine should appear dark and concentrated".
- D. "Your breast should stay firm after the baby breastfeeds".
Correct Answer: B
Rationale: Rationale: Choice B is correct because a newborn should have at least 6-8 wet diapers in a 24-hour period, indicating adequate hydration and effective breastfeeding. This frequency of wet diapers is a sign of adequate milk intake and hydration for the baby, which is crucial for their growth and development. Choices A, C, and D are incorrect because feeling a tugging sensation, dark and concentrated urine, and firm breasts are not indicators of effective breathing or breastfeeding in a newborn.
Which herbs would you counsel a lactating client to use to stimulate blood flow to the breast glands, stimulate milk production, and enrich milk flow?
- A. Milk thistle
- B. Cabbage juice
- C. Lanolin
- D. Aloe vera
Correct Answer: B
Rationale: The correct answer is B: Cabbage juice. Cabbage juice contains phytoestrogens that help stimulate blood flow to the breast glands and promote milk production. It is used traditionally to increase milk supply in lactating women. Milk thistle (A) is more commonly used for liver health and not specifically for lactation. Lanolin (C) is a topical ointment for sore nipples, not for milk production. Aloe vera (D) is not recommended for internal use during lactation due to potential laxative effects. In summary, cabbage juice is the best choice as it directly supports milk production and flow in lactating clients.