Nokea
A labor client has been diagnosed with CPD following attempts of pushing for 2 hours with no progress. Based on the info, which birth method is available when you have CPD (baby can't come out)?
- A. C/S
- B. Induced labor
- C. Vaginal birth with vacuum
- D. Insert foley catheter to empty bladder and make more room
Correct Answer: A
Rationale: CPD (cephalopelvic disproportion) occurs when the baby's head or body is too large to pass through the mother's pelvis. In cases where CPD is diagnosed and labor has stalled despite adequate efforts (such as pushing for 2 hours with no progress), the safest and most appropriate method to deliver the baby is through a cesarean section (C/S). This surgical procedure allows for a safe delivery when vaginal delivery is not possible due to CPD, ensuring the well-being of both the baby and the mother. Induced labor, vaginal birth with vacuum, or inserting a foley catheter to empty the bladder would not be effective or safe in cases of CPD where the baby cannot pass through the birth canal.
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The nurse is explaining how a newly delivered baby initiates respiration. Which statement explains this process?
- A. Chemical thermal and mechanical factors
- B. Increase of po2 and decreased pco2
- C. Continued function of foramen ovale
- D. Drying off the infant
Correct Answer: A
Rationale: The correct statement explaining how a newly delivered baby initiates respiration is "Chemical thermal and mechanical factors." When a baby is born, various factors come into play to stimulate the baby's first breath. Chemically, the baby senses a decrease in oxygen and an increase in carbon dioxide levels, triggering the respiratory centers in the brain to start the breathing process. Thermally, exposure to the cooler air outside the womb stimulates the baby's skin receptors, encouraging the baby to take a breath. Mechanically, the pressure changes during delivery and the physical stimulation of the baby's face and body also play a role in initiating respiration. Overall, it is the combined effect of these chemical, thermal, and mechanical factors that help a newly delivered baby begin breathing independently.
A nurse is caring for a client 2 hr after a spontaneous vaginal birth and the client has saturated two perineal pads with blood in a 30-min period. Which of the following is the priority nursing intervention at this time?
- A. Palpate the client's uterine fundus.
- B. Assist the client on a bedpan to urinate.
- C. Prepare to administer oxytocic medication.
- D. Increase the client's fluid intake.
Correct Answer: A
Rationale: The priority nursing intervention in this situation is to palpate the client's uterine fundus. Saturating two perineal pads with blood in a 30-minute period after childbirth is indicative of excessive postpartum bleeding, also known as postpartum hemorrhage (PPH). Palpating the uterine fundus helps the nurse assess for uterine atony, a common cause of PPH. If the fundus is boggy or not firm, it indicates that the uterus is not contracting effectively to control bleeding, which can lead to further complications if not addressed promptly. Once uterine atony is identified, other interventions such as administering oxytocic medications can be initiated to help the uterus contract and control bleeding.
The nurse provides education regarding female sterilization. What important information is provided?
- A. “You will need to wait 3 months before you are sterile.â€
- B. “You can have this procedure in the hospital after you give birth.â€
- C. “Fertilization will affect your milk supply for breast-feeding.â€
- D. “Tubal ligation is reversible.â€
Correct Answer: D
Rationale: The important information provided regarding female sterilization is that tubal ligation, which is a form of female sterilization, is generally considered irreversible. This means that it is a permanent method of contraception and should not be relied upon as a temporary solution. It is important for individuals considering this procedure to understand that it is meant to be permanent and should be approached as such. If there is any consideration for future fertility, alternative contraceptive options should be discussed with a healthcare provider.
A patient is about to undergo an amniocentesis. tion on her postpartum clients. Which client has a Which procedures should the nurse perform? Select high risk for postpartum hemorrhage? Select all all that apply.
- A. Have the patient give verbal consent for the
- B. Client who delivered vaginally at 40 weeks procedure.
- C. Client who delivered by cesarean delivery because
- D. Assess for bleeding disorders.
Correct Answer: A
Rationale: Having the patient give verbal consent for the procedure is a standard practice and an important step to ensure that the patient understands the risks and benefits of the amniocentesis.
A patient is taking oral contraceptives and asks whether they will still be effective if she has diarrhea. What should the nurse respond?
- A. Oral contraceptives will still work if taken with food.
- B. Oral contraceptives may be less effective during diarrhea due to absorption issues.
- C. Oral contraceptives need to be stopped for 7 days when experiencing diarrhea.
- D. Oral contraceptives will be more effective during diarrhea due to faster metabolism.
Correct Answer: B
Rationale: Diarrhea can reduce the absorption of oral contraceptives, potentially making them less effective. Choice A is incorrect because food does not always affect oral contraceptive absorption. Choice C is incorrect because there is no need to stop the contraceptives, but additional methods may be recommended during diarrhea. Choice D is incorrect because diarrhea does not increase the effectiveness of oral contraceptives.