Nokea
A woman is receiving patient-controlled analgesia (PCA) post -cesarean section. Which of the following must be included in the patient teaching?
- A. The client should monitor how often she presses the button.
- B. The client should report any feelings of nausea or itching to the nurse.
- C. The family should press the button whenever they feel the woman is in pain.
- D. The family should inform the nurse if the client becomes sleepy.
Correct Answer: B
Rationale: It is important for the client to report any adverse effects, such as nausea or itching, to the nurse while using PCA.
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Hemabate has been ordered for a postpartum patient who has uncontrolled bleeding and uterine atony. Which is the appropriate nursing action?
- A. Check the patient’s vital signs first for hypotension, and lower the head of the bed.
- B. Check the patient’s blood glucose and increase the IV fluid rate.
- C. Check the patient’s record for a history of asthma, and ask the licensed provider for an order of an antidiarrheal medication.
- D. Check the patient’s record for a history of hypothyroid, and ask the licensed provider to order something for nausea.
Correct Answer: C
Rationale: Hemabate can cause bronchospasm in patients with asthma, so checking the patient’s medical history is important before administering.
The nurse educates the person with a newborn in the NICU. What guidance does the nurse provide?
- A. Breast milk is not good for a premature baby.
- B. Premature babies breast-feed easily.
- C. Skin-to-skin contact helps both baby and breast-feeding person.
- D. A bottle is recommended for all feedings.
Correct Answer: C
Rationale: Skin-to-skin contact enhances bonding promotes successful breastfeeding and stabilizes the baby's physiological status.
The nurse notices the person with a PPH looks pale and their capillary refill is >3 seconds. What intervention can the nurse initiate?
- A. Wrap the person in a warm blanket.
- B. Put a pulse oximeter on the patient’s finger.
- C. Sit the person up at 90 degrees.
- D. Start an IV bolus.
Correct Answer: D
Rationale: The correct answer is D: Start an IV bolus. In postpartum hemorrhage (PPH), the priority is to restore circulating volume quickly to prevent shock. Starting an IV bolus with fluids or blood products helps improve perfusion and oxygenation. Choice A is incorrect as warming the person does not address the underlying issue of hypovolemia. Choice B is incorrect as monitoring oxygen saturation is not the immediate priority. Choice C is incorrect as sitting the person up could potentially worsen their condition by reducing venous return.
A client is receiving an epidural infusion of a narcotic for pain relief after a cesarean section. The nurse would report to the anesthesiologist if which of the following were assessed?
- A. Respiratory rate 8 rpm.
- B. Complaint of thirst.
- C. Urinary output of 250 mL/hr.
- D. Numbness of feet and ankles.
Correct Answer: A
Rationale: A respiratory rate of 8 breaths per minute indicates respiratory depression, which must be reported immediately as a potential complication of narcotic use.
The nurse is discussing the importance of doing Kegel exercises during the postpartum period. Which of the following should be included in the teaching plan?
- A. She should repeatedly contract and relax her rectal and thigh muscles.
- B. She should practice by stopping the urine flow midstream every time she voids.
- C. She should get on her hands and knees whenever performing the exercises.
- D. She should be taught that toned pubococcygeal muscles decrease blood loss.
Correct Answer: B
Rationale: Kegel exercises involve contracting the pelvic floor muscles, and one way to identify these muscles is by stopping the urine flow midstream.