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Placental circulation is dependent on maternal circu- tions for preventing sudden infant death syndrome? lation. In which maternal circumstances is placental Select all that apply. circulation impeded? Select all that apply.
- A. Position newborns in the prone position to
- B. Hypotension
- C. Pre-eclampsia
- D. Avoid soft bedding or pillows in the newborn's
Correct Answer: B
Rationale: The correct answer is B: Hypotension. Hypotension in the mother can result in decreased blood flow to the placenta, affecting placental circulation and oxygen delivery to the fetus, increasing the risk of sudden infant death syndrome.
A: Positioning newborns in the prone position does not directly impede placental circulation.
C: Pre-eclampsia can affect placental circulation due to high blood pressure, but it is not the only maternal condition that can impede placental circulation.
D: Avoiding soft bedding or pillows in the newborn's crib is related to safe sleep practices but does not directly impede placental circulation.
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A patient has delivered twins. The first twin was stillborn, and the second is in the intensive care nursery, recovering quickly from respiratory distress. The patient is crying softly and says, "wish my baby could have lived." What is the most therapeutic response?
- A. "How soon do you plan to have another baby?"
- B. "Don't be sad. At least you have one healthy baby."
- C. "have a friend who lost a twin and she's doing just fine now."
- D. "am so sorry about your loss. Would you like to talk about it?"
Correct Answer: D
Rationale: The correct answer is D because it shows empathy, acknowledges the patient's loss, and invites further discussion if the patient wishes to talk. It validates the patient's feelings and offers support. Choice A is inappropriate as it disregards the patient's current emotional state. Choice B diminishes the patient's grief and may come off as insensitive. Choice C redirects the focus to someone else's experience, which may not be helpful in addressing the patient's emotions.
The nurse is caring for a postpartum client with excessive bleeding. What is the priority nursing intervention?
- A. Administer IV fluids.
- B. Massage the uterine fundus.
- C. Notify the healthcare provider.
- D. Check the client's vital signs.
Correct Answer: B
Rationale: The correct answer is B: Massage the uterine fundus. This is the priority intervention because excessive bleeding postpartum may indicate uterine atony, which can lead to hemorrhage. Massaging the uterine fundus helps to stimulate uterine contractions and control bleeding. Administering IV fluids (A) can be important, but controlling bleeding takes precedence. Notifying the healthcare provider (C) can be done after implementing immediate interventions. Checking vital signs (D) is important, but addressing the underlying cause of bleeding is the priority.
A nurse is reinforcing teaching about reducing perineal infection with a client following a vaginal delivery. Which of the following should the nurse include in the teaching? (Select all that apply.)
- A. Blot the perineal area dry after cleansing.
- B. Clean the perineal area from front to back.
- C. Perform hand hygiene before and after voiding.
- D. Wash the perineal area using a squeeze bottle of warm water after each voiding.
Correct Answer: A
Rationale: Correct Answer: A - Blot the perineal area dry after cleansing.
Rationale: Blotting the perineal area dry after cleansing helps prevent moisture accumulation, reducing the risk of perineal infection. Moisture can create a favorable environment for bacterial growth and infection. This practice also helps maintain skin integrity and promotes healing post-vaginal delivery.
Summary of other choices:
B: Cleaning the perineal area from front to back is important to prevent introducing fecal bacteria to the urinary tract but is not directly related to reducing perineal infection.
C: Performing hand hygiene before and after voiding is crucial for infection prevention but does not directly address reducing perineal infection.
D: Washing the perineal area using a squeeze bottle of warm water after each voiding can be beneficial for cleanliness but does not specifically address reducing perineal infection like blotting dry after cleansing does.
The nurse is assessing a postpartum client. Which finding requires immediate intervention?
- A. Fundus firm and midline.
- B. Lochia rubra with large clots.
- C. Mild swelling in the perineal area.
- D. Breast tenderness on day 2 postpartum.
Correct Answer: B
Rationale: The correct answer is B because Lochia rubra with large clots could indicate excessive bleeding, which is a postpartum hemorrhage and requires immediate intervention to prevent further complications. A: Fundus firm and midline is a normal finding. C: Mild swelling in the perineal area is expected after childbirth. D: Breast tenderness on day 2 postpartum is a common finding due to milk production starting.
A nurse is caring for newborn who is 1 hr. old and has a respiratory rate of 50/min, a heart rate of 130/min, and an auxiliary temperature of 36.1*C (97F). Which of the following actions should the nurse take?
- A. Give the newborn a warm bath.
- B. Apply a cap to the newborn head.
- C. Reposition the newborn.
- D. Obtain an oxygen saturation level
Correct Answer: C
Rationale: The correct action is to reposition the newborn. The vital signs provided indicate that the newborn may be experiencing cold stress, which can lead to hypothermia. Repositioning the newborn can help conserve heat and maintain a stable temperature. Giving a warm bath (choice A) may further decrease body temperature. Applying a cap (choice B) may help retain heat but does not address the underlying issue. Obtaining an oxygen saturation level (choice D) is not necessary based on the information provided.