Nokea
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 is important for both mother and premature infant.
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The nurse is caring for a woman who is 6 hours postpartum after a vaginal delivery. She has a history of labial varicose veins and is reporting perineal pain of 8 on a 10-point scale. What interventions should the nurse include in the plan of care?
- A. Provide the patient with an inflatable donut ring to sit on and administer her oral pain medication.
- B. Explain that this is normal after a vaginal delivery and assist her to a side-lying position.
- C. Assess the perineum for a hematoma or inflamed varicosities, and administer oral pain medication.
- D. Administer oral stool softeners and encourage fluids.
Correct Answer: C
Rationale: The correct answer is C because it addresses the patient's specific issue of perineal pain related to her history of labial varicose veins. By assessing the perineum for a hematoma or inflamed varicosities, the nurse can identify the cause of the pain and provide appropriate treatment. Administering oral pain medication targets the source of discomfort.
Choice A is incorrect because providing an inflatable donut ring may offer temporary relief but does not address the underlying cause of the pain. Administering oral pain medication alone may not be sufficient without assessing the perineum.
Choice B is incorrect because dismissing the patient's pain as normal without further assessment can lead to overlooking potential complications. Assisting the patient to a side-lying position does not address the pain.
Choice D is incorrect because administering stool softeners and encouraging fluids may be beneficial for postpartum care but does not directly address the patient's perineal pain related to varicose veins.
What would a steady trickle of bright red blood from the vagina in the presence of a firm fundus suggest to the nurse?
- A. Uterine atony
- B. Lacerations of the genital tract
- C. Perineal hematoma
- D. Infection of the uterus
Correct Answer: A
Rationale: The steady trickle of bright red blood from the vagina in the presence of a firm fundus suggests uterine atony. Uterine atony is a condition where the uterus fails to contract effectively after childbirth, resulting in postpartum hemorrhage. The firm fundus indicates that the uterus is not properly contracting to control bleeding, leading to the continuous flow of blood from the vagina. Prompt intervention is crucial to manage uterine atony and prevent further complications such as excessive blood loss.
What nursing diagnosis would be appropriate for the person with a coagulation disorder?
- A. risk for bleeding
- B. risk for fluid overload
- C. risk for breast-feeding failure
- D. risk for hypertension
Correct Answer: B
Rationale: Risk for bleeding is the main diagnosis in patients with coagulation disorders.
What is a risk factor for PPD?
- A. vaginal birth
- B. family support
- C. traumatic birth
- D. breast-feeding
Correct Answer: C
Rationale: PPD is more common after traumatic births and with lack of support.
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.