Nokea
The nurse is providing postpartum care for a patient after a vaginal delivery. Which assessment finding causes the nurse to suspect endometritis from beta-hemolytic streptococcus?
- A. Scant amount of odorless lochia
- B. Presence of headache, malaise, and chills
- C. Pain or discomfort in the midline lower abdomen
- D. Elevated temperature greater than 100.4°F (38°C)
Correct Answer: D
Rationale: Endometritis from beta-hemolytic streptococcus specifically exhibits scant, odorless lochia in addition to the more universal signs of infection.
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A woman is 1 hour postcesarean delivery with nausea and an estimated blood loss of 1,200 mL. She is currently experiencing heavy vaginal bleeding and has a uterus that firms with massage. She has a history of asthma with a current O2 saturation of 89%. The licensed provider has ordered Cytotec 800 mcg and Methergine 0.2 mg. What collaborative communication should occur between the nurse and provider?
- A. Since the total blood loss is under 1,500 mL, Cytotec and Methergine administration could be delayed for a time.
- B. Cytotec should be given rectally because the patient is already nauseated, and the Methergine route should be ordered.
- C. Recommend that the abdominal dressing be removed to inspect for incisional bleeding.
- D. Recommend that the patient not get Methergine because she has a history of asthma.
Correct Answer: D
Rationale: The correct answer is D: Recommend that the patient not get Methergine because she has a history of asthma. Methergine is contraindicated in patients with a history of asthma due to its potential to cause bronchospasm and worsen respiratory function. As the patient has a history of asthma with a current low O2 saturation, administering Methergine could exacerbate her respiratory status. Collaborative communication between the nurse and provider is crucial to ensure patient safety and avoid potential complications.
Summary of other choices:
A: Delaying administration of Cytotec and Methergine is not appropriate as the patient is experiencing heavy vaginal bleeding and needs prompt management.
B: Giving Cytotec rectally and considering the route for Methergine do not address the contraindication of Methergine in a patient with asthma.
C: Removing the abdominal dressing to inspect for incisional bleeding may be necessary but does not address the contraindication of Methergine in a
A client, G1 P1, who had an epidural, has just delivered a daughter, Apgar 9/9, over a mediolateral episiotomy. The physician used low forceps. While recovering, the client states, 'I 'm a failure. I couldn 't stand the pain and couldn 't even push my baby out by myself! ' Which of the following is the best response for the nurse to make?
- A. You 'll feel better later after you have had a chance to rest and to eat.
- B. Don 't say that. There are many women who would be ecstatic to have that baby.
- C. I am sure that you will have another baby. I bet that it will be a natural delivery.
- D. To have things work out differently than you had planned is disappointing.
Correct Answer: D
Rationale: The nurse should acknowledge the emotional distress and disappointment while offering validation and understanding about how things didn't go as expected.
What assessment data increases the risk of postpartum infection?
- A. precipitous labor
- B. urinary retention
- C. breast-feeding
- D. intact perineum
Correct Answer: A
Rationale: The correct answer is A: precipitous labor. Precipitous labor can cause trauma to the birth canal, leading to increased risk of infection. Urinary retention (B) may lead to urinary tract infections but not necessarily postpartum infections. Breastfeeding (C) and intact perineum (D) are not direct risk factors for postpartum infections.
Which of the following complementary therapies can a nurse suggest to a multiparous woman who is complaining of severe afterbirth pains?
- A. Lie prone with a small pillow cushioning her abdomen.
- B. Contract her abdominal muscles for a count of ten.
- C. Slowly ambulate in the hallways.
- D. Drink ice tea with lemon or lime.
Correct Answer: A
Rationale: Afterbirth pains are caused by uterine contractions. Lying prone with a pillow can help reduce discomfort by applying pressure and providing support to the abdomen. Ambulating or contracting the abdominal muscles is not generally recommended in this scenario.
A nurse is assessing a 1-day-postpartum woman who had her baby by cesarean section. Which of the following should the nurse report to the surgeon?
- A. Fundus at the umbilicus.
- B. Nodular breasts.
- C. Pulse rate 60 bpm.
- D. Pad saturation every 30 minutes.
Correct Answer: D
Rationale: Excessive pad saturation every 30 minutes indicates possible postpartum hemorrhage and should be reported immediately to the surgeon.