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What nursing intervention does the nurse include in the plan of care for a person with postpartum endometritis?
- A. Monitor for signs of sepsis.
- B. Discourage breast-feeding.
- C. Avoid fundal assessment.
- D. Increase family visiting hours.
Correct Answer: A
Rationale: Monitoring for signs of sepsis is important in postpartum endometritis as it can lead to severe complications if untreated.
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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 correct answer is C because using a peri-bottle for cleaning front to back helps prevent introducing more bacteria into the infected perineal laceration. This method maintains proper hygiene, reduces the risk of further infection, and promotes healing. A urinary catheter (A) is not typically indicated for a perineal laceration infection. An abdominal binder (B) may provide support but does not directly address the infection. Discouraging pain medications (D) is not appropriate as pain management is important for patient comfort and healing.
A maternity nurse knows that obstetric clients are most at high risk for cardiovascular compromise during the one hour immediately following a delivery because of which of the following?
- A. Weight of the uterine body is significantly reduced.
- B. Excess blood volume from pregnancy is circulating in the woman 's periphery.
- C. Cervix is fully dilated and the lochia flows freely.
- D. Maternal blood pressure drops precipitously once the baby 's head emerges.
Correct Answer: B
Rationale: During the first hour postpartum, the excess blood volume that was circulating to the uterus is redistributed to the woman's peripheral circulation, which can lead to cardiovascular instability.
The nurse educates the non -breast-feeding person on breast discomfort caused by engorgement. What instructions would they give?
- A. Massage breasts to release milk.
- B. Apply cold packs and cabbage leaves.
- C. Stand in the warm shower to stimulate letdown.
- D. Do not wear a bra.
Correct Answer: B
Rationale: Cold packs and cabbage leaves help reduce swelling and discomfort caused by engorgement in non-breastfeeding individuals.
The nurse works in a labor and delivery facility with new protocols for estimating postpartum blood loss. Which method for estimating blood loss is implemented in the delivery room?
- A. Ask the patient how many peripads she considered to be “soaked.”
- B. Collect blood in calibrated, under-buttocks drapes for vaginal birth.
- C. Place a basin at the foot of the delivery table to catch any blood.
- D. Rely on the primary health care provider’s estimate of blood loss.
Correct Answer: B
Rationale: Collecting blood in calibrated, under-buttocks drapes for vaginal birth and then weighing the drapes is the easiest way to estimate blood loss in the delivery room.
Which medications are used to manage PPH? (Select all that apply.)
- A. Oxytocin
- B. Methergine
- C. Terbutaline
- D. Hemabate
Correct Answer: A
Rationale: The correct answer is A: Oxytocin. Oxytocin is the first-line medication for managing postpartum hemorrhage (PPH) as it helps in the contraction of the uterus to control bleeding. Methergine (B) is used for uterine atony but is not the first-line choice. Terbutaline (C) is a tocolytic agent and not indicated for PPH. Hemabate (D) is used as a second-line medication for PPH after oxytocin.