Maternity Exam - Questions and Answers

Maternity Exam - Questions and Answers On the second postpartum day, a client complains of burning, urgency, and frequency of urination. A urinalysis is obtained, and the results indicate the presence of a urinary tract infection. The nurse instructs the client regarding which measures to take for the prevention and treatment of the infection? Select all that apply. - 1.Urinate frequently throughout the day. 2. Fluid intake should be increased to at least 3000 mL/day. 3. Prescribed medication must be taken until it is completed. 5. Wipe the perineal area from front to back after urinating. Rationale: The woman with a urinary tract infection must be encouraged to take the medication for the entire time it is prescribed. The woman also should be instructed to drink at least 3000 mL of fluid each day to flush the infection from the bladder and to urinate frequently throughout the day. Foods and fluids that acidify the urine need to be encouraged. The client is also taught to wipe the perineal area from front to back after urinating or having a bowel movement. The nurse visits a client at home who delivered a healthy newborn 2 days ago. The client is complaining of breast discomfort. The nurse notes that the client is experiencing breast engorgement. The nurse provides which instructions to the client regarding relief of the engorgement? Select all that apply. - Feed the infant at least every 2 hours for 15 to 20 minutes on each side. Apply moist heat to both breasts for about 20 minutes before a feeding. Massage the breasts gently during a feeding, from the outer areas to the nipples. Wear a supportive bra between feedings. Rationale: During breast engorgement, the client should be advised to feed the infant frequently, at least every 2 hours, for 15 to 20 minutes on each side. The infant will have an easier time latching on if the client softens her breast and expresses her milk before a feeding. Instruct the client to apply moist heat to both breasts for about 20 minutes before a feeding. This can be done in the shower or with warm wet towels. During a feeding, it is helpful to massage the breast gently from the outer area to the nipple. This helps stimulate the let-down and flow of milk. The client also should be instructed to wear a supportive bra between feedings. The nurse provides which instructions to the client following delivery regarding care of the episiotomy site to prevent infection? Select all that apply. - Take a warm sitz baths three times a day. Wipe the perineum from front to back after voiding and defecation. Use warm water to rinse the perineum after elimination. Report a foul-smelling discharge. Rationale: Warm sitz baths and cleansing with warm water are helpful for relieving pain, and these measures will promote cleanliness in the perineal area to prevent infection. The client should also be instructed to wipe the perineum from front to back after voiding and defecation to decrease the risk for contamination with microorganisms from the anus to the vagina. Warm water should be used to rinse the perineum after elimination. The client also should be instructed that the perineal pad should be changed after each elimination and may be changed in between. The nurse is collecting data from a pregnant client in the second trimester of pregnancy who was admitted to the maternity unit with a suspected diagnosis of abruptio placentae. Which of the following findings are associated with abruptio placentae? Select all that apply. - Acute abdominal pain A hard, "board-like" abdomen Increased uterine resting tone on fetal monitoring Uterine tenderness Rationale: Painless, bright red vaginal bleeding in the second or third trimester of pregnancy is a sign of placenta previa. In abruptio placentae, acute abdominal pain is present. Uterine tenderness accompanies placental abruption, especially with a central abruption and trapped blood behind the placenta. The abdomen will feel hard and board-like on palpation as the blood penetrates the myometrium and causes uterine irritability. Observation of the fetal monitoring often reveals increased uterine resting tone, caused by placental abruption. Which of the following are modes of heat loss in the newborn? Select all that apply. - Convection Radiation Conduction Evaporation Rationale: The newborn can lose heat through convection, radiation, conduction, and evaporation. Heat is not lost through urination. .....................