Nokea
The nurse is assisting the primary care provider with the third stage of a vaginal delivery. The patient is multiparous, experienced a precipitous birth, and has a history of hypertension. Which medical prescription does the nurse anticipate for this patient?
- A. Methylergonovine
- B. Fresh frozen plasma
- C. Carboprost-tromethamine
- D. Magnesium sulfate
Correct Answer: C
Rationale: Carboprost-tromethamine is classified as a prostaglandin and is prescribed to maintain contraction of the uterine muscles.
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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 aware of concern about the increasing numbers of severe maternal morbidity (SMM). It is believed to be related to changes in the overall health of the population of women giving birth. Which reasons does the nurse identify as causes of SMM? Select all that apply.
- A. Increases in maternal age
- B. Prepregnancy obesity
- C. Cesarean deliveries
- D. Inability to pay for health care
Correct Answer: B
Rationale: Documented increases in maternal age is a likely cause for SMM; older women have increased risk. Obesity is a general health risk in the United States; prepregnancy obesity causes increased incidences of SMM. Cesarean deliveries are increasing, and surgical procedures always carry a risk for complications. Preexisting chronic medical conditions are a contributor to the increasing rates of SMM.
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: Screening for PPD is essential during postpartum care.
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.
What nursing intervention does the nurse include in the plan of care for a person with mastitis?
- A. Provide antipyretic.
- B. Stop antibiotics when redness is resolved.
- C. Encourage the person to stop breast-feeding.
- D. Start an IV and prepare for signs of sepsis.
Correct Answer: A
Rationale: Correct Answer: A. Provide antipyretic.
Rationale:
1. Mastitis is an inflammation of the breast tissue usually caused by infection.
2. Antipyretics help reduce fever, a common symptom of infection.
3. Providing antipyretics can help alleviate discomfort and promote healing.
4. Stopping antibiotics when redness is resolved (choice B) may lead to recurrence of infection.
5. Encouraging the person to stop breast-feeding (choice C) can negatively impact milk production and bonding.
6. Starting an IV and preparing for signs of sepsis (choice D) is an extreme measure not indicated unless sepsis is confirmed.