Nokea
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.
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What is characteristic of a late (secondary) PPH?
- A. occurs within the first 24 hours
- B. is caused by subinvolution of the uterus
- C. does not occur after cesarean births
- D. cannot be treated with Methergine
Correct Answer: B
Rationale: Late PPH is caused by uterine subinvolution or retained tissue.
The nurse is caring for a client who had an emergency cesarean section, with her husband in attendance, the day before. The baby 's Apgar was 9/9. The woman and her partner had attended childbirth education classes and had anticipated having a water birth with family present. Which of the following comments by the nurse is appropriate?
- A. Sometimes babies just don 't deliver the way we expect them to.
- B. With all of your preparations, it must have been disappointing for you to have had a cesarean.
- C. I know you had to have surgery, but you are very lucky that your baby was born healthy.
- D. At least your husband was able to be with you when the baby was born.
Correct Answer: B
Rationale: The nurse should acknowledge the emotional impact of an unplanned cesarean section while validating the mother's feelings.
What assessment finding would indicate a fluid volume deficit?
- A. skin tenting with testing of skin turgor
- B. hypertension
- C. bradycardia
- D. bounding pulse
Correct Answer: A
Rationale: The correct answer is A because skin tenting with testing of skin turgor is a classic sign of fluid volume deficit. When there is a lack of fluid in the body, the skin loses its elasticity, causing it to tent or stay elevated when pinched. This indicates dehydration.
Choice B, hypertension, is incorrect because fluid volume deficit typically leads to hypotension, not hypertension. Choice C, bradycardia, is also incorrect as fluid volume deficit usually causes tachycardia to compensate for decreased blood volume. Choice D, bounding pulse, is incorrect as it is associated with fluid overload, not deficit.
The nurse is aware the greatest source of bleeding during childbirth occurs following detachment of the placenta. Which physiological change takes place immediately after the expulsion of the placenta to decrease the amount of blood loss?
- A. Contractions of the uterine myometrium
- B. Factor VIII complex increases during gestation
- C. Platelet activity increases before labor and delivery
- D. Fibrin formation increases before the birth occurs
Correct Answer: A
Rationale: The correct answer is A: Contractions of the uterine myometrium. After the placenta is expelled, the uterine myometrium contracts, causing compression of blood vessels at the site of placental detachment, which helps to decrease blood loss. This contraction also helps to close off blood vessels and reduce the risk of postpartum hemorrhage.
Summary of other choices:
B: Factor VIII complex increases during gestation - Factor VIII is involved in blood clotting, but its increase during gestation is not directly related to decreasing blood loss after placental expulsion.
C: Platelet activity increases before labor and delivery - While platelet activity is important for blood clotting, the increase before labor and delivery does not specifically address the immediate decrease in blood loss after placental expulsion.
D: Fibrin formation increases before the birth occurs - Fibrin formation is part of the clotting process, but its increase before birth does not directly address the immediate decrease in blood loss post
What type of lochia is bright to dark red and occurs on days 1 -3 postpartum?
- A. rubra
- B. serosa
- C. placental
- D. alba
Correct Answer: A
Rationale: Lochia rubra is red in color and occurs for the first 1-3 days postpartum as the body sheds blood decidua and trophoblastic tissue.