Nursing Care in Perinatal Health
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Nursing Care in Perinatal Health

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What should the nurse explain as the primary purpose of amniocentesis requested by a 12-week pregnant client?

  • To identify potential complications during labor.
  • To assess the mother's nutritional deficiencies.
  • To confirm the fetal heartbeat.
  • To determine if the baby has genetic or congenital disorders. (correct)

    • Which source of vitamin B should a nurse recommend for a vegan client during prenatal teaching?

  • Fortified soy milk (correct)
  • Almonds
  • Spinach
  • Tofu

    • What potential complication should the nurse be vigilant for following a forceps-assisted birth?

  • Facial Palsy (correct)
  • Umbilical hernia
  • Respiratory distress
  • Delayed developmental milestones

    • Which statement indicates that a parent understands the teaching about car seat safety for a newborn?

    <p>My baby will need a car seat challenge test before discharge.</p> Signup and view all the answers

    What should a nurse expect when assessing a newborn with neonatal abstinence syndrome?

    <p>Excessive crying</p> Signup and view all the answers

    Which action should the nurse take when preparing a newborn with jaundice for phototherapy?

    <p>Close the newborn's eyes before applying eyepatches.</p> Signup and view all the answers

    What instruction should a nurse give to a postpartum client seeking to continue using her diaphragm for contraception?

    <p>You should have your provider refit you for a new diaphragm.</p> Signup and view all the answers

    What question should a nurse ask to assess the dietary intake of a vegan client at 6 weeks of gestation?

    <p>How much protein do you eat in a day?</p> Signup and view all the answers

    What should the nurse do immediately following the delivery of a stillborn fetus?

    <p>Provide the client with photos of the fetus</p> Signup and view all the answers

    What isolation precautions should be taken for a client with methicillin-resistant Staphylococcus aureus?

    <p>Contact precautions</p> Signup and view all the answers

    Which food should a nurse recommend to a client who follows a vegan diet and needs to increase vitamin B intake?

    <p>Fortified soy milk</p> Signup and view all the answers

    What question should the nurse ask to assess the effectiveness of a hands-and-knees position for a woman in labor?

    <p>Has your back labor improved?</p> Signup and view all the answers

    Which food selection should a nurse recommend to an antepartum client seeking to increase dietary fiber?

    <p>Lentils</p> Signup and view all the answers

    What instruction should a nurse include when providing discharge instructions to a breastfeeding client?

    <p>Allow the baby to feed at least every 3 hours</p> Signup and view all the answers

    What is the first action a nurse should take when excessive vaginal bleeding is noted in a client 1 hour postpartum?

    <p>Massage the client's fundus</p> Signup and view all the answers

    Which finding should a nurse expect when assessing a client with endometritis 6 hours postpartum?

    <p>Uterine tenderness</p> Signup and view all the answers

    What should a nurse assess first when admitting a client for labor who is 8 cm dilated?

    <p>Fetal heart rate</p> Signup and view all the answers

    Which of the following findings in a client who had a vacuum-assisted delivery may indicate risk for postpartum hemorrhage?

    <p>History of uterine atony</p> Signup and view all the answers

    What action should a nurse take first for a client experiencing bladder distention after a vaginal birth?

    <p>Assist the client to the bathroom</p> Signup and view all the answers

    When should a nurse delay the instillation of antibiotic ophthalmic ointment in a newborn?

    <p>To allow manifestations of infection to be identified</p> Signup and view all the answers

    What should a nurse monitor for in a newborn who underwent a forceps-assisted birth?

    <p>Facial palsy</p> Signup and view all the answers

    What is an appropriate non-pharmacological treatment option for clients undergoing fertility treatments?

    <p>Maintain a healthy weight</p> Signup and view all the answers

    What does leukocytosis indicate about a client's condition?

    <p>Indication of Worsening Condition</p> Signup and view all the answers

    Which finding is associated with a sign of potential improvement in a client's postpartum condition?

    <p>Scant lochia rubra</p> Signup and view all the answers

    How should the nurse interpret a platelet count of 90,000/mm3 in a client with preeclampsia?

    <p>Sign of potential worsening condition</p> Signup and view all the answers

    Which of the following findings in a postpartum client requires immediate follow-up?

    <p>Lateral deviation of the uterus</p> Signup and view all the answers

    What does a blood pressure of 80/50 mm Hg indicate in a postpartum hemorrhage case?

    <p>Indication of potential worsening condition</p> Signup and view all the answers

    In the evaluation of a 48-hour old term newborn, which sign indicates worsening condition?

    <p>High-pitched cry</p> Signup and view all the answers

    Which of the following findings would suggest improvement in a postpartum assessment?

    <p>Decreased extremity edema</p> Signup and view all the answers

    What does a finding of cloudy urine indicate in a postpartum client?

    <p>Sign of potential worsening condition</p> Signup and view all the answers

    What does increased muscle tone in a newborn suggest?

    <p>Sign of potential worsening condition</p> Signup and view all the answers

    Which of these findings in a postpartum assessment is an indication of worsening condition?

    <p>Fundus at level of umbilicus</p> Signup and view all the answers

    Which finding should the nurse identify as an adverse effect of the medication?

    <p>Hypotension</p> Signup and view all the answers

    What action should the nurse take when caring for a client who is 1 hour postpartum with peripartum cardiomyopathy?

    <p>Assess blood pressure twice daily</p> Signup and view all the answers

    Which laboratory finding in a client at 20 weeks of gestation should the nurse report to the provider?

    <p>Fasting blood glucose 180 mg/dL</p> Signup and view all the answers

    What finding should the nurse identify as a manifestation of pyelonephritis in a client at 30 weeks of gestation?

    <p>Flank pain</p> Signup and view all the answers

    What should the nurse do after observing fetal bradycardia and a protruding umbilical cord following the spontaneous rupture of membranes?

    <p>Cover the umbilical cord with a sterile saline-saturated towel</p> Signup and view all the answers

    What should the nurse include in the care plan for a newborn with a leaking myelomeningocele?

    <p>Cleanse the site with povidone-iodine</p> Signup and view all the answers

    What finding indicates a decline in the status of a newborn who is 2 hours old?

    <p>Oxygen saturation of 89%</p> Signup and view all the answers

    What information should the nurse provide to the parents regarding the Plastibell circumcision technique?

    <p>Notify the provider if the end of your baby's penis appears dark red</p> Signup and view all the answers

    What action should the nurse take when administering a hepatitis B vaccine to a newborn?

    <p>Administer the injection into the vastus lateralis muscle</p> Signup and view all the answers

    What should the nurse assess in a breastfeeding client who reports sore nipples 1 day postpartum?

    <p>Newborn's latch while breastfeeding</p> Signup and view all the answers

    What indicates understanding of discharge teaching following tubal ligation?

    <p>Ovulation will remain the same.</p> Signup and view all the answers

    What safety instruction should the nurse give to a client who is 2 days postpartum?

    <p>Wash your baby's face with plain water.</p> Signup and view all the answers

    What finding should the nurse report for a client who is 3 days postpartum?

    <p>Cool clammy skin</p> Signup and view all the answers

    What is the first action the nurse should take when instructed to perform the McRoberts maneuver during a shoulder dystocia?

    <p>Assist the client in pulling their knees toward their abdomen</p> Signup and view all the answers

    What should the nurse do for a client who is hypotensive following epidural anesthesia?

    <p>Turn the client to a side-lying position</p> Signup and view all the answers

    Study Notes

    Amniocentesis

    • Amniocentesis determines genetic and congenital disorders, not sex

    Vegan Diet

    • Fortified soy milk is a recommended food source for B vitamins

    Forceps Assisted Birth

    • Facial palsy can be a clinical manifestation

    Car Seat Safety

    • A newborn who has been born at 38 weeks of gestation needs a car seat challenge test before discharge

    Neonatal Abstinence Syndrome

    • Excessive crying is a finding for newborns with neonatal abstinence syndrome

    Phototherapy

    • Close the newborn’s eyes before applying eyepatches for phototherapy

    Diaphragm Contraception

    • A new diaphragm fitting is needed postpartum

    Clomiphene Citrate

    • Breast tenderness is an adverse effect of clomiphene citrate

    Vegan Diet

    • Assessing a client’s protein intake is important to understand a vegan diet

    Stillbirth

    • The nurse should tell the client an autopsy can be performed within 24 hours
    • The nurse should provide photos of the fetus

    Methicillin-resistant Staphylococcus Aureus

    • Contact isolation precautions are required for Methicillin-resistant Staphylococcus Aureus

    Constipation During Pregnancy

    • Lentils are a high fiber food

    Breastfeeding

    • Allow baby to feed at least every 3 hours

    Dinoprostone

    • Informed consent is required prior to administration

    Fertility Treatment Options

    • Maintaining a healthy weight is a nonpharmacological treatment option

    Labor Contractions

    • 80% effaced and 8 cm dilated is at risk for postpartum hemorrhage

    Full-term Newborn

    • A subconjunctival hemorrhage should be reported to the provider

    Oxytocin Infusion

    • Administer oxygen at 10 L/min via nonrebreather facemask after discontinuing oxytocin infusion

    Maternal Cytomegalovirus

    • Transmission can occur via the saliva and urine of the newborn

    Postpartum Hemorrhage

    • Massage the client's fundus to stop bleeding

    Endometritis

    • Uterine tenderness is a finding

    Contraindication for Contraction Stress Test

    • A client who has a previous classical incision

    Third-degree Perineal Laceration

    • A third-degree perineal laceration contraindicates suppository use

    Severe Vomiting During Pregnancy

    • A client who is 8 weeks pregnant and reports severe vomiting should be assessed first

    Digoxin

    • Ask the client if they are taking the medication as prescribed to assess adherence

    Nagele's Rule

    • The estimated date of delivery is May 17

    Bladder Distention

    • Assist the client to the bathroom

    Antibiotic Ophthalmic Ointment

    • Delay installation to allow for observation of infection

    Cesarean Birth

    • Evaluate urinary output for a steady trickle of vaginal bleeding that does not stop with fundal massage

    Postpartum Hemorrhage Risk Factors

    • Vacuum-assisted delivery
    • History of uterine atony
    • Labor induction with oxytocin

    Trichomoniasis During Pregnancy

    • A malodorous discharge is expected

    Epidural Block

    • Hypotension is an adverse effect of epidural anesthesia

    Peripartum Cardiomyopathy

    • Assess blood pressure twice daily

    Fasting Blood Glucose

    • A fasting blood glucose of 180 mg/dL should be reported

    Pyelonephritis

    • Flank pain is a manifestation

    Spontaneous Rupture of Membranes (PROM)

    • Call for assistance and notify the provider
    • Cover the umbilical cord with a sterile saline-saturated towel

    Myelomeningocele

    • Cleanse the site with povidone-iodine

    Newborn Decline

    • An oxygen saturation of 89% indicates a decline in status

    Plastibell Circumcision

    • Notify the provider if the end of the baby’s penis appears dark red

    Hepatitis B Vaccine

    • Administer the injection into the vastus lateralis muscle

    Breastfeeding Sore Nipples

    • Assess the newborn’s latch

    Tubal Ligation

    • Ovulation will remain the same

    Home Safety - Newborn

    • Wash the baby’s face with plain water

    Postpartum Assessment

    • Cool/clammy skin should be reported to the provider

    McRoberts Maneuver

    • Assist the client in pulling their knees toward their abdomen

    Hypotension Following Epidural Anesthesia

    • Turn the client to a side-lying position

    Fourth-degree Laceration

    • Provide the client with a cool sitz bath

    Uterine Atony

    • Anticipate a prescription for misoprostol

    Neonatal Abstinence Syndrome - Nursing Actions

    • Maintain a low-stimulation environment
    • Instruct the parent to avoid breastfeeding
    • Perform Ballard newborn screening each shift
    • Weigh the newborn daily
    • Swaddle the newborn with flexed extremities

    Leopold Maneuvers

    • Instruct the client to empty their bladder
    • Position the client supine with knees flexed and place a small rolled towel under one of their hips
    • Palpate the fetal part positioned in the fundus
    • Palpate the fetal parts along both sides of the uterus
    • Palpate the fetal part positioned above the symphysis pubis

    Deep Vein Thrombosis (DVT)

    • Leukocytosis is a sign that the client's condition is worsening
    • Redness in the extremity is a sign that the client's condition is worsening
    • Scant lochia rubra is a sign that the client's condition is improving
    • Increased warmth of the extremity is a sign that the client's condition is worsening
    • Tachycardia is a sign that the client's condition is worsening
    • Decreased extremity edema is a sign that the client's condition is improving

    Preeclampsia

    • A platelet count of 90,000/mm³ is a sign of potential worsening
    • Hematuria is a sign of potential worsening
    • Positive clonus is a sign of potential worsening
    • Proteinuria (2+) is a sign of potential worsening
    • Leukorrhea is a sign of potential improvement
    • BUN of 40 mg/dL is a sign of potential worsening

    Postpartum Assessment

    • Lateral deviation of the uterus
    • Large amount of lochia rubra
    • Uterine tone (firmness or softness)

    Postpartum Hemorrhage

    • Blood pressure of 80/50 mm Hg is a sign of potential worsening
    • Cloudy urine is a sign of potential worsening
    • Moderate lochia rubra is a sign of potential worsening
    • Fundus firm to palpation is a sign of potential improvement
    • Fundus at level of umbilicus is a sign of potential worsening

    Neonatal Abstinence Syndrome

    • Regurgitation is a sign of potential worsening
    • Mottling is a sign of potential worsening
    • Transient strabismus is a sign of potential improvement
    • Continuous high-pitched cry is a sign of potential worsening
    • Respiratory rate of 70/min is a sign of potential worsening
    • Loose stools are a sign of potential worsening

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    Description

    This quiz covers essential aspects of nursing care in perinatal health, addressing topics such as amniocentesis, vegan diet considerations, forceps-assisted birth complications, and car seat safety for newborns. It also explores issues related to neonatal abstinence syndrome and the effects of medications like clomiphene citrate. Test your knowledge on best practices and critical nursing interventions in perinatal care.

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