Podcast
Questions and Answers
Which of these options are correct regarding discharge teaching for a client who experiences premature rupture of membranes?
Which of these options are correct regarding discharge teaching for a client who experiences premature rupture of membranes?
- Wipe from the back to front when performing perineal hygiene
- Use a condom with sexual intercourse
- Avoid bubble bath solution when taking a tub bath
- Keep a daily record of fetal kick counts (correct)
Which stage and phase of labor is a client with a cervix that is 2 cm dilated and 50% effaced likely experiencing?
Which stage and phase of labor is a client with a cervix that is 2 cm dilated and 50% effaced likely experiencing?
- First stage, latent phase (correct)
- First stage, active phase
- First stage, transition phase
- Second stage of labor
What should the nurse do first when a client experiences a large gush of fluid from her vagina?
What should the nurse do first when a client experiences a large gush of fluid from her vagina?
- Monitor uterine contractions
- Monitor FHR for distress (correct)
- Check the amniotic fluid for meconium
- Dry the client and make her comfortable
What actions should the nurse take for a client at 40 weeks of gestation experiencing contractions and asking for pain medication? (Select all that apply)
What actions should the nurse take for a client at 40 weeks of gestation experiencing contractions and asking for pain medication? (Select all that apply)
What should the nurse ensure prior to performing an amniotomy?
What should the nurse ensure prior to performing an amniotomy?
What should the nurse do first when a client's water breaks and a loop of pulsating umbilical cord is outside the vagina?
What should the nurse do first when a client's water breaks and a loop of pulsating umbilical cord is outside the vagina?
How should the nurse classify the discharge of a client who has a saturated perineal pad with approximately 12 cm of dark-red discharge?
How should the nurse classify the discharge of a client who has a saturated perineal pad with approximately 12 cm of dark-red discharge?
Which statement indicates understanding of discharge teaching after receiving the varicella vaccine?
Which statement indicates understanding of discharge teaching after receiving the varicella vaccine?
What should a nurse instruct a postpartum client experiencing breast engorgement to do?
What should a nurse instruct a postpartum client experiencing breast engorgement to do?
What finding should the nurse report for a client with sore nipples after breastfeeding?
What finding should the nurse report for a client with sore nipples after breastfeeding?
What interventions should the nurse suggest for a postpartum client reporting leaking urine when sneezing or coughing?
What interventions should the nurse suggest for a postpartum client reporting leaking urine when sneezing or coughing?
Which intervention should a nurse recommend for a client with thrombophlebitis?
Which intervention should a nurse recommend for a client with thrombophlebitis?
What should the nurse say to a client with mastitis who is breastfeeding?
What should the nurse say to a client with mastitis who is breastfeeding?
Which risk factors for urinary tract infections should a nurse include?
Which risk factors for urinary tract infections should a nurse include?
What findings in a postpartum client suggest postpartum blues?
What findings in a postpartum client suggest postpartum blues?
What priority action should the nurse take for a client with postpartum psychosis?
What priority action should the nurse take for a client with postpartum psychosis?
What classification should a nurse assign to a newborn born at 38 weeks of gestation weighing 3,200g?
What classification should a nurse assign to a newborn born at 38 weeks of gestation weighing 3,200g?
What condition is indicated by the presence of small white nodules on a newborn's mouth?
What condition is indicated by the presence of small white nodules on a newborn's mouth?
What action should the nurse take to check for the Moro reflex in a newborn?
What action should the nurse take to check for the Moro reflex in a newborn?
Which findings indicate that a newborn is adapting to extrauterine life? (Select all that apply)
Which findings indicate that a newborn is adapting to extrauterine life? (Select all that apply)
What statement should a nurse make regarding a bluish marking across a newborn's lower back?
What statement should a nurse make regarding a bluish marking across a newborn's lower back?
Which medication should a nurse administer to prevent ophthalmia neonatorum in a newborn?
Which medication should a nurse administer to prevent ophthalmia neonatorum in a newborn?
What action should the nurse take to ensure the safety of a newborn returning from circumcision?
What action should the nurse take to ensure the safety of a newborn returning from circumcision?
What action indicates understanding of breastfeeding teaching by a mother?
What action indicates understanding of breastfeeding teaching by a mother?
What instruction should a nurse provide regarding bottle feeding techniques?
What instruction should a nurse provide regarding bottle feeding techniques?
What indicates a newborn's readiness to feed?
What indicates a newborn's readiness to feed?
What conditions should a nurse identify as contraindications for circumcision? (Select all that apply)
What conditions should a nurse identify as contraindications for circumcision? (Select all that apply)
What should a nurse say to a client at 42 weeks of gestation about what to expect with a postmature baby?
What should a nurse say to a client at 42 weeks of gestation about what to expect with a postmature baby?
What is the priority finding in a newborn receiving phototherapy for high bilirubin levels?
What is the priority finding in a newborn receiving phototherapy for high bilirubin levels?
What findings should the nurse expect for a newborn born at 32 weeks of gestation weighing 1,100g? (Select all that apply)
What findings should the nurse expect for a newborn born at 32 weeks of gestation weighing 1,100g? (Select all that apply)
Which findings should the nurse expect for a postterm newborn? (Select all that apply)
Which findings should the nurse expect for a postterm newborn? (Select all that apply)
What indicates understanding of neonatal abstinence syndrome by a newly licensed nurse?
What indicates understanding of neonatal abstinence syndrome by a newly licensed nurse?
What action should a nurse take to promote father-newborn bonding when the father appears nervous?
What action should a nurse take to promote father-newborn bonding when the father appears nervous?
What should a nurse do when a postpartum client is excited and talkative, making data collection difficult?
What should a nurse do when a postpartum client is excited and talkative, making data collection difficult?
What behaviors in a postpartum client indicate need for nursing intervention regarding maternal bonding? (Select all that apply)
What behaviors in a postpartum client indicate need for nursing intervention regarding maternal bonding? (Select all that apply)
What should a nurse say when a client expresses frustration about her 4-year-old son who is wetting himself after the arrival of a new sibling?
What should a nurse say when a client expresses frustration about her 4-year-old son who is wetting himself after the arrival of a new sibling?
What actions should a nurse take to promote bonding with the family and siblings of a newborn?
What actions should a nurse take to promote bonding with the family and siblings of a newborn?
Which of the following statements by an adolescent reflects an understanding of contraceptive use?
Which of the following statements by an adolescent reflects an understanding of contraceptive use?
Which of the following manifestations should a client taking oral contraceptives report?
Which of the following manifestations should a client taking oral contraceptives report?
Which of the following statements about using an IUD indicates an understanding of the information?
Which of the following statements about using an IUD indicates an understanding of the information?
Which of the following adverse effects should the nurse include when discussing implantable progestins?
Which of the following adverse effects should the nurse include when discussing implantable progestins?
Which of the following information should the nurse include for a client prescribed medroxyprogesterone?
Which of the following information should the nurse include for a client prescribed medroxyprogesterone?
What is the client's estimated date of delivery if her last menstrual period was April 1st?
What is the client's estimated date of delivery if her last menstrual period was April 1st?
How should the nurse interpret the data G3 T1 P0 A1 L1?
How should the nurse interpret the data G3 T1 P0 A1 L1?
Which of the following probable signs of pregnancy should the nurse expect?
Which of the following probable signs of pregnancy should the nurse expect?
What causes episodes of hypotension during pregnancy?
What causes episodes of hypotension during pregnancy?
Which information should the nurse provide to a client requesting a pregnancy test after a late period?
Which information should the nurse provide to a client requesting a pregnancy test after a late period?
Which measures should the nurse include for relieving backache during pregnancy?
Which measures should the nurse include for relieving backache during pregnancy?
Which complications should the nurse include that need to be reported during pregnancy?
Which complications should the nurse include that need to be reported during pregnancy?
Which information should the nurse provide to a client experiencing nausea and vomiting in the morning?
Which information should the nurse provide to a client experiencing nausea and vomiting in the morning?
Which discomforts of pregnancy should the nurse include in teaching?
Which discomforts of pregnancy should the nurse include in teaching?
Which response should the nurse provide to a client expressing uncertainty about being pregnant?
Which response should the nurse provide to a client expressing uncertainty about being pregnant?
What source of calcium should the nurse recommend to a client who dislikes milk?
What source of calcium should the nurse recommend to a client who dislikes milk?
Which client's weight gain should the nurse report to the provider?
Which client's weight gain should the nurse report to the provider?
Which defects can occur in the neonate from folic acid deficiency?
Which defects can occur in the neonate from folic acid deficiency?
With which beverage should iron supplements be taken?
With which beverage should iron supplements be taken?
Which response indicates understanding of the teaching about postpartum nutrition needs?
Which response indicates understanding of the teaching about postpartum nutrition needs?
Which variables should be included in a biophysical profile (BPP)?
Which variables should be included in a biophysical profile (BPP)?
Which tests should the nurse review to determine fetal lung maturity?
Which tests should the nurse review to determine fetal lung maturity?
Why is a vibroacoustic stimulation device used during a nonstress test?
Why is a vibroacoustic stimulation device used during a nonstress test?
Which statement should the nurse make about the amniocentesis procedure?
Which statement should the nurse make about the amniocentesis procedure?
What are indications for undergoing a contraction stress test (CST)?
What are indications for undergoing a contraction stress test (CST)?
What should the nurse suspect if a client reports abrupt, sharp, right lower quadrant pain and vaginal bleeding?
What should the nurse suspect if a client reports abrupt, sharp, right lower quadrant pain and vaginal bleeding?
Which risk factors for developing marginal abruptio placentae should the nurse be aware of?
Which risk factors for developing marginal abruptio placentae should the nurse be aware of?
Which medication should be expected for a client with placenta previa who is actively bleeding?
Which medication should be expected for a client with placenta previa who is actively bleeding?
What complication should the nurse suspect for a client at 16 weeks of gestation with nausea and vomiting and prune-colored discharge?
What complication should the nurse suspect for a client at 16 weeks of gestation with nausea and vomiting and prune-colored discharge?
What is an expected finding in a client with a ruptured ectopic pregnancy?
What is an expected finding in a client with a ruptured ectopic pregnancy?
Which interventions are contraindicated for a client with HIV during labor?
Which interventions are contraindicated for a client with HIV during labor?
Which findings should the nurse expect from a client with a TORCH infection?
Which findings should the nurse expect from a client with a TORCH infection?
Which medication is anticipated for a client diagnosed with gonorrhea?
Which medication is anticipated for a client diagnosed with gonorrhea?
Which infections can be treated during labor or immediately after birth?
Which infections can be treated during labor or immediately after birth?
Which statement indicates understanding of preventing a TORCH infection during pregnancy?
Which statement indicates understanding of preventing a TORCH infection during pregnancy?
Which risk factors should the nurse note for a client with hyperemesis gravidarum?
Which risk factors should the nurse note for a client with hyperemesis gravidarum?
What laboratory result indicates hyperemesis gravidarum?
What laboratory result indicates hyperemesis gravidarum?
Which manifestations indicate magnesium sulfate toxicity?
Which manifestations indicate magnesium sulfate toxicity?
What medication should the nurse anticipate administering for magnesium sulfate toxicity?
What medication should the nurse anticipate administering for magnesium sulfate toxicity?
Which statement indicates understanding about taking ferrous sulfate?
Which statement indicates understanding about taking ferrous sulfate?
What risk factors should the nurse identify for preterm labor?
What risk factors should the nurse identify for preterm labor?
Which medication is expected for a client in preterm labor to hasten fetal lung maturity?
Which medication is expected for a client in preterm labor to hasten fetal lung maturity?
Which manifestations should the nurse monitor for in a client receiving nifedipine?
Which manifestations should the nurse monitor for in a client receiving nifedipine?
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Study Notes
Contraceptive Teaching
- A water-soluble lubricant is recommended for use with condoms.
- Shortness of breath is a serious indication to report while on oral contraceptives.
- Clients should verify the presence of the IUD strings after menstruation.
IUD and Implantable Progestins
- Adverse effects of implantable progestins include irregular vaginal bleeding, weight gain, and breast changes.
- Clients on medroxyprogesterone should increase calcium intake and may experience irregular spotting.
Pregnancy Calculations and Terminology
- Estimated date of delivery for a last menstrual period on April 1 is January 8.
- Gravid, term, preterm, and living child information can be denoted as G3 T1 P0 A1 L1.
Signs of Pregnancy and Complications
- Probable signs include Goodell's sign, ballottement, and Chadwick's sign.
- Hypotension in pregnancy is often due to uterine weight on blood vessels.
- Vaginal bleeding is a critical symptom that requires prompt reporting.
Common Pregnancy Discomforts
- Nausea can be mitigated by eating dry foods before getting out of bed.
- Common discomforts at early gestation include breast tenderness, urinary frequency, and epistaxis.
Nutritional Needs During Pregnancy
- Dark green leafy vegetables are excellent calcium sources if the client dislikes milk.
- Weight gain should be monitored; a gain of 3.6 kg in the first trimester may require further evaluation.
Folic Acid and Iron Supplementation
- Folic acid deficiency can lead to neural tube defects.
- Iron supplements should be taken with orange juice to enhance absorption.
Labor and Delivery Considerations
- Clients in preterm labor at higher risk due to infections, multifetal pregnancies, and uterine abnormalities.
- Betamethasone may be prescribed to promote fetal lung maturity in preterm labor scenarios.
Monitoring and Interventions
- Signs of magnesium sulfate toxicity include low respiratory rate, decreased urinary output, and altered consciousness.
- Continuous assessment of fetal heart rate is crucial upon signs of rupture of membranes.
Infections and Their Management
- Gonorrhea may be treated with ceftriaxone.
- Safety precautions include avoiding undercooked meat to prevent TORCH infections.
Pain Management and Discomfort Relief
- During labor, implement breathing techniques and assess for client comfort.
- Monitor uterine contractions and fetal heart rate continuously for optimal maternal-fetal care.### Labor and Delivery
- Amniotomy is performed to facilitate labor progression; checking for fetal engagement is crucial prior.
- In cases of cord prolapse, finger pressure on the presenting part is prioritized to prevent fetal distress.
Postpartum Monitoring
- Saturated perineal pads with 12 cm dark-red discharge should be documented as moderate.
- Postpartum clients with no varicella immunity should receive a second vaccination during the postpartum visit.
- Breastfeeding mothers experiencing engorgement should apply cold compresses between feedings to alleviate discomfort.
Maternal Health Concerns
- Following a cesarean birth, clients experiencing urine leakage should be advised to perform Kegel exercises for pelvic floor strengthening.
- Persistent sore nipples with cracks and fissures warrant immediate contact with a healthcare provider for further assessment.
Newborn Care
- Epstein pearls are small white nodules found in a newborn's mouth; they are a normal finding.
- Assessing a newborn's reflexes, including the Moro reflex, involves allowing the newborn's head and trunk to fall backward.
- The presence of small white spots on the gums signifies Epstein pearls rather than pathological conditions.
Conditions and Complications
- Urinary tract infections risk factors include epidural anesthesia, urinary catheterization, and a history of UTIs.
- Symptoms such as tearfulness, lack of appetite, and sadness in the postpartum period may indicate postpartum blues.
Neonatal and Infant Care
- Newborns classified as appropriate for gestational age weigh 3,200g at 38 weeks.
- Circumcision is contraindicated in cases of hypospadias, family history of hemophilia, and epispadias.
- Postterm newborns may present with thin, loose skin and meconium staining of the umbilical cord.
Breastfeeding Guidance
- Proper breastfeeding technique involves ensuring the infant's nose, cheek, and chin touch the mother’s breast during latch.
- For bottle feeding, keep the nipple full of formula throughout the feeding to ensure proper intake.
Sibling Dynamics
- Postpartum mothers should be informed that behavioral changes in older siblings, like wetting themselves, are expected responses to a new baby in the family, and not necessarily indicative of a problem.
Safety and Procedure Protocols
- Administer erythromycin prophylactically to prevent ophthalmia neonatorum in newborns.
- Always match the mother's identification band with the newborn's band to ensure safety after procedures like circumcision.
Mental Health Awareness
- In cases of postpartum psychosis, priority actions include assessing for thoughts of self-harm or harm to the infant.
Newborn Adaptation
- Observing normal behaviors in newborns post-birth may indicate adaptation to extrauterine life, such as obligate nasal breathing, while signs like expiratory grunting may require intervention.
Family Bonding Strategies
- Promote bonding by encouraging parents to explore the newborn's features and facilitate participation of siblings in newborn care activities.
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