Pregnancy, Labor, Childbirth, Postpartum - At Risk

Pregnancy, Labor, Childbirth, Postpartum - At Risk A nurse applies fetal and uterine monitors to the abdomen of a client in active labor. When the client has contractions, the nurse notes a 15 beats/min deceleration of the fetal heart rate below the baseline lasting 15 seconds. What is the next nursing action? - Changing the maternal position To prevent or stabilize a client in heroin withdrawal during labor, which medication should be administered as ordered if the woman is nauseated, vomiting, or did not receive her daily dose at a chemical dependence center? - Dolophine (Methadone) A primigravida in whom placenta previa has already been diagnosed is admitted with bright-red vaginal bleeding at 34 weeks' gestation. What is the nurse's initial intervention? - Positioning the client in the side-lying position to ease pressure on the cervix What should be included in the nursing care for a client at 41 weeks' gestation who is to have a contraction stress test? - Having the client empty her bladder A nurse is caring for a client who has been admitted with a tentative diagnosis of placenta previa. What procedure does the nurse anticipate? - Ultrasound examination A pregnant client comes to the emergency department because of vaginal bleeding. The nurse asks the client to estimate how heavy the bleeding is. What is the best gauge for the client to use? - Amount of blood lost in relation to usual menstrual flow Several hours after delivery, a new mother expresses ambivalence about her infant. How will the nurse promote bonding between this mother and her newborn? - Having the mother feed the infant A client at term is admitted in active labor. She has tested positive for HIV. Which intervention in the standard orders should the nurse question as a risk to the fetus? - Internal fetal scalp electrode A pregnant client with a history of preterm labor is at home on bedrest. What instructions should a teaching plan for this client include? - Lie on the side with the head raised on a small pillow. After a difficult labor a client gives birth to a 9-lb boy who dies shortly afterward. That evening the client tearfully describes to the nurse her projected image of her son and what his future might have been. What is the nurse's most therapeutic response? - "It must be difficult to think of him now." A woman is admitted to the high-risk unit in preterm labor at 30 weeks' gestation. What does the nurse suspect precipitated this preterm labor? - Incompetent cervix A multipara whose membranes have ruptured is admitted in early labor. Assessment reveals a breech presentation, cervical dilation of 3 cm, and fetal station at −2. For what complication should the nurse assess when caring for this client? - Prolapse of the umbilical cord Which client is at risk for a postpartum infection? - A woman who required catheterization after voiding less than 75 mL A nurse is concerned about a client's mother-infant bonding when on the first postpartum day she is reluctant to: - Look at her newborn's face. A client in labor, who is at term, is admitted to the birthing room. The fetus is in the left occiput posterior position. The client's membranes rupture spontaneously. What observation requires the nurse to notify the practitioner? - Greenish amniotic fluid When entering the room of a client in active labor to answer the call light, the nurse sees that she is ashen gray, dyspneic, and clutching her chest. What should the nurse do after pressing the emergency light in the client's room? - Administer oxygen by facemask. A client who had a cesarean birth is unable to void 3 hours after the removal of an indwelling catheter. How can the nurse evaluate whether the client's bladder is distended? - By palpating the client's suprapubic area gently A 24-year-old client who has had type 1 diabetes for 6 years is concerned about how her pregnancy will affect her diet and insulin needs. How should the nurse respond? - "Insulin dosage and dietary needs will be adjusted in accordance with the results of blood glucose monitoring." A nonstress test (NST) is scheduled for a client with mild preeclampsia. During the test, the client asks the nurse what it means when the fetal heart rate goes up every time the fetus moves. What should the nurse consider before responding? - These accelerations are a sign of fetal well-being. A client had a cesarean birth 4 hours ago. What is the major nursing intervention at this time? - Relieving postoperative pain ............