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What would the nurse planning discharge instruction teach the woman to do?
- A. Report any increase in fetal activity.
- B. Notify her obstetrician if she has a temperature above 37.8?°C (100?°F).
- C. Massage her breasts to promote uterine relaxation.
- D. Rest in a side-lying Trendelenburg's position with hips elevated.
Correct Answer: B
Rationale: For the woman with premature rupture of membranes (PROM) who is not having labor induced right away, teaching combines information about infection and preterm labor. The woman should monitor her temperature and report a temperature greater than 37.8?°C (100?°F).
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What action by the physician will the nurse anticipate?
- A. Perform an amniotomy.
- B. Initiate tocolytic drugs.
- C. Order a sedative for the patient.
- D. Plan to do an emergency cesarean section.
Correct Answer: A
Rationale: Medical treatment for hypotonic labor dysfunction includes an amniotomy as the first remedy if the membranes are intact.
How might the nurse instruct the patient to stimulate her nipples in an attempt to increase the quality of uterine contractions?
- A. Place a warm, moist washcloth over the breast.
- B. Brush the nipples with a dry washcloth.
- C. Gently pull on the nipples.
- D. Apply suction to the nipples with a breast pump.
- E. Press the palms of her hands down on her breasts.
Correct Answer: B,C,D
Rationale: Brushing nipples with a dry washcloth, gently pulling nipples, and applying suction with a breast pump are effective methods to increase uterine contractions.
What is the cause?
- A. Prolonged pressure against the partially dilated cervix
- B. Small leak of fluid through the posterior fontanelle
- C. Pressure of the forceps during delivery
- D. The effect of the vacuum extractor
Correct Answer: D
Rationale: The 'chignon' is due to the effect of the vacuum extractor and will disappear in a few days.
What complications of overstimulation of uterine contractions may occur?
- A. Water intoxication
- B. Impaired placental exchange of oxygen and nutrients
- C. Increased blood pressure
- D. Convulsions
- E. Uterine rupture
Correct Answer: A,B,E
Rationale: The most common complications are impaired placental exchange, uterine rupture, and water intoxication due to fluid retention.
How would the nurse position the woman to prevent compression of a prolapsed cord?
- A. On her right side with knees flexed
- B. On her left side with a pillow placed between her legs
- C. On her back with her head lower than the rest of her body
- D. Supine with her legs elevated and bent at the knee
Correct Answer: C
Rationale: The Trendelenburg's (head down) position displaces the fetus upward to stop compression of the prolapsed cord.