Upgrade to remove ads
chap. 9 10 12 13 maternity CA
Terms in this set (73)
which postpartum patient assessment requires immediate nursing intervention?
soft uterine funds to the right of the midline, 2 hours after birth
the most serious potential problem if a woman's bladder is distended in the early postpartum period is:
Which woman is most likely to have afterpains?
Gravida 4, para 4, 9.5lb (4313 g) infant
2 hours after a woman's uncomplicated vaginal birth requiring no anesthesia, the nurse notes that her uterus is firm, 2 finger widths about her umbilicus, and deviated slightly to her right side. the most appropriate nursing action at this time is to:
helper her walk to the bathroom to urinate
choose the situation that describes appropriate admin of Rh (D) immune globulin(RhoGAM).
Rh positive infant, Rh negative mother, given IM to the mother within 72 hours of birth
when teaching parents about PKU testing, the nurse should teach them that:
follow up testing should be done during one of the early clinic visits
the nurse gives a post partum woman a rubella immunization. which is the most important patient teaching related to this immunization?
use a reliable birth control method for 3 months
Colostrus greatest benefit to the infant is prevention of:
the let down reflex is stimulated by:
suckling of the baby
what should the nursing mother be taught about breast care?
clean the breasts with plain water when washing
parents should be taught that the safest position for their term newborn in the crib is:
on either the back or side
at her 2 week postpartum checkup, the woman's uterus should be:
no longer palpable through the abdomen
Diuresis in the early postpartum period indicates:
excretion of excess fluid
the earliest time when sexual intercourse can usually be resumed after birth is:
when a laceration heals
the most appropriate way to identify mother and infant when reuniting them is to:
check the identification band numbers of each
which is the best nursing measure to increase the womwans perineal comfort during the first hour after vaginal birth with a midline episiotomy?
place an ice pack on that ares
a mother phones the postpartum unit 4 days after birth. She says her baby cannot suck well on her nipples because her breasts are full and engorged. what should the nurse recommend?
massage the breasts and express a small amount of milk before nursing
the nurse notes that a new mother has several bottles of partly consumed formula on her overbid table. Choose the most appropriate nursing action.
Check the room for other partially used bottles, then throw all of them in the trash.
which lochia characteristic should the nurse teach the woman to report?
return of red flow at 12 days postpartum
which nursing assessment suggests that a postpartum woman has cystitis?
burning with every urination
which nurses's teaching is appropriate for the new mother who has cystitis?
drink about 2 liters of non caffeinated beverages daily
A woman is 8 hours postpartum after a spontaneous vaginal birth. Her admission hemoglobin was 9.5 g/dL, and her estimated blood loss during the birth was 1000mL. She asks the nurse if she can walk to the bathroom. the best nursing response is to:
have her sit briefly on the side of the bed before helping her to the bathroom
which nursing assessment suggest infection of an episiotomy?
redness of the perineum with separation of the suture line
a woman has postpartum uterine atony with hemorrhage. after bleeding is controlled the physician orders an indwelling catheter mainly because it:
allows better estimation of the woman's fluid volume
a woman who is 3 days postpartum comes to the emergency clinic because she is having pain and burning discomfort when she urinates. she denies that she has had any fever and states that her lochia is "light pink" the nurse should expect an initial order for:
clean catch urine specimen
a woman is 5 days postpartum and breastfeeding. she telephones the nurse at the clinic and says that her breasts feel very heavy and one of them is tender. she says the infant nurses fair. the nurse should tell the woman that:
she should come to the clinic for evaluation of her symptoms
Methylergonevine(methergine) should be avoided if the woman has:
A woman had a forceps assisted birth 2 hours ago. Baseline vital signs were T 37.1 C (98.8 F), P 78, R 20, BP 118/70. Which assessment suggests possible development of hypovelemic shock in this woman?
Pulse 100 Respirations 24
A woman had a 16 hour labor that ended with the cesarean birth of a 4313g (9.5lb) infant. Her membranes were ruptured for 24 hours and oxytocin augmentation of labor was attempted before the cesarean birth. She has an IV infusion of ringers lactate and an indwelling catheter. For which complication should the nurse be most observant during the immediate recovery-room period?
if the nurse finds that a new mother's uterus is soft, the appropriate initial action is to:
massage the uterus until it is firm
one hour after vaginal birth, the nurse notes that a woman has a flat purple area, about 2 cm by 3cm, on her perineum. Which is the most appropriate nursing action at this time?
reapply a chemical cold pack on the area
when teaching a woman following vaginal birth 24 hours ago, the nurse should tell her to report:
pink vaginal drainage followed by red drainage
most approbate intervention to prevent deep vein thrombosis in a woman who is one day post cesarean birth.
encourage her to walk several times each day
Finding that suggests infection after birth
persistent and severe cramping 3 days postpartum
the best position for the woman who has postpartum endometritis is:
A woman who is a greatest risk for bleeding from a vaginal wall laceration
vaginal birth assisted with vacuum extractor
Foods that are highest in iron
Enriched bread, dark green leafy vegtables
A woman comes to the clinic for her 6 week postpartum check after having her first baby. she says to the nurse, "I don't know whats wrong with me. I'm exhausted all the time and yet i can't seem to sleep when i have the chance." the nurse should:
find a quiet place to talk with her about her feelings related to her new role as a mother.
Postpartum bipolar disorder is characterized by:
impaired reality characterized by euphoria alliterating with depression
which reflex shows the baby's reaction to sudden movement by drawing up the legs, extending the arms, then folding the arms across the the chest with the fingers open?
when teaching a mother how to nurse her baby, how should you explain the baby's rooting reflex? The rooting reflex:
is the babes way of seeking her nipple to obtain milk when hungry
in the birthing room, a first time father asks the nurse why the babes head is "long and pointy". the nurse should respond:
the head changes shape so it can pass thought the mothers pelvis during birth
visually babies prefer:
the human face.
The correct way to suction a babes mouth with a bulb syringe is to:
compress the bulb, place the tip in the side of the mouth, then release the bulb
When admitted to the nursery, a baby's initial rectal temperature is 35.8 C (96.6F). What is the most appropriate nursing response for this assessment?
keep the baby in a radiant warmer during admission and recheck the temperature in 30 mins.
One hour after a plastibell circumcision, the nurse notes a small amount of blood oozing from the area. Which is the appropriate initial nursing response to this observation?
apply pressure with a gauze pad and gloved fingers.
A new mother asks why her 2 day old babes skin appears slightly yellow. What is the best nursing response to explain the cause of the skin color?
excess blood cells are being broken down rapidly because the baby is now breathing air.
new parents should be taught to clean their babes ears by:
wiping the outside with a cotton ball that is moistened with water
a small area of a 6 day old term infants abdominal skin remains distorted when pinched gently. This assessment suggests:
what should the parents be taught about caring for the umbilical cord?
a sponge bath is easy and allows the cord to remain dry until healed
An infant has a small laceration on the forehead when delivered by cesarean. Brief finger pressure in the operating room stopped the bleeding and the physician does not need to suture the laceration. the nurse should primarily observe for what other complicating related to the babes laceration?
infection limited to the site or possibly generalized
A newborn has a heelstick for studies. the mother is concerned because the baby is crying loudly. the best response for the nurse is:
Hold the baby close and comfort him by gentle rocking
How should the nurse respond to acrocyanosis in a 12 hour old infant?
continue routine newborn nursing observations
which is an abnormal clinic assessment for a latino boy at 1 week of age? Birth weight was 3772g (8 pounds, 5 ounces); vital signs at hospital discharge time were: T 36.8(98.4F) (axillary); P142; R 40. There were no complications during pregnancy.
the infant weighs 3318g (7 pounds, 5 ounces) at 1 week
a new mother asks why her term newborn sometimes shakes when he cries. what is the best nursing response?
this is a normal newborn behavior during crying
A term newborn should pass the first meconium stool no later than how many hours after birth?
a new mother is concerned because her 3 day old daughter has a slightly blood tinged vaginal mucus discharge. how should the nurse respond to this mothers concern?
effects of your pregnancy hormones cause this response
the nurse should teach parents to avoid using baby powder because it:
irritates the newborns respiratory tract
an infant looks at her mother and remains quiet when the mothers sings to her in soft, high pitched tones. this is an example of:
the quiet alert state of reactivity
which physical characteristic should make the nurse think an infants gestational age may be preterm?
superficial scalp and abdominal veins easily seen
gestational age is best determined with:
assessment of physical and neurological characteristics
a preterm infant is subject to hypothermia because the:
relatively large body surface area allows heat to escape
Choose the normal blood glucose level for a preterm infant.
the nurse must handle the preterm infant gently because capillaries are:
fragile and prone to bleed spontaneously
the advantage of radiant warmers in the care of preterm infants is that they:
mainatin warmth with easy caregiver access
the ideal feeding for most preterm newborns is:
breast milk given by suckling, bottle, or garage.
an infant is brought to the newborn nursery. the gestation stated on the chart is 39 weeks. the nurse doing the initial assessment notes that the infant has peeling skin and a long, thin appearance. what is the probable reason for the infants appearance?
the actual gestational age may be greater than 42 weeks.
a mother gives birth to a preterm infant at 30 weeks gestation. when visiting the baby in the intensive care unit, she seems interested in the baby, but sits and watches everything the nurse does for her baby. which is the most appropriate nursing intervention to promote mother-infant attachment?
invite her to provide simple care to her infant
Which busing assessment best suggest respiratory distress syndrome?
grunting, respiratory rate of 65/min, nasal flaring
the alarm on on apnea monitor for a preterm infant sounds. the infant is asleep, the skin color is pink, and the heart rate is 130-135/ min. the most appropriate initial nursing response is to:
gently rub the infants back.
A key nursing intervention to prevent retinopathy of prematurity is to:
monitor the infants blood oxygen levels
most problems of the post term infant result from:
decreased function of the placenta
choose the bilirubin level or levels that should be reported to the physician for an infant of 38 weeks gestation:
4mg/dL at 18 hours after birth; 12 mg prior to discharge at 36 hours
THIS SET IS OFTEN IN FOLDERS WITH...
Ob Study quide ch 6, 7 & 8 workbook NCLEX
Fetal development and pregnancy
Maternity Chap 5
YOU MIGHT ALSO LIKE...
OB 12.10.12 Test
questions for test 4
ch 17 pillitteri
OB exam 3
OTHER SETS BY THIS CREATOR
Psychology Chap. 8