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A nurse is educating a birthing person about the signs and symptoms of postpartum hemorrhage. Which of the following is an early sign of postpartum hemorrhage?
- A. bright red bleeding
- B. increased blood pressure
- C. severe abdominal pain
- D. increased heart rate
Correct Answer: A
Rationale: The correct answer is A: bright red bleeding. This is an early sign of postpartum hemorrhage because it indicates active bleeding from the uterus. Bright red blood suggests fresh bleeding, which is more concerning than darker blood. Increased blood pressure (B) is not typically associated with postpartum hemorrhage. Severe abdominal pain (C) is more indicative of other complications like uterine rupture. Increased heart rate (D) can be a sign of postpartum hemorrhage, but bright red bleeding is a more specific early indicator.
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What is the priority nursing action when a postpartum person experiences a boggy uterus after delivery?
- A. perform fundal massage
- B. administer a uterotonic medication
- C. administer an analgesic
- D. administer pain medication
Correct Answer: B
Rationale: The correct answer is B: administer a uterotonic medication. This is the priority nursing action because a boggy uterus indicates uterine atony, which can lead to postpartum hemorrhage. Uterotonic medications help the uterus contract and reduce bleeding. Performing fundal massage (A) can be done after administering the medication to aid in uterine contraction. Administering an analgesic (C) or pain medication (D) is not the priority as the main concern is preventing excessive bleeding.
A pregnant patient at 32 weeks gestation reports increased pressure in the pelvic area and mild cramping. What should the nurse assess first?
- A. The fetal heart rate and signs of labor.
- B. The patient's blood pressure and urine for protein.
- C. The presence of vaginal discharge or bleeding.
- D. The patient's dietary intake and hydration status.
Correct Answer: A
Rationale: The correct answer is A: The fetal heart rate and signs of labor. At 32 weeks gestation, any pelvic pressure and cramping could be indicative of preterm labor, which is a critical concern. Assessing the fetal heart rate can help determine fetal well-being and signs of distress. Monitoring for signs of labor such as contractions, cervical changes, and rupture of membranes is essential for timely intervention.
Choice B: Assessing blood pressure and urine for protein is important in monitoring for preeclampsia, but it is not the priority in this case where signs of preterm labor are reported.
Choice C: Vaginal discharge or bleeding could indicate various conditions, but in this scenario, the focus should be on ruling out preterm labor first.
Choice D: Dietary intake and hydration status are important aspects of prenatal care, but they are not the priority when assessing a pregnant patient reporting pelvic pressure and cramping at 32 weeks gestation.
A nurse is educating a pregnant patient at 32 weeks gestation about safe physical activity. Which of the following recommendations should the nurse prioritize?
- A. Perform strenuous exercise to strengthen muscles and improve endurance.
- B. Engage in moderate exercise, such as walking or swimming, to maintain health.
- C. Avoid all physical activity during pregnancy to reduce the risk of complications.
- D. Engage in high-impact exercises to strengthen bones and joints.
Correct Answer: B
Rationale: The correct answer is B because engaging in moderate exercise like walking or swimming is recommended for pregnant patients at 32 weeks gestation. This type of activity helps maintain health without putting excessive strain on the body. Strenuous exercises (Choice A) may increase the risk of injury or complications during pregnancy. Avoiding all physical activity (Choice C) can lead to decreased muscle tone and potential complications. High-impact exercises (Choice D) can be too harsh on the joints and bones during pregnancy. Therefore, moderate exercise is the safest and most beneficial option for pregnant patients at this stage.
A pregnant patient is at 32 weeks gestation and complains of shortness of breath, swelling of the hands, and increased weight gain. What is the nurse's priority action?
- A. Administer oxygen and prepare the patient for a cesarean section.
- B. Assess the patient's blood pressure and check for protein in the urine.
- C. Encourage the patient to rest and elevate the legs.
- D. Instruct the patient to drink plenty of fluids to reduce swelling.
Correct Answer: B
Rationale: The correct answer is B. At 32 weeks gestation, the patient's symptoms suggest possible preeclampsia, a serious condition characterized by high blood pressure and protein in the urine. Assessing blood pressure and checking for proteinuria are crucial for diagnosing and managing preeclampsia. Administering oxygen or preparing for a cesarean section is not the priority without proper assessment. Encouraging rest and elevation of legs may help with swelling, but addressing the potential preeclampsia is more urgent. Instructing the patient to drink fluids is not the priority as it does not address the underlying issue of preeclampsia.
A pregnant patient at 28 weeks gestation reports feeling nauseated and vomiting after meals. What is the most appropriate action for the nurse to take?
- A. Encourage the patient to eat large meals less frequently.
- B. Recommend the patient eat smaller, more frequent meals and avoid greasy foods.
- C. Instruct the patient to rest after meals to reduce nausea.
- D. Advise the patient to avoid all foods until the nausea resolves.
Correct Answer: B
Rationale: The correct answer is B: Recommend the patient eat smaller, more frequent meals and avoid greasy foods. This is because smaller, more frequent meals can help alleviate nausea and vomiting during pregnancy by preventing the stomach from becoming too full. Greasy foods can exacerbate nausea, so avoiding them is beneficial.
A: Encouraging large meals less frequently can worsen symptoms by overwhelming the digestive system.
C: Resting after meals may not directly address the underlying cause of nausea and vomiting.
D: Avoiding all foods can lead to inadequate nutrition for both the patient and the developing fetus.
In summary, choice B is the most appropriate as it addresses the symptoms effectively and promotes better nutrition during pregnancy.