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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.
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The nurse is caring for a postpartum woman and her 2-hour-old baby. The new mother has been preoccupied with breastfeeding and visitors, but suddenly she complains of dizziness and is light-headed. Which response by the nurse is appropriate?
- A. Explain that she needs to drink more fluids and eat because she needs to replace fluids and calories.
- B. Encourage the patient to rest, and ask a family member to watch the newborn in the crib.
- C. Tell the patient that the dizziness is probably caused by her pain medication and that it is normal.
- D. Obtain vital signs, assess fundal tone, and observe for excessive lochia.
Correct Answer: D
Rationale: Obtaining vital signs, assessing fundal tone, and observing for excessive lochia is appropriate to identify the cause of dizziness.
Which medications are used to manage PPH? (Select all that apply.)
- A. Oxytocin
- B. Methergine
- C. Terbutaline
- D. Hemabate
Correct Answer: A
Rationale: The correct answer is A: Oxytocin. Oxytocin is the first-line medication for managing postpartum hemorrhage (PPH) as it helps in the contraction of the uterus to control bleeding. Methergine (B) is used for uterine atony but is not the first-line choice. Terbutaline (C) is a tocolytic agent and not indicated for PPH. Hemabate (D) is used as a second-line medication for PPH after oxytocin.
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.
The nurse is caring for a Seventh Day Adventist woman who delivered a baby boy by cesarean section. Which of the following questions should be asked regarding this woman 's care?
- A. Would you like me to order a vegetarian clear liquid diet for you?
- B. Is there anything special you will need for your Sabbath on Sunday?
- C. Would you like to telephone your clergy to set up a date for the baptism?
- D. Will a rabbi be performing the circumcision on your baby?
Correct Answer: B
Rationale: Seventh Day Adventists observe the Sabbath on Saturday. The nurse should ask if special arrangements are needed for Sabbath observance.
What important assessment should the nurse perform on all postpartum persons?
- A. Screen for PPD with the EPDS.
- B. Screen for drug use with a urine drug screen.
- C. Screen for breast-feeding failure.
- D. Screen for contraception contraindications.
Correct Answer: A
Rationale: Using the Edinburgh Postnatal Depression Scale (EPDS) helps identify postpartum depression and provides early intervention.