NURS 415 EXAM 2 REVIEW STUDY GUIDE WITH COMPLETE
SOLUTION!!
If the uterus is hypotonic or boggy, what should the nurse do?
Answers :increase contractility and minimize blood loss by encouraging the
patient to urinate and administering prescribed IV fluids of 10 to 40 units of
oxytocin added to 1000mL of Lactated Ringers or normal saline
What other interventions can the nurse do to treat a patient undergoing postpartum
hemorrhaging ?
Answers :-give oxygen by nonrebreather mask to enhance oxygen delivery to the
cells
-insert an indwelling urinary catheter to monitor urinary output to measure renal
perfusion
-monitor vital signs especially heart rate and blood pressure, oxygen saturation,
arterial blood gases, and hematocrit and hemoglobin
-measure and record the amount of bleeding by weighing and counting saturated
pads (save clots and tissues for further examination)
-monitor for signs of infection (fever, foul-smelling lochia, increased pain or
tenderness of uterus)
What lab studies are done when a woman is experiencing postpartum bleeding ?
Answers :complete blood count with platelet count, fibrinogen, fibrin split
products, prothrombin time, and partial thromboplastin time
Why is oxytocin (pitocin) given to a pregnant woman hemorrhaging ?
Answers :it decreases bleeding
When should the pregnant woman notify the health care provider ?
,Answers :when a woman is at risk for preterm labor and infection
Which electrolyte would be abnormal for a woman experiencing hyperemesis
gravida (morning sickness)?
Answers :sodium, potassium, chloride
Sodium: 135-145
Potassium: 3.5-5.0
Chloride: 96-106
Psychosocial assessment for a woman experiencing hyperemesis gravida (morning
sickness )
Answers :-The woman with hyperemesis gravidarum needs calm, compassionate,
and sympathetic care.
-Irritability, tearfulness, and mood changes are often consistent with this disorder.
-The nurse can provide an environment conducive to discussion of concerns and
help the woman to identify and mobilize sources of support.
-The family should be included in the plan of care whenever possible. Their
participation may help reduce some of the emotional stress associated with this
disorder.
Physical exam findings of hyperemesis gravida (morning sickness)
Answers :-dry mucous membranes
-decreased BP
, - increased pulse rate
- poor skin turgor.
-unable to keep down even clear liquids taken by mouth.
-laboratory tests may reveal electrolyte imbalances.
Complications of hyperemesis gravidarum
Answers :-esophageal rupture
-pneumomediastinum
-deficiencies of vitamin K and thiamine with resulting Wernicke encephalopathy
(CNS involvement)
-Infants may have a low birthweight, or be born prematurely
Diet for Hyperemesis Gravidarum
Answers :-Avoid an empty stomach.
-Eat frequently, at least every 2 to 3 h.
-Separate liquids from solids, and alternate every 2 to 3 h.
- Eat a high-protein snack at bedtime.
- Eat dry, bland, low-fat, and high-protein foods. Cold foods may be better
tolerated than those served at a warm temperature.
-In general, eat what sounds good to you rather than trying to balance your meals.
- Follow the salty and sweet approach; even so-called junk foods are okay.
- Eat protein after sweets.
-Dairy products may stay down more easily than other foods.
-If you vomit even when your stomach is empty, try sucking on a Popsicle.
-Try ginger tea.
SOLUTION!!
If the uterus is hypotonic or boggy, what should the nurse do?
Answers :increase contractility and minimize blood loss by encouraging the
patient to urinate and administering prescribed IV fluids of 10 to 40 units of
oxytocin added to 1000mL of Lactated Ringers or normal saline
What other interventions can the nurse do to treat a patient undergoing postpartum
hemorrhaging ?
Answers :-give oxygen by nonrebreather mask to enhance oxygen delivery to the
cells
-insert an indwelling urinary catheter to monitor urinary output to measure renal
perfusion
-monitor vital signs especially heart rate and blood pressure, oxygen saturation,
arterial blood gases, and hematocrit and hemoglobin
-measure and record the amount of bleeding by weighing and counting saturated
pads (save clots and tissues for further examination)
-monitor for signs of infection (fever, foul-smelling lochia, increased pain or
tenderness of uterus)
What lab studies are done when a woman is experiencing postpartum bleeding ?
Answers :complete blood count with platelet count, fibrinogen, fibrin split
products, prothrombin time, and partial thromboplastin time
Why is oxytocin (pitocin) given to a pregnant woman hemorrhaging ?
Answers :it decreases bleeding
When should the pregnant woman notify the health care provider ?
,Answers :when a woman is at risk for preterm labor and infection
Which electrolyte would be abnormal for a woman experiencing hyperemesis
gravida (morning sickness)?
Answers :sodium, potassium, chloride
Sodium: 135-145
Potassium: 3.5-5.0
Chloride: 96-106
Psychosocial assessment for a woman experiencing hyperemesis gravida (morning
sickness )
Answers :-The woman with hyperemesis gravidarum needs calm, compassionate,
and sympathetic care.
-Irritability, tearfulness, and mood changes are often consistent with this disorder.
-The nurse can provide an environment conducive to discussion of concerns and
help the woman to identify and mobilize sources of support.
-The family should be included in the plan of care whenever possible. Their
participation may help reduce some of the emotional stress associated with this
disorder.
Physical exam findings of hyperemesis gravida (morning sickness)
Answers :-dry mucous membranes
-decreased BP
, - increased pulse rate
- poor skin turgor.
-unable to keep down even clear liquids taken by mouth.
-laboratory tests may reveal electrolyte imbalances.
Complications of hyperemesis gravidarum
Answers :-esophageal rupture
-pneumomediastinum
-deficiencies of vitamin K and thiamine with resulting Wernicke encephalopathy
(CNS involvement)
-Infants may have a low birthweight, or be born prematurely
Diet for Hyperemesis Gravidarum
Answers :-Avoid an empty stomach.
-Eat frequently, at least every 2 to 3 h.
-Separate liquids from solids, and alternate every 2 to 3 h.
- Eat a high-protein snack at bedtime.
- Eat dry, bland, low-fat, and high-protein foods. Cold foods may be better
tolerated than those served at a warm temperature.
-In general, eat what sounds good to you rather than trying to balance your meals.
- Follow the salty and sweet approach; even so-called junk foods are okay.
- Eat protein after sweets.
-Dairy products may stay down more easily than other foods.
-If you vomit even when your stomach is empty, try sucking on a Popsicle.
-Try ginger tea.
