Nokea
The nurse is aware the greatest source of bleeding during childbirth occurs following detachment of the placenta. Which physiological change takes place immediately after the expulsion of the placenta to decrease the amount of blood loss?
- A. Contractions of the uterine myometrium
- B. Factor VIII complex increases during gestation
- C. Platelet activity increases before labor and delivery
- D. Fibrin formation increases before the birth occurs
Correct Answer: A
Rationale: After placenta detachment, contractions of the myometrium compress the blood vessels at the placental site, thus decreasing the amount of blood loss.
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What nursing intervention does the nurse include in the plan of care for a person with a wound infection?
- A. Reassure the postpartum person that infection will resolve without antibiotics.
- B. Assess for REEDA.
- C. Call health-care provider when temperature is 99.0° F.
- D. Scrub the incision vigorously with soap and water.
Correct Answer: B
Rationale: The correct answer is B: Assess for REEDA. REEDA stands for Redness, Edema, Ecchymosis, Drainage, and Approximation, which are key indicators of wound infection. By assessing for REEDA, the nurse can monitor and evaluate the progress of the infection. This intervention allows for early detection and prompt treatment of wound infections.
Choice A is incorrect because reassuring the postpartum person without antibiotics may lead to worsening infection. Choice C is incorrect as a temperature of 99.0° F is not necessarily indicative of a wound infection. Choice D is incorrect as scrubbing the incision vigorously with soap and water can introduce more bacteria and worsen the infection.
What do ineffective parenting practices put the newborn at risk for?
- A. sleeplessness
- B. reflux
- C. lack of attachment
- D. NICU admission
Correct Answer: C
Rationale: Ineffective parenting practices can lead to a lack of emotional bonding and attachment which can impact the child's development.
A patient who has been on prolonged bedrest for bleeding associated with placenta previa was taken to the operating room for an emergency cesarean delivery. Sixteen hours postoperatively, the patient complains that her left leg is hurting. The nurse finds that the entire left leg is swollen and has pitting edema, while the right leg appears to be normal. Which order does the nurse anticipate when paging the health care provider to the room?
- A. White blood cell count (WBC)
- B. Ultrasound of the leg
- C. X-ray of the leg
- D. Serum creatinine
Correct Answer: B
Rationale: The correct answer is B: Ultrasound of the leg. In this scenario, the patient is at risk for deep vein thrombosis (DVT) due to prolonged bedrest and recent surgery. The symptoms of leg pain, swelling, and pitting edema raise suspicion for DVT. An ultrasound of the leg is the most appropriate diagnostic test to confirm the presence of a blood clot. This test is non-invasive, highly sensitive, and specific for detecting DVT. It allows for prompt diagnosis and initiation of appropriate treatment such as anticoagulation therapy to prevent potential complications like pulmonary embolism.
Summary:
- A: White blood cell count (WBC) is not indicated for evaluating leg pain and swelling in this context.
- C: X-ray of the leg is not useful for diagnosing DVT, as it primarily shows bones and is not sensitive for detecting blood clots.
- D: Serum creatinine is a test for kidney function and is not relevant for assessing
The nurse is assessing a patient who is 12 hours postpartum. The uterus is firm to palpation, at midline, and is 1 cm below the umbilicus with continuous heavy vaginal bleeding. What is the nurse’s first action?
- A. Massage the uterus and resume the IV Pitocin drip.
- B. Change the peri-pad and reassess the bleeding.
- C. Call the provider to check for a cervical laceration.
- D. Administer the ordered iron supplement and ibuprofen.
Correct Answer: A
Rationale: The correct answer is A: Massage the uterus and resume the IV Pitocin drip. The patient is showing signs of uterine atony with heavy vaginal bleeding. Massaging the uterus helps stimulate contractions, controlling bleeding. Resuming IV Pitocin enhances uterine contractions further. Choices B, C, and D are incorrect. Changing the peri-pad does not address the underlying cause of bleeding. Checking for a cervical laceration may be needed later but is not the immediate priority. Administering iron supplement and ibuprofen does not address the acute issue of uterine atony and bleeding.
A client, G1 P0101, postpartum 1 day, is assessed. The nurse notes that the client 's lochia rubra is moderate and her fundus is boggy 2 cm above the umbilicus and deviated to the right. Which of the following actions should the nurse take first?
- A. Notify the woman 's primary health care provider.
- B. Massage the woman 's fundus.
- C. Escort the woman to the bathroom to urinate.
- D. Check the quantity of lochia on the peripad.
Correct Answer: B
Rationale: A boggy fundus can indicate uterine atony, which can lead to postpartum hemorrhage. The first step is to massage the fundus to stimulate uterine contraction.