Podcast
Questions and Answers
What is a common finding in a newborn with neonatal abstinence syndrome?
What is a common finding in a newborn with neonatal abstinence syndrome?
Which action should a nurse prioritize when performing a blood glucose test on a client?
Which action should a nurse prioritize when performing a blood glucose test on a client?
What finding should a nurse expect when assessing a postterm newborn?
What finding should a nurse expect when assessing a postterm newborn?
Which statement by a parent shows understanding of car seat safety for a newborn?
Which statement by a parent shows understanding of car seat safety for a newborn?
Signup and view all the answers
What is the appropriate action for managing hypotension following epidural anesthesia?
What is the appropriate action for managing hypotension following epidural anesthesia?
Signup and view all the answers
When planning care for a postpartum client with peripartum cardiomyopathy, which action should the nurse include?
When planning care for a postpartum client with peripartum cardiomyopathy, which action should the nurse include?
Signup and view all the answers
What is an expected assessment finding for a newborn exhibiting symptoms of Group B Streptococcus infection?
What is an expected assessment finding for a newborn exhibiting symptoms of Group B Streptococcus infection?
Signup and view all the answers
What is the recommended care for a client who has received epidural anesthesia and is experiencing side effects?
What is the recommended care for a client who has received epidural anesthesia and is experiencing side effects?
Signup and view all the answers
What is the primary reason for performing Group B Streptococcus screening during pregnancy?
What is the primary reason for performing Group B Streptococcus screening during pregnancy?
Signup and view all the answers
Which statement best describes safe car seat practices for newborns?
Which statement best describes safe car seat practices for newborns?
Signup and view all the answers
What is a common component of postpartum care that should be discussed with a new mother?
What is a common component of postpartum care that should be discussed with a new mother?
Signup and view all the answers
During a newborn assessment, which finding would be considered abnormal?
During a newborn assessment, which finding would be considered abnormal?
Signup and view all the answers
What is an appropriate management step for a nurse when providing epidural anesthesia?
What is an appropriate management step for a nurse when providing epidural anesthesia?
Signup and view all the answers
What is a key assessment finding in a newborn that could indicate successful adaptation to extrauterine life?
What is a key assessment finding in a newborn that could indicate successful adaptation to extrauterine life?
Signup and view all the answers
Which of the following should be included in a discharge plan for a mother who has received an epidural?
Which of the following should be included in a discharge plan for a mother who has received an epidural?
Signup and view all the answers
When assessing a newborn, which of the following visual characteristics should raise concern?
When assessing a newborn, which of the following visual characteristics should raise concern?
Signup and view all the answers
What is the primary reason for performing Group B Streptococcus screening in pregnant women?
What is the primary reason for performing Group B Streptococcus screening in pregnant women?
Signup and view all the answers
When considering car seat safety, which of the following recommendations should the nurse provide to new parents?
When considering car seat safety, which of the following recommendations should the nurse provide to new parents?
Signup and view all the answers
What is the most important assessment for a nurse caring for a client postpartum who has undergone a cesarean section?
What is the most important assessment for a nurse caring for a client postpartum who has undergone a cesarean section?
Signup and view all the answers
Which assessment finding in a newborn may indicate the need for immediate intervention?
Which assessment finding in a newborn may indicate the need for immediate intervention?
Signup and view all the answers
In the management of epidural anesthesia, which of the following symptoms should the nurse monitor for as a potential adverse effect?
In the management of epidural anesthesia, which of the following symptoms should the nurse monitor for as a potential adverse effect?
Signup and view all the answers
Which action is appropriate for a nurse upon discovering a steady trickle of vaginal bleeding in a postpartum client?
Which action is appropriate for a nurse upon discovering a steady trickle of vaginal bleeding in a postpartum client?
Signup and view all the answers
Before an amniocentesis procedure, what is the most important action a client should take to ensure safety?
Before an amniocentesis procedure, what is the most important action a client should take to ensure safety?
Signup and view all the answers
What is the best method for a nurse to administer a hepatitis B vaccine to a newborn?
What is the best method for a nurse to administer a hepatitis B vaccine to a newborn?
Signup and view all the answers
Study Notes
Postpartum Hemorrhage
- A nurse is caring for a client with a postpartum hemorrhage and a new prescription for misoprostol.
- The nurse assesses the client 30 minutes later.
- The nurse should interpret the findings as unrelated to the diagnosis, an indication of potential improvement, or an indication of potential worsening condition for each finding.
Vital Signs
- A nurse is assessing a postpartum client during a follow-up visit.
- The nurse should monitor vital signs, including temperature (37° C or 98.6° F), pulse rate (78/min), respiratory rate (12/min), blood pressure (124/80 mm Hg), and pulse oximetry (100%).
Postpartum Client Assessment
- A nurse is assessing a postpartum client who delivered vaginally 8 hours prior.
- The nurse should assess for the following:
- Breasts - soft, nipples intact; moderate lochia rubra;
- Episiotomy site - well approximated with mild edema, client reports 2/10 pain
- Uterus - firm, midline, at the level of the umbilicus, or soft with lateral deviation.
- Deep tendon reflexes - 1+
- Edema - 2+ in bilateral lower extremities
- Blood pressure - 136/86 mm Hg
- The data should be observed and immediate follow-up should be taken if there are indications of potential worsening condition.
Client Receiving Epidural Block with Opioid Analgesic
- A nurse should monitor for hyperglycemia, bilateral crackles, hypotension, and polyuria as potential side effects.
Amniocentesis Client Teaching
- The client should empty their bladder before the procedure.
- The client should lie on their side during the amniocentesis, not be asleep.
- There is no need to fast 24 hours prior to the amniocentesis.
Neonatal Abstinence Syndrome
- The nurse should monitor blood glucose levels hourly.
- The client should be placed on his back with legs extended.
- Initiate seizure precautions.
- Avoid a stimulating environment.
Hepatitis B Vaccine Administration to Newborn
- The vaccine should be administered intramuscularly into the vastus lateralis muscle.
- Do not massage the injection site vigorously following the injection.
- Insert the needle at a 45-degree angle.
- Use a 21-gauge needle.
Postpartum Vaginal Bleeding
- A client who delivered by cesarean birth 6 hours prior and has a continuous trickle of vaginal bleeding should have urinary output evaluated.
- An ice pack should be applied to the incision site.
- An IV bolus of 500 mL Lactated Ringer's should be administered when there is continuous vaginal bleeding
Gestational Diabetes Mellitus
- A nurse assessing a newborn whose mother has gestational diabetes should monitor for hypoglycemia, manifested by:
- Abdominal distention
- Petechiae
- Increased muscle tone
- Jitteriness
Pyelonephritis
- A nurse should monitor a client at 30 weeks gestation for epigastric discomfort, flank pain, temperature of 37.7°C (99.8°F), and abdominal cramping, as these are possible manifestations of pyelonephritis.
Plastibell Circumcision Technique
- The Plastibell will be removed 4 hours after the procedure.
- Make sure the newborn's diaper is snug.
- Yellow exudate will typically form at the surgical site in 24 hours.
- Notify the provider if the end of the baby's penis appears dark red.
Tubal Ligation Post-Discharge Teaching
- Premenstrual tension may not be present following a tubal ligation
- Menstrual periods may be shorter following a tubal ligation
- Hormone replacement therapy may be needed following a tubal ligation
- Ovulation is typically not present following a tubal ligation
Postpartum Hemorrhage (Uterine Atony)
- The nurse should administer betamethasone IM to prevent problems.
- Avoid performing sterile vaginal examinations.
- Anticipate a prescription for misoprostol if bleeding is excessive.
- Obtain a specimen for a Kleihauer-Betke test to evaluate fetal blood loss.
Estimated Date of Delivery (Nägele's Rule)
- To estimate a client's delivery date, subtract 3 months from the first day of her last menstrual period (LMP) and add 7 days.
Methicillin-Resistant Staphylococcus Aureus (MRSA)
- The nurse should institute contact precautions in cases of MRSA.
Stillborn Delivery
- Limit the amount of time the fetus remains in the client's room.
- Provide the client with photos of the fetus, as deemed appropriate.
- Instruct the client that an autopsy should be completed within 24 hours.
- Notify the client that the law requires them to name the fetus.
Postpartum Hemorrhage Risk Factors
- History of uterine atony
- Labor induction
- Newborn weight
- Vacuum assisted delivery
Persistent Late Decelerations
- Instruct the client to bear down.
- Administer oxygen at 10 L/min via face mask.
- Avoid positioning the client supine.
- Do not perform amnioinfusions unless specifically ordered.
Vegan Diet Assessment
- Inquire about daily protein intake as a vegan.
- Inquire about vitamin and mineral intake.
- Determine if the client is taking supplements.
Labor and Delivery Considerations: Occipitoposterior Position
- The nurse should ask questions to assess the effectiveness of interventions, such as:
- Does that lessen your suprapubic pain?
- Are you feeling relief from your pelvic pressure?
- Do your contractions feel further apart?
- Has your back labor improved?
Fourth-Degree Laceration
- A moist, warm compress for the perineum is unnecessary when a fourth-degree laceration exists.
- Providing the client with a cool sitz bath or applying povidone-iodine to the perineum is inappropriate due to risk of infection in an open wound.
- Administering methylergonovine is not the primary concern.
- The nurse's focus should be on the possibility of hemorrhage and infection, not an IV bolus.
Client with Fertility Treatment Options
- The nurse should recommend the use of a lubricant during intercourse.
- Instructing the client to drink 2 cups of herbal tea daily for treatment of infertility is not recommended.
- The nurse should encourage a healthy weight because obesity and inadequate nutrition may negatively affect fertility success.
- Daily hot baths have no effect on fertility treatment.
Client with 20 Weeks Gestation
- For a client at 20 weeks of gestation, Hematocrit 37% (37% to 47%), Creatinine 0.9 mg/dL (0.5 to 1 mg/dL), WBC count 11,000/mm³ (5,000 to 10,000/mm²), fasting blood glucose 180 mg/dL (74 to 106 mg/dL) should be reported to the provider.
Home Safety Teaching for Postpartum Client
- The nurse should caution against placing a bumper pad in the client's crib.
- The nurse should explain the importance of keeping a crib free from blankets and pillows for safety.
- The nurse should advise the client to bathe the newborn and not use plain water on the baby's face.
- The nurse should also advise not to bathe immediately after feeding.
Forceps-Assisted Birth Complication
- A complication of a forceps-assisted birth is polycythemia, hypoglycemia, bronchopulmonary dysplasia, and facial palsy.
Newborn with Jaundice and Phototherapy
- The nurse should provide the newborn with 15 mL glucose water every 4 hours.
- Position the newborn and rotate frequently but do not turn every 4 hours.
- The client should put hydrating lotion on the baby's skin prior to treatment.
- Avoid closing the newborn's eyes during treatment as it will obstruct light exposure required.
Client with Diaphragm for Contraception
- Recommend that the client seek a provider for a refit.
- The use of oil-based lubricants is not recommended.
- The diaphragm should remain in place for at least 4 hours post intercourse.
- Diaphragms should not be stored in sterile water
Constipation and Suppository Contraindication
- Abdominal distention is a contraindication to suppository use.
- Vaginal candidiasis, afterpains, and third-degree perineal lacerations are not contraindications to suppository use.
Metronidazole
- To determine the needed dose of metronidazole, the nurse needs to know the strength and size of the tablet or milligram/unit/gram.
Peripartum Cardiomyopathy
- Assess the client's blood pressure twice daily.
- Prevent the client from restricting oral fluid intake.
- The nurse should administer an IV to prevent dehydration.
Leopold Maneuvers Sequence
- Place the client supine with hips flexed, and place a rolled towel under one hip.
- Instruct the client to empty her bladder.
- Palpate the fetal part positioned in the fundus.
- Palpate the fetal part positioned along both sides of the uterus.
- Palpate the fetal part positioned above the symphysis pubis.
Group B Streptococcus Testing
- A nurse should explain that there was no indication of GBS in earlier prenatal testing.
- It does not need to be conducted at this time, as the client is not exhibiting any symptoms.
- The nurse should emphasize this.
- Previous testing can make the testing unnecessary.
Newborn with Myelomeningocele
- Broad-spectrum antibiotics should be administered.
- Monitor the rectal temperature every 4 hours.
- Cleanse the site of the myelomeningocele with povidone-iodine.
- Prepare for surgical closure after 72 hours.
Newborn with Nuchel Cord
- Clinical findings to observe are:
- Telangiectatic nevi
- Facial petechiae
Full-Term Newborn Admission
- Findings to report to the provider include single palmar creases, rust-stained urine, transient circumoral cyanosis, and subconjunctival hemorrhage.
Postpartum Client with Contractions
- The nurse should expect a postpartum client with 80% effacement and 8 cm dilation to be at risk for postpartum hemorrhage.
- The risk is present due to rapid progress and the client has not yet given birth.
- The nurse needs to monitor closely for excessive bleeding and other significant complications.
Postpartum Client with Endometritis
- Elevated temperature of 37.4°C (99.3°F)
- Elevated white blood cell count may be present, and pain or tenderness in the uterus should be expected.
Shoulder Dystocia
- The nurse should apply pressure to the suprapubic area.
- Pulling the knees toward the abdomen.
- These actions are critical to deliver the impacted shoulder and ensure a safe delivery for mother and child.
Neonatal Abstinence Syndrome
- Excessive crying is a finding expected to be seen in a newborn with neonatal abstinence syndrome.
- Diminshed deep tendon reflexes may be present, and absent moro reflex.
- Decreased muscle tone and excessive crying may be reported.
Post-Prandial Blood Glucose
- The lateral side of the client's finger should be used to perform the puncture.
- The finger should be held above the client's heart to reduce bleeding.
- The blood should not be smeared on the reagent strip to ensure an accurate reading.
Postterm Newborn
- The nurse should expect the newborn to have large deposits of subcutaneous fat, a thin covering of fine hair on the shoulders and back, nails extending over the finger tips, and pale/translucent skin.
Car Seat Safety Teaching
- A parent should have the client's car seat set at a 45-degree angle for the newborn.
- Parents should use a sleep sack when the newborn is in the car seat to ensure warmth.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Related Documents
Description
This quiz covers essential topics in neonatal care, including neonatal abstinence syndrome, blood glucose testing, and safety practices for newborns. It also addresses important assessments and management strategies for postpartum complications. Test your knowledge on these critical nursing practices!
