Maternal Exam 2 Study Set 2

Three hours after a vaginal delivery, the client reports increase perineal pain. What should the nurse do first? - assess the perineum A woman gave birth to a 7 pound 6 ounce infant girl one hour ago. The birth was vaginal, and the estimated blood loss (ebl) was 1500 ml. When assessing the woman's vital sign what should be msot concerning to the nurse? - hr 116 The nurse is caring for 15-year old primipara who was delivered yesterday. Which is the most appropriate intervention when planning discharge education? - demonstrate how to care for the newborn and have the clients return the demonstration A woman present to labor and delivery 35 weeks gestation with the following obstretric history. She delivered one child at 28 weeks gestation; child still living. She had a miscarriage at 8 weeks gestation. Should deliver one child at 36 weeks gestation. Child still living. What is her gtpal. - g4 T0 P2 A1 L2 The nurse is caring for a client who has just delivered vaginally. After assuring there is a patent airway. Which of the following action should the nurse's next priority in the care of the neonate? - dry, the infant and place the infant skin to skin with mom A gravida, 3 para 2 client at 39 weeks of gestation with poorly controlled gestation diabetes has just given birth via cesarean section. What would the nurse expect to find in the neonate? - hypoglycemic, large for gestation age After delivering a 9 pound 10 ounce baby a client who is gravida 5 para 5 is admitted to the postpartum unit what would be a priority nursing action for this client? - palpate the fundus because she is at risk for uterine atony While completing a postpartum assessment the nurse finds the fundus to be located fingerbreadth the umbilicus. How should this be documented? - u/1 below -1 below A clinet is identifying as rh negative. At 28 weeks gestation, the healthcare provider orders prophylactic rhogam. The client tells the nurse she does not need the medication because her last child was rh negative. What should the nurse do? - explain to the client why she needs the injection A woman gave birth vaginally to a 9 pound 12 ounce girl yesterday. Her primary care provider has written order for perineal ice packs. Use of sitz bath tid and a stool softener. What information is most closely correlated with disorders? - the woman has epiostomy The prenatal nurse providing care to a laboring woman recognized variable deceleration. What is the appropriate initial nursing action? - assist the woman to a left lateral position A nurse applies an external fetal monitor and toco-transducer to monitor the fetal heart rate and contractions of a client in labor. The fhr is in the one 40s contractions are every 2-3 minutes and 60 seconds in duration. The nurse performs a vaginal exam and finds the cervix is 6 cm dilated, and the fetus is at a -1 station. Which of the following stages and phases of labor is this client experiencing? - first stage, active phase A client experiences a large gush of fluid from her vagina while walking in the hallway of the birthing unit. The nurse established the fluid is amniotic fluid. What should be the nurses first action? - monitor the fetal heart rate for distress A client who is pregnant present with chronic hypertension. Which of the following is the primary adverse effect of this disorder that result in risk to the fetus? - uteroplacental insufficency If a newborn does not pass meconium during the first 36 hours of life. What is the most appropriate priority action by the nurse? - notify the physician A client at 39 weeks of gestation in the latent phase of labor is admitted to the labor and delivery unit. The client is attempting a vaginal birth after cesarean birth. In reviewing the client's medical record. The nurse should recognize which of the following has a contraindication to a vbac. - a classical vertical incision A client is admitted in labor. Her cervix is 100% effaced and 5 cm dilated, her fetus is in cephalic position and is at +1 station. What does the nurse know about the position of the fetus head? - it is below the ischial of the spine A g2 t2 p0 a l2 client experienced a precipitous birth 90 minutes ago. Her in front weight 4200 grams and a repair of a second degree laceration was needed following the birth. As part of the nurse assessment, the nurse discovers that the patient's urterus boggy. Furthermore, it is noted that the patient's vaginal bleeding has increased. What is the nurse most appropriate for actions? - massage the uterine fundus with continual lower segment support A client is diabetes mellitus give birth to a 9 pounds 10 ounce neonate at 39 weeks gestation. Which of the neonate's serum levels should be assessed immediately after birth? - glucose A nurse is assessing a newborn 1 hour after birth. Which of the following respiratory rate is within the expected reference range for a newborn? - 48/min A laboring a client being prepared for an epidural anesthesia, the perinatal nurse assists the anesthesiologist with the procedure and then position the client in a supine position. The clients blood pressure drops to 90/52 mm hg and there is a decrease in the fetal heart rate to 100 bpm. What would be the perinatal nurse's best response? - place a wedge under the clients left hip By drying the newborn immediately after birth, the nurse is preventing which type of heat loss? - evaporation Which symptoms would require careful medical assessment during the postpartum period? - headaches A laboring woman received butorphanol in opioid, ivp 30 minutes before she gave birth. Which medication should be available to reduce the effect the butorphanol on the neonate? - naloxone The mothers of a term neonate ask the nurse what the thick, white, cheesy coating is on her baby's skin. Which correctly describes this finding? - vernix A client continues to pass large number of clots and bright red lochia despite the nurses attempt to massage the fundus. Upon reexamination, the nurse finds that the client uterine fundus remains boggy. The nursing action and oxytocin do not seem to be helping to keep the fundus firm, which of the following medications would the nurse anticipate the physicians may order to manage uterin atony - methylergonovine