Nokea
The nurse is educating a client about the benefits of skin-to-skin contact after delivery. What is one of the key benefits?
- A. Prevents postpartum hemorrhage.
- B. Improves maternal milk production.
- C. Reduces the risk of neonatal jaundice.
- D. Stabilizes neonatal temperature and heart rate.
Correct Answer: D
Rationale: Skin-to-skin contact helps stabilize the newborn's temperature and heart rate while promoting bonding.
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The nurse knows that contraindication of the induction of labor includes:
- A. Placenta previa
- B. Diabetes mellitus
- C. PROM
- D. Isoimmunization
Correct Answer: A
Rationale: Placenta previa is a contraindication for the induction of labor because the placenta partially or completely covers the cervix. Inducing labor in this situation can lead to complications such as excessive bleeding and compromised blood flow to the baby. Therefore, it is important to avoid inducing labor in cases of placenta previa to ensure the safety of both the mother and the baby.
A nurse is reviewing the electronic medical record of a postpartum client. The nurse should identify that which of the following factors paces the client at risk for infection.
- A. Meconium "“ start fluid
- B. Placenta previa
- C. Midline episiotomy
- D. Gestational hypertension
Correct Answer: C
Rationale: A midline episiotomy increases the risk for infection in postpartum clients due to the incision made in the perineum during childbirth. This incision can serve as a portal of entry for microorganisms, leading to an increased risk of infection. Meconium-stained amniotic fluid (choice A) can increase the risk of respiratory distress in the newborn but is not directly related to infection in the postpartum client. Placenta previa (choice B) is a condition during pregnancy where the placenta partially or completely covers the cervix, which poses risks related to bleeding rather than infection postpartum. Gestational hypertension (choice D) is a risk factor for developing preeclampsia or eclampsia during pregnancy but does not directly increase the risk of infection in the postpartum period.
A nurse is caring for a client who experienced a vaginal delivery 12 hr ago. When palpating the client's abdomen, at which of the following positions should the nurse expect to find the uterine fundus?
- A. At the level of the umbilicus
- B. 2 cm above the umbilicus
- C. One fingerbreadth above the symphysis pubis
- D. To the right of the umbilicus
Correct Answer: C
Rationale: After a vaginal delivery, the uterus typically undergoes involution, which is the process of the uterus returning to its pre-pregnancy size and position. At 12 hours postpartum, the uterine fundus should be palpated approximately one fingerbreadth above the symphysis pubis. This position indicates proper contraction of the uterus and helps prevent postpartum hemorrhage. As time progresses, the uterine fundus will gradually descend back into the pelvis.
A nurse on the labor and delivery unit is caring for a patient who is having induction of labor with oxytocin administered through a secondary IV line. Uterine contractions occur every 2 min, last 90 sec, and are strong to palpation. The baseline fetal heart rate is 150/min, with uniform decelerations beginning at the peak of the contraction and a return to baseline after the contraction is over. Which of the following actions should the nurse take?
- A. Decrease the rate of infusion of the maintenance IV solution.
- B. Discontinue the infusion of the IV oxytocin.
- C. Increase the rate of infusion of the IV oxytocin.
- D. Slow the client's rate of breathing.
Correct Answer: B
Rationale: The described scenario suggests the presence of late decelerations, which occur when uteroplacental insufficiency leads to decreased fetal oxygenation. In this case, the late decelerations are evident with each contraction, indicating a potential adverse reaction to the oxytocin infusion. The appropriate action would be to discontinue the infusion of IV oxytocin to prevent further compromise to fetal well-being. Alternatively, the nurse should consider repositioning the mother, administering oxygen via a face mask, and notifying the healthcare provider for further assessment and interventions.
A nurse in the ambulatory surgery center is providing discharge teaching to a client who had a dilation and curettage (D&C) following a spontaneous miscarriage. Which of the following should be included in the teaching?
- A. Vaginal intercourse can be resumed after 2 weeks.
- B. Products of conception will be present in vaginal bleeding.
- C. Increased intake of zinc-rich foods is recommended.
- D. Aspirin may be taken for cramps.
Correct Answer: B
Rationale: Following a dilation and curettage (D&C) procedure for a miscarriage, it is important to inform the client that they may experience vaginal bleeding containing products of conception. This is a normal part of the recovery process after this type of procedure. The presence of these products of conception in the vaginal bleeding should be monitored and reported to the healthcare provider if there are any unusual symptoms or excessive bleeding. It is essential for the nurse to provide appropriate information and guidance to the client about what to expect post-procedure to ensure they can differentiate between normal and abnormal symptoms.