Antepartum Exam4: part 2of1 Flashcards

A woman who is 39 weeks pregnant expresses fear about her impending labor and how she will manage. The nurse's best response is:

A primigravida has just delivered a healthy infant girl. The nurse is about to administer erythromycin ointment in the infant's eyes when the mother asks, 'What is that medicine for?' The nurse responds:

An 18-year-old pregnant woman, gravida 1, is admitted to the labor and birth unit with moderate contractions every 5 minutes that last 40 seconds. The woman states, 'My contractions are so strong that I don't know what to do.' The nurse should:
Answer

In planning for home care of a woman with preterm labor, the nurse needs to address what concern?

The early postpartum period is a time of emotional and physical vulnerability. Many mothers can easily become psychologically overwhelmed by the reality of their new parental responsibilities. Fatigue compounds these issues. Although the baby blues are a common occurrence in the postpartum period, about one-half million women in America experience a more severe syndrome known as postpartum depression (PPD). Which statement regarding PPD is essential for the nurse to be aware of when attempting to formulate a nursing diagnosis

A multiparous woman has been in labor for 8 hours. Her membranes have just ruptured. The nurse's initial response would be to:

After giving birth to a healthy infant boy, a primiparous woman, 16, is admitted to the postpartum unit. An appropriate nursing diagnosis for her at this time is risk for impaired parenting related to deficient knowledge of newborn care. In planning for the woman's discharge, what should the nurse be certain to include in the plan of care?

For a woman at 42 weeks of gestation, which finding would require more assessment by the nurse?

The parents of a newborn ask the nurse how much the newborn can see. The parents specifically want to know what type of visual stimuli they should provide for their newborn. The nurse responds to the parents by telling them:

A pregnant woman was admitted for induction of labor at 43 weeks of gestation with sure dates. A non-stress test (NST) in the obstetrician's office revealed a nonreactive tracing. On artificial rupture of membranes, thick, meconium-stained fluid was noted. The nurse caring for the infant after birth should anticipate:

A nurse is discussing the signs and symptoms of mastitis with a mother who is breastfeeding. What signs and symptoms should the nurse include in her discussion? Choose all that apply.

A macrosomic infant is born after a difficult forceps-assisted delivery. After stabilization the infant is weighed, and the birth weight is 4550 g (9 pounds, 6 ounces). The nurse's most appropriate action is to:

A client weighs 176 pounds. Heparin infusion 20,000 units in 1 L NS. Order: Bolus with heparin sodium at 80 units/kg, then initiate drip at 18 units/kg/hr. Calculate the bolus dosage in units.
Answer with a whole number

A woman who has recently given birth complains of pain and tenderness in her leg. On physical examination the nurse notices warmth and redness over an enlarged, hardened area. The nurse should suspect __________ and should confirm the diagnosis by ___________.

A woman in the active phase of the first stage of labor is using a shallow pattern of breathing, which is about twice the normal adult breathing rate. She starts to complain about feeling lightheaded and dizzy and states that her fingers are tingling. The nurse should:

The nurse is discussing storage of breast milk with a mother whose infant is preterm and in the special care unit. What statement would indicate that the mother needs additional teaching?

You are evaluating the fetal monitor tracing of your client, who is in active labor. Suddenly you see the fetal heart rate (FHR) drop from its baseline of 125 down to 80. You reposition the mother, provide 10 liters oxygen via facemask, increase intravenous (IV) fluid, and perform a vaginal examination. The cervix has not changed. Five minutes have passed, and the fetal heart rate remains in the 80s. What additional nursing measures should you take?

A mother expresses fear about changing her infant's diaper after he is circumcised. What does the woman need to be taught to take care of the infant when she gets home?

A new client and her partner arrive on the labor, delivery, recovery, and postpartum unit for the birth of their first child. You apply the electronic fetal monitor (EFM) to the woman. Her partner asks you to explain what is printing on the graph, referring to the EFM strip. He wants to know what the baby's heart rate should be. Your best response is:

A client weighs 132 pounds. Heparin IV infusion: heparin sodium 25,000 units in 250 mL D5W. Order is to bolus with heparin sodium 80 units/kg, then initiate maintenance drip at 18 units/kg/hr.
At what rate will the nurse set the infusion pump in mL/hr for the maintenance dose.
Answer with a whole number.

At 1 minute after birth the nurse assesses the infant and notes: a heart rate of 80 beats/min, some flexion of extremities, a weak cry, grimacing, and a pink body but blue extremities. The nurse would calculate an Apgar score of:

New parents express concern that, because of the mother's emergency cesarean birth under general anesthesia, they did not have the opportunity to hold and bond with their daughter immediately after her birth. The nurse's response should convey to the parents that:

A newborn is jaundiced and receiving phototherapy via ultraviolet bank lights. An appropriate nursing intervention when caring for an infant with hyperbilirubinemia and receiving phototherapy by this method would be to:

Order: Heparin 1800 units/hr IV. Available: 25,000 units heparin in 250 mL D5W.
What rate in mL/hr will deliver 1800 units/hr?
Answer with a whole number only.

The nurse who performs vaginal examinations to assess a woman's progress in labor should:

During a prenatal examination, the woman reports having two cats at home. The nurse informs her that she should not be cleaning the litter box while she is pregnant. When the woman asks why, the nurse's best response would be:

When preparing to administer a hepatitis B vaccine to a newborn, the nurse should:

A pregnant woman's amniotic membranes rupture. Prolapsed cord is suspected and the physician is notified. What intervention would be the top priority

An infant at 26 weeks of gestation arrives from the delivery room intubated. The nurse weighs the infant, places him under the radiant warmer, and attaches him to the ventilator at the prescribed settings. A pulse oximeter and cardiorespiratory monitor are placed. The pulse oximeter is recording oxygen saturations of 80%. The prescribed saturations are 92%. The nurse's most appropriate action would be to:

On examining a woman who gave birth 5 hours ago, the nurse finds that the woman has completely saturated a perineal pad within 15 minutes. The nurse's first action is to:

A client weighs 154 pounds. Heparin IV infusion: heparin sodium 200,000 units in 1000 mL D5W. The hospital protocol is to bolus the client with 80 units /kg and start a maintenance drip at 14 units /kg/hr. What is the infusion rate for the maintenance drip in units/hr.
Answer with a whole number

A woman has requested an epidural for her pain. She is 5 cm dilated and 100% effaced. The baby is in a vertex position and is engaged. The nurse increases the woman's intravenous fluid for a preprocedural bolus. She reviews her laboratory values and notes that the woman's hemoglobin is 12 g/dl, hematocrit is 38%, platelets are 67,000, and white blood cells (WBCs) are 12,000/mm3. Which factor would contraindicate an epidural for the woman?

A plan of care for an infant experiencing symptoms of drug withdrawal should include:

What woman is at greatest risk for early postpartum hemorrhage (PPH)?

While evaluating an external monitor tracing of a woman in active labor, the nurse notes that the fetal heart rate (FHR) for five sequential contractions begins to decelerate late in the contraction, with the nadir of the decelerations occurring after the peak of the contraction. The nurse's first priority is to:

The first and most important nursing intervention when a nurse observes profuse postpartum bleeding is to:

The nurse recognizes that uterine hyperstimulation with oxytocin requires emergency interventions. What clinical cues would alert the nurse that the woman is experiencing uterine hyperstimulation? Choose all that apply.

Order: Heparin 40,000 units in 500 mL D5W and infuse at 30 mL/hr.
Calculate the hourly heparin dosage in units/hr.
Answer with a whole number.

A woman gave birth 48 hours ago to a healthy infant girl. She has decided to bottle-feed. During your assessment you notice that both of her breasts are swollen, warm, and tender on palpation. The woman should be advised that this condition can best be treated by:

While evaluating an external monitor tracing of a woman in active labor whose labor is being induced, the nurse notes that the fetal heart rate (FHR) begins to decelerate at the onset of several contractions and returns to baseline before each contraction ends. The nurse should:

A pregnant woman wants to breastfeed her infant, but her husband is not convinced that there are any scientific reasons to do so. The nurse can give the couple printed information comparing breastfeeding and bottle-feeding. What statement is true? Bottle-feeding using commercially prepared infant formulas:

The nurse is caring for a client whose labor is being augmented with oxytocin. He or she recognizes that the oxytocin should be discontinued immediately if there is evidence of:

The nurse teaches a pregnant woman about the characteristics of true labor contractions. The nurse evaluates the woman's understanding of the instructions when she states, 'True labor contractions will:

The nurse providing care for a woman with preterm labor on terbutaline would include which intervention to identify side effects of the drug?

What position would be least effective when gravity is desired to assist in fetal descent?

A woman in labor has just received an epidural block. The most important nursing intervention is to:

A primigravida at 40 weeks of gestation is having uterine contractions every 1.5 to 2 minutes and says that they are very painful. Her cervix is dilated 2 cm and has not changed in 3 hours. The woman is crying and wants an epidural. What is the likely status of this woman's labor?

While assessing the integument of a 24-hour-old newborn, the nurse notes a pink, papular rash with vesicles superimposed on the thorax, back, and abdomen. The nurse should:

In evaluating the effectiveness of oxytocin induction, the nurse would expect:

A 25-year-old gravida 2, para 2-0-0-2 gave birth 4 hours ago to a 9-pound, 7-ounce boy after augmentation of labor with Pitocin. She puts on her call light and asks for her nurse right away, stating, 'I'm bleeding a lot.' The most likely cause of postpartum hemorrhage in this woman is: