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A woman provides the nurse with the following obstetrical history: Delivered a son, now 7 years old, at 28 weeks’ gestation; delivered a daughter, now 5 years old, at 39 weeks’ gestation; had a miscarriage 3 years ago, and had a first-trimester abortion 2 years ago. She is currently pregnant. Which of the following portrays an accurate picture of this woman’s gravidity and parity?
- A. G4 P2121.
- B. G4 P1212.
- C. G5 P1122.
- D. G5 P2211.
Correct Answer: D
Rationale: Gravidity includes all pregnancies (live births, miscarriages, abortions, and current pregnancy). Parity reflects live births. This woman has had 5 pregnancies (2 live births, 1 miscarriage, 1 abortion, and 1 current pregnancy), making her G5 P2211.
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The blood of a pregnant client was initially assessed at 10 weeks’ gestation and reassessed at 38 weeks’ gestation.
- A. Rise in hematocrit from 34% to 38%.
- B. Rise in white blood cells from 5 000 cells/mm3 to 15 000 cells/mm3.
- C. Rise in potassium from 3.9 mEq/L to 5.2 mEq/L.
- D. Rise in sodium from 137 mEq/L to 150 mEq/L.
Correct Answer: B
Rationale: White blood cell count increases during pregnancy due to physiological stress and immune system changes. Hematocrit levels typically decrease due to plasma expansion, while potassium and sodium levels remain stable.
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.
A nurse is assisting a postpartum person with breastfeeding. What is the best intervention to help relieve nipple pain?
- A. apply lanolin cream
- B. administer analgesics
- C. apply a warm compress
- D. apply cold compresses
Correct Answer: A
Rationale: The correct answer is A: apply lanolin cream. Lanolin cream helps to soothe and moisturize the nipples, reducing pain and promoting healing. It is safe for the baby and does not need to be removed before breastfeeding. Applying analgesics (B) is not recommended as they can be harmful to the baby. Warm compresses (C) may not provide the same level of relief for nipple pain as lanolin cream. Cold compresses (D) are not suitable for relieving nipple pain as they can further exacerbate discomfort. Therefore, applying lanolin cream is the best intervention for relieving nipple pain during breastfeeding.
A nurse is educating a postpartum person about newborn care. What is the best way to prevent diaper rash?
- A. frequent diaper changes
- B. use of a barrier cream
- C. apply petroleum jelly to the skin
- D. change diapers frequently
Correct Answer: C
Rationale: The correct answer is C: apply petroleum jelly to the skin. Petroleum jelly acts as a barrier, protecting the baby's skin from moisture and irritants in the diaper. It helps maintain the skin's natural moisture and prevents diaper rash.
Rationale:
1. Petroleum jelly creates a protective barrier on the skin, preventing direct contact with moisture and irritants.
2. It helps to keep the skin moisturized, reducing the risk of irritation.
3. Petroleum jelly is safe and gentle on the baby's skin.
4. It is particularly effective for preventing diaper rash compared to other options.
Summary:
A: Frequent diaper changes are important but may not provide enough protection against moisture and irritants.
B: Barrier creams can be effective, but petroleum jelly is a more commonly recommended option.
D: Changing diapers frequently is essential, but applying petroleum jelly as an additional protective measure is more effective in preventing diaper rash.
A pregnant patient who is 28 weeks gestation reports a sudden headache and visual changes. What is the nurse's priority action?
- A. Encourage the patient to take a warm bath to relieve the headache.
- B. Assess the patient's blood pressure and check for signs of preeclampsia.
- C. Administer pain medication to relieve the headache.
- D. Instruct the patient to rest in a dark, quiet room to relieve symptoms.
Correct Answer: B
Rationale: The correct answer is B. Assess the patient's blood pressure and check for signs of preeclampsia. This is the priority action because sudden headache and visual changes in a pregnant patient at 28 weeks gestation could indicate preeclampsia, a serious condition characterized by high blood pressure and organ damage. Checking blood pressure and signs of preeclampsia is crucial for early detection and prompt management to prevent complications for both the mother and baby. Encouraging a warm bath, administering pain medication, or instructing the patient to rest may provide temporary relief but do not address the underlying cause of the symptoms.