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What nursing intervention does the nurse include in the plan of care for a person with a perineal laceration infection?
- A. Demonstrate the use of a urinary catheter.
- B. Provide an abdominal binder.
- C. Encourage use of the peri-bottle for cleaning front to back.
- D. Discourage use of pain medications.
Correct Answer: C
Rationale: The peri-bottle helps maintain cleanliness and reduce infection risk in perineal lacerations.
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A G2 P2002, who is postpartum 6 hours from a spontaneous vaginal delivery, is assessed. The nurse notes that the fundus is firm at the umbilicus, there is heavy lochia rubra, and perineal sutures are intact. Which of the following actions should the nurse take at this time?
- A. Do nothing. This is a normal finding.
- B. Massage the woman 's fundus.
- C. Take the woman to the bathroom to void.
- D. Notify the woman 's primary health care provider.
Correct Answer: A
Rationale: A firm fundus at the umbilicus and heavy lochia rubra is normal during the first few hours after delivery.
What is a risk factor for uterine atony?
- A. small for gestational age
- B. primipara
- C. multiple gestation
- D. intrauterine growth restriction
Correct Answer: C
Rationale: Multiple gestation increases the risk of uterine atony due to over-distention of the uterus.
What is characteristic of an early (primary) PPH?
- A. occurs after 12 weeks postpartum
- B. is not an emergency
- C. often occurs due to uterine atony
- D. is diagnosed after the person is discharged
Correct Answer: C
Rationale: Early PPH is typically caused by uterine atony.
A breastfeeding woman, 1 1/2 months postdelivery, calls the nurse in the obstetrician 's office and states, 'I am very embarrassed but I need help. Last night I had an orgasm when my husband and I were making love. You should have seen the milk. We were both soaking wet. What is wrong with me? ' The nurse should base the response to the client on which of the following?
- A. The woman is exhibiting signs of pathological galactorrhea.
- B. The same hormone stimulates orgasms and the milk ejection reflex.
- C. The woman should have a serum galactosemia assessment done.
- D. The baby is stimulating the woman to produce too much milk.
Correct Answer: B
Rationale: The hormone oxytocin is responsible for both milk ejection during breastfeeding and uterine contractions during orgasm, which explains the milk release.
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.