Podcast
Questions and Answers
A nurse is a provider office amniocenteses to determine the sex of the fetus
A nurse is a provider office amniocenteses to determine the sex of the fetus
- To assess fetal heart rate
- To evaluate the mother's overall health
- To determine the sex of the fetus
- This procedure determines if your baby has genetic or congenital disorders (correct)
Which food source is most appropriate for a vegan client looking to increase vitamin B intake during pregnancy?
Which food source is most appropriate for a vegan client looking to increase vitamin B intake during pregnancy?
- Charred beef
- Eggs
- Cheddar cheese
- Fortified soy milk (correct)
What complication should a nurse be alert for following the forceps-assisted delivery of a newborn?
What complication should a nurse be alert for following the forceps-assisted delivery of a newborn?
- Caput Succedaneum
- Facial Palsy (correct)
- Brachial Plexus Injury
- Cleft Lip
What statement by a parent indicates proper understanding of car seat safety for a newborn delivered at 38 weeks of gestation?
What statement by a parent indicates proper understanding of car seat safety for a newborn delivered at 38 weeks of gestation?
What key finding should a nurse expect when assessing a newborn with neonatal abstinence syndrome?
What key finding should a nurse expect when assessing a newborn with neonatal abstinence syndrome?
What should a nurse do before applying eyepatches for phototherapy in a newborn with jaundice?
What should a nurse do before applying eyepatches for phototherapy in a newborn with jaundice?
Which instruction is important for a postpartum client who wishes to continue using her diaphragm for contraception?
Which instruction is important for a postpartum client who wishes to continue using her diaphragm for contraception?
What question should a nurse ask a vegan client at 6 weeks of gestation to assess dietary intake?
What question should a nurse ask a vegan client at 6 weeks of gestation to assess dietary intake?
What does leukocytosis indicate in a client?
What does leukocytosis indicate in a client?
What does decreased extremity edema suggest about a client's condition?
What does decreased extremity edema suggest about a client's condition?
Which finding requires immediate follow-up in the postpartum client?
Which finding requires immediate follow-up in the postpartum client?
What is the significance of a blood pressure reading of 80/50 mm Hg in a client experiencing postpartum hemorrhage?
What is the significance of a blood pressure reading of 80/50 mm Hg in a client experiencing postpartum hemorrhage?
How should a nurse interpret the presence of cloudy urine in a postpartum client?
How should a nurse interpret the presence of cloudy urine in a postpartum client?
What does the presence of large amounts of lochia rubra signify in a postpartum assessment?
What does the presence of large amounts of lochia rubra signify in a postpartum assessment?
What does the presence of proteinuria 2+ indicate in a pregnant client?
What does the presence of proteinuria 2+ indicate in a pregnant client?
What might be indicated by a continuous high-pitched cry in a newborn?
What might be indicated by a continuous high-pitched cry in a newborn?
How should a nurse interpret a respiratory rate of 70/min in a newborn?
How should a nurse interpret a respiratory rate of 70/min in a newborn?
What does excessive sucking in a newborn potentially indicate?
What does excessive sucking in a newborn potentially indicate?
When caring for a client immediately following the delivery of a stillborn fetus, which action should the nurse take?
When caring for a client immediately following the delivery of a stillborn fetus, which action should the nurse take?
What type of isolation precautions should be initiated for a client at 36 weeks of gestation with methicillin-resistant Staphylococcus aureus?
What type of isolation precautions should be initiated for a client at 36 weeks of gestation with methicillin-resistant Staphylococcus aureus?
Which food item should the nurse recommend to a client on a vegan diet to increase their vitamin B intake?
Which food item should the nurse recommend to a client on a vegan diet to increase their vitamin B intake?
To evaluate the effectiveness of the hands-and-knees position in active labor for a fetus in the occipitoposterior position, what should the nurse ask?
To evaluate the effectiveness of the hands-and-knees position in active labor for a fetus in the occipitoposterior position, what should the nurse ask?
Which food selection has the highest fiber content per cup for a client reporting constipation?
Which food selection has the highest fiber content per cup for a client reporting constipation?
What instruction should be included in discharge instructions for a client breastfeeding her newborn?
What instruction should be included in discharge instructions for a client breastfeeding her newborn?
Before administering a dinoprostone insert for labor induction, what action should the nurse take?
Before administering a dinoprostone insert for labor induction, what action should the nurse take?
Which finding should a nurse expect when assessing a client with endometritis 6 hours postpartum?
Which finding should a nurse expect when assessing a client with endometritis 6 hours postpartum?
What complication should a nurse monitor for in a client who is 80% effaced and 8 cm dilated?
What complication should a nurse monitor for in a client who is 80% effaced and 8 cm dilated?
What should a nurse assess first for a client reporting significant vaginal bleeding 1 hour postpartum?
What should a nurse assess first for a client reporting significant vaginal bleeding 1 hour postpartum?
Which clinical manifestation should a nurse identify as a potential complication after forceps-assisted delivery?
Which clinical manifestation should a nurse identify as a potential complication after forceps-assisted delivery?
In evaluating medication adherence for a pregnant client taking digoxin, what is the best action for the nurse?
In evaluating medication adherence for a pregnant client taking digoxin, what is the best action for the nurse?
What indicates a contraindication for a contraction stress test in a pregnant client?
What indicates a contraindication for a contraction stress test in a pregnant client?
Which of the following findings should the nurse identify as an adverse effect of medication?
Which of the following findings should the nurse identify as an adverse effect of medication?
What is the most appropriate action for a nurse caring for a client who is 1 hour postpartum with peripartum cardiomyopathy?
What is the most appropriate action for a nurse caring for a client who is 1 hour postpartum with peripartum cardiomyopathy?
Which laboratory finding warrants immediate reporting to the healthcare provider for a client at 20 weeks of gestation?
Which laboratory finding warrants immediate reporting to the healthcare provider for a client at 20 weeks of gestation?
In assessing a client at 30 weeks of gestation, what finding should the nurse identify as a symptom of pyelonephritis?
In assessing a client at 30 weeks of gestation, what finding should the nurse identify as a symptom of pyelonephritis?
What is the nursing priority after observing fetal bradycardia and a protruding umbilical cord?
What is the nursing priority after observing fetal bradycardia and a protruding umbilical cord?
What action should the nurse take when caring for a newborn with a leaking myelomeningocele?
What action should the nurse take when caring for a newborn with a leaking myelomeningocele?
Which oxygen saturation level indicates a decline in a newborn's status within the first 2 hours post-birth?
Which oxygen saturation level indicates a decline in a newborn's status within the first 2 hours post-birth?
During discharge teaching for a newborn circumcision, what information should be included to ensure parental understanding?
During discharge teaching for a newborn circumcision, what information should be included to ensure parental understanding?
What is the appropriate site for administering the hepatitis B vaccine in a newborn?
What is the appropriate site for administering the hepatitis B vaccine in a newborn?
What should the nurse do first when a client reports sore nipples while breastfeeding?
What should the nurse do first when a client reports sore nipples while breastfeeding?
After tubal ligation, which statement indicates the client's understanding of post-operative changes?
After tubal ligation, which statement indicates the client's understanding of post-operative changes?
For home safety teaching, what should the nurse instruct a postpartum client regarding infant care?
For home safety teaching, what should the nurse instruct a postpartum client regarding infant care?
What finding should a nurse report after assessing a client who is 3 days postpartum?
What finding should a nurse report after assessing a client who is 3 days postpartum?
What is the correct nursing action when assisting a client with shoulder dystocia during labor?
What is the correct nursing action when assisting a client with shoulder dystocia during labor?
What does leukocytosis indicate regarding a client's condition?
What does leukocytosis indicate regarding a client's condition?
How should a nurse interpret a finding of scant lochia rubra?
How should a nurse interpret a finding of scant lochia rubra?
What should a nurse conclude if a client presents with a positive clonus?
What should a nurse conclude if a client presents with a positive clonus?
When considering the findings from a postpartum assessment, which of these requires immediate follow-up?
When considering the findings from a postpartum assessment, which of these requires immediate follow-up?
What does a finding of cloudy urine suggest in a postpartum client?
What does a finding of cloudy urine suggest in a postpartum client?
How should the nurse interpret increased warmth in an extremity?
How should the nurse interpret increased warmth in an extremity?
What is the significance of a finding of large amounts of lochia rubra?
What is the significance of a finding of large amounts of lochia rubra?
What does decreased extremity edema indicate?
What does decreased extremity edema indicate?
How should the nurse interpret a continuous high-pitched cry in a newborn?
How should the nurse interpret a continuous high-pitched cry in a newborn?
What do moderate lochia rubra and a blood pressure of 80/50 mm Hg in a postpartum client suggest?
What do moderate lochia rubra and a blood pressure of 80/50 mm Hg in a postpartum client suggest?
What should the nurse instruct a client who wishes to continue using her diaphragm for contraception within two days postpartum?
What should the nurse instruct a client who wishes to continue using her diaphragm for contraception within two days postpartum?
Which clinical manifestation should the nurse identify when assessing a newborn delivered using forceps?
Which clinical manifestation should the nurse identify when assessing a newborn delivered using forceps?
When preparing to administer phototherapy for a newborn with jaundice, which action should the nurse take first?
When preparing to administer phototherapy for a newborn with jaundice, which action should the nurse take first?
Which statement by a parent indicates an understanding of car seat safety for a newborn who was delivered at 38 weeks of gestation?
Which statement by a parent indicates an understanding of car seat safety for a newborn who was delivered at 38 weeks of gestation?
Which adverse effect should the nurse inform a client experiencing infertility about when discussing clomiphene citrate?
Which adverse effect should the nurse inform a client experiencing infertility about when discussing clomiphene citrate?
What question can the nurse ask a vegan client at 6 weeks of gestation to assess her dietary intake?
What question can the nurse ask a vegan client at 6 weeks of gestation to assess her dietary intake?
What should the nurse communicate to a client about the purpose of amniocentesis at 12 weeks of gestation?
What should the nurse communicate to a client about the purpose of amniocentesis at 12 weeks of gestation?
What should the nurse expect to find when assessing a newborn who has neonatal abstinence syndrome?
What should the nurse expect to find when assessing a newborn who has neonatal abstinence syndrome?
Which finding should the nurse identify as a potential adverse effect of a medication?
Which finding should the nurse identify as a potential adverse effect of a medication?
What is the most appropriate initial nursing action for a client exhibiting vaginal bleeding and uterine atony 1 hour postpartum?
What is the most appropriate initial nursing action for a client exhibiting vaginal bleeding and uterine atony 1 hour postpartum?
Which laboratory finding during pregnancy warrants immediate reporting to the healthcare provider?
Which laboratory finding during pregnancy warrants immediate reporting to the healthcare provider?
When caring for a newborn with myelomeningocele, what is the priority nursing intervention?
When caring for a newborn with myelomeningocele, what is the priority nursing intervention?
What indicates a significant decline in a newborn's respiratory status?
What indicates a significant decline in a newborn's respiratory status?
What instruction regarding newborn care should a nurse include in discharge teaching to new parents?
What instruction regarding newborn care should a nurse include in discharge teaching to new parents?
After performing Leopold maneuvers, what is the critical step the nurse must take?
After performing Leopold maneuvers, what is the critical step the nurse must take?
What action should a nurse take when caring for a client who has excessive vaginal bleeding 1 hour postpartum?
What action should a nurse take when caring for a client who has excessive vaginal bleeding 1 hour postpartum?
Which assessment finding should prompt further evaluation in a client presenting 3 days postpartum?
Which assessment finding should prompt further evaluation in a client presenting 3 days postpartum?
Which dietary recommendation should a nurse provide for a client who is vegan and needs to increase vitamin B intake?
Which dietary recommendation should a nurse provide for a client who is vegan and needs to increase vitamin B intake?
What symptom should a nurse recognize as a manifestation of pyelonephritis in a 30-week pregnant client?
What symptom should a nurse recognize as a manifestation of pyelonephritis in a 30-week pregnant client?
When assessing a client 6 hours postpartum with endometritis, which finding should the nurse expect?
When assessing a client 6 hours postpartum with endometritis, which finding should the nurse expect?
What action should a nurse take for a client presenting with hypotension following epidural anesthesia?
What action should a nurse take for a client presenting with hypotension following epidural anesthesia?
What does the nurse need to include in teaching parents about the Plastibell circumcision technique?
What does the nurse need to include in teaching parents about the Plastibell circumcision technique?
What is the best action for a nurse after discontinuing oxytocin in a client experiencing late decelerations in FHR?
What is the best action for a nurse after discontinuing oxytocin in a client experiencing late decelerations in FHR?
For a client who is experiencing shoulder dystocia, which maneuver should the nurse assist with?
For a client who is experiencing shoulder dystocia, which maneuver should the nurse assist with?
Which intervention should a nurse implement for a client at 36 weeks of gestation diagnosed with methicillin-resistant Staphylococcus aureus?
Which intervention should a nurse implement for a client at 36 weeks of gestation diagnosed with methicillin-resistant Staphylococcus aureus?
What is the recommended action for a client who is in labor and experiences fetal bradycardia with a protruding umbilical cord?
What is the recommended action for a client who is in labor and experiences fetal bradycardia with a protruding umbilical cord?
What should a nurse assess first for a client who is 8 weeks of gestation and reports severe vomiting?
What should a nurse assess first for a client who is 8 weeks of gestation and reports severe vomiting?
During discharge instructions for a breastfeeding client, what should the nurse emphasize?
During discharge instructions for a breastfeeding client, what should the nurse emphasize?
Which uterine condition increases the risk of postpartum hemorrhage?
Which uterine condition increases the risk of postpartum hemorrhage?
For a client who has bladder distention following vaginal birth, what is the priority nursing action?
For a client who has bladder distention following vaginal birth, what is the priority nursing action?
Which finding should a nurse recognize as contraindicating a contraction stress test?
Which finding should a nurse recognize as contraindicating a contraction stress test?
What does the presence of malodorous discharge in a client with trichomoniasis indicate?
What does the presence of malodorous discharge in a client with trichomoniasis indicate?
When reviewing a medical record for a client 2 days postpartum with constipation, which finding contraindicates the use of a suppository?
When reviewing a medical record for a client 2 days postpartum with constipation, which finding contraindicates the use of a suppository?
Which should a nurse do first for a newborn following a forceps-assisted birth?
Which should a nurse do first for a newborn following a forceps-assisted birth?
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Study Notes
Amniocentesis
- 20-year-old client at 12 weeks of gestation
- Amniocentesis can indicate genetic or congenital disorders, not just sex determination
Vegan Diet During Pregnancy
- Vegan client needs to supplement vitamin B
- Fortified soy milk is a good source of vitamin B
Forceps-Assisted Birth
- Birth method can lead to facial palsy
Car Seat Safety
- Newborn at 38 weeks of gestation needs a car seat challenge test before discharge
Neonatal Abstinence Syndrome (NAS)
- Excessive crying is a common finding in newborns with NAS
Phototherapy
- For newborns with jaundice, close their eyes before applying eye patches
Diaphragm Contraception Postpartum
- New diaphragm fitting is required after giving birth
Clomiphene Citrate for Infertility
- Potential adverse effect is breast tenderness.
Assessing a Vegan Diet During Pregnancy
- Assess protein intake to ensure adequate nutrition during pregnancy
Stillbirth Care
- After stillbirth, instruct the client that an autopsy should be performed within 24 hours.
- Provide the client with photos of the fetus.
Isolation Precautions for MRSA in Pregnancy
- Client at 36 weeks of gestation with MRSA requires contact isolation precautions.
Constipation in Antepartum Client
- Lentils are a high-fiber food to recommend for constipation
Postpartum Breastfeeding
- Allow the baby to feed at least every 3 hours.
Dinoprostone Insert to Induce Labor
- Ensure informed consent is obtained before administering dinoprostone
Nonpharmacological Fertility Treatment
- Maintaining a healthy weight is a nonpharmacological fertility treatment
Assessing Labor Contractions
- 80% effaced and 8 cm dilated can be a risk factor for postpartum hemorrhage.
Full-Term Newborn Assessment
- Subconjunctival hemorrhage in a full-term newborn should be reported to the provider
Late Decelerations in FHR with Oxytocin Infusion
- Discontinue oxytocin infusion and administer oxygen at 10 L/min via nonrebreather facemask
Maternal Cytomegalovirus Info
- Transmission can occur via saliva and urine of the newborn.
Postpartum Hemorrhage
- Massage the client's fundus to help control bleeding.
Endometritis
- Uterine tenderness is an expected symptom of endometritis
Contraindication for Contraction Stress Test
- A client who has had a previous classical incision has a contraindication for a contraction stress test
Constipation and Third-Degree Perineal Laceration
- Contraindication for using a suppository.
Assessing Clients in Prenatal Clinic
- Client at 8 weeks gestation reporting severe vomiting should be assessed first.
Digoxin During Pregnancy
- Ask the client if they are taking the medication as prescribed to assess medication adherence
Nägele's Rule
- Estimated date of delivery for a last menstrual period of August 10th is May 17th.
Bladder Distention Postpartum
- Assist the client to the bathroom to address bladder distention
Delaying Antibiotic Ophthalmic Ointment in Newborn
- Delay instillation to allow manifestations of infection to be identified.
Cesarean Birth and Vaginal Bleeding
- Evaluate urinary output when a client has steady vaginal bleeding after cesarean birth.
Risk Factors for Postpartum Hemorrhage
- Risk factors include vacuum-assisted delivery, history of uterine atony, and labor induction with oxytocin.
Trichomoniasis in Pregnancy
- Malodorous discharge is a common symptom of trichomoniasis
Epidural Anesthesia and Opioid Analgesics
- Hypotension is a potential adverse effect of opioid analgesics used for epidural anesthesia.
Peripartum Cardiomyopathy
- Assess blood pressure twice daily for a client with peripartum cardiomyopathy
Laboratory Findings in Pregnancy – Fasting Blood Glucose
- Report a fasting blood glucose of 180 mg/dL to the provider
Pyelonephritis Symptoms
- Flank pain is a manifestation of pyelonephritis
Prolapsed Umbilical Cord
- Cover the protruding umbilical cord with a sterile saline-saturated towel after calling for assistance and notifying the provider.
Myelomeningocele Care
- Cleanse the site with povidone-iodine for a newborn with a leaking myelomeningocele.
Newborn Assessment with Respiratory Distress
- Oxygen saturation of 89% indicates a decline in the newborn's status with respiratory distress
Plastibell Circumcision
- Notify the provider if the end of the baby's penis appears dark red after a Plastibell circumcision.
Hepatitis B Vaccine for Newborns
- Administer into the vastus lateralis muscle
Breastfeeding Sore Nipples
- Assess the newborn's latch while breastfeeding for sore nipples
Tubal Ligation Understanding
- Ovulation remains the same after tubal ligation
Home Safety for Newborns
- Wash the baby's face with plain water for home safety.
Postpartum Assessment – Cool, Clammy Skin
- Cool, clammy skin 3 days postpartum should be reported to the provider.
McRoberts Maneuver
- Assist the client in pulling their knees toward their abdomen for the McRoberts maneuver.
Hypotension After Epidural Anesthesia
- Turn the client to a side-lying position.
Fourth-Degree Perineal Laceration Postpartum Care
- Provide the client with a cool sitz bath.
Uterine Atony and Postpartum Hemorrhage
- Anticipate a prescription for misoprostol to address uterine atony and heavy bleeding.
Neonatal Abstinence Syndrome (NAS) Treatment
- Maintaining a low-stimulation environment
- Instructing the parent to avoid breastfeeding
- Performing Ballard newborn screening each shift
- Weighing the newborn daily
- Swaddling the newborn with flexed extremities
Leopold’s Maneuvers
- Instruct the client to empty their bladder.
- Position the client supine with knees flexed and place a small rolled towel under one hip.
- Palpate the fetal part in the fundus
- Palpate the fetal parts along both sides of the uterus
- Palpate the fetal part positioned above the symphysis pubis
Interpreting Findings for Postpartum Deep Vein Thrombosis
- Leukocytosis, redness in the extremity, increased warmth in the extremity, and tachycardia indicate a worsening condition
- Scant lochia rubra and decreased extremity edema indicate improvement.
Interpreting Findings for Preeclampsia
- A platelet count of 90,000/mm3, hematuria, positive clonus, proteinuria 2+, and increased BUN indicate potential worsening of preeclampsia.
- Leukorrhea is a sign of potential improvement
Postpartum Client at Risk for Hemorrhage (8 Hours Postpartum)
- Lateral deviation of the uterus
- Large amount of lochia rubra
- Uterine tone
Interpreting Findings for Postpartum Hemorrhage
- Blood pressure of 80/50 mm Hg, cloudy urine, and moderate lochia rubra indicate potential worsening of condition.
- Fundus firm to palpation and fundus at the level of the umbilicus indicate that condition is potentially worsening.
Interpreting Findings for NAS in Term Newborn (48 Hours Old)
- Regurgitation, mottling, continuous high-pitched cry, respiratory rate of 70/min, and loose stools indicate potential worsening of condition.
- Transient strabismus indicates potential improvement.
Amniocentesis During Pregnancy
- Amniocentesis is a procedure that involves obtaining amniotic fluid for testing.
- It is typically performed to detect genetic or congenital disorders in the fetus.
- It's not used to determine fetal sex.
Vegan Diet and Vitamin B12 Intake
- A vegan diet lacks vitamin B12 naturally found in animal products.
- Fortified soy milk is a recommended food source to increase vitamin B12 intake for vegans.
Forceps-Assisted Birth Complications
- Facial palsy is a potential complication of forceps-assisted birth.
- The nurse should assess the newborn for facial symmetry and movement.
Car Seat Safety for Premature Infants
- Premature infants require a car seat challenge test before discharge to ensure they can tolerate the position and safety of a car seat.
- The nurse should teach parents about this required test.
Neonatal Abstinence Syndrome (NAS)
- NAS occurs when infants born to mothers who use opioids during pregnancy experience withdrawal symptoms.
- Excessive crying is a common manifestation of NAS and should be reported to the provider.
Phototherapy for Jaundice
- Phototherapy uses light to break down bilirubin in the blood.
- The nurse should close the infant's eyes before applying eyepatches to reduce the chance of light exposure.
Diaphragm Contraception Postpartum
- Diaphragms require refitting after pregnancy and before resuming use.
- The nurse should advise the client to consult their healthcare provider for refitting.
Clomiphene Citrate for Infertility
- Clomiphene citrate is a medication used to induce ovulation in women with infertility.
- Breast tenderness is a known adverse effect of clomiphene citrate.
Vegan Diet During Pregnancy
- Ensure protein intake is adequate during pregnancy.
- Ask the client about their daily protein consumption to assess nutritional adequacy.
Stillborn Delivery Care
- If an autopsy is performed, it helps determine the cause of death and provide answers to the family.
- Providing the client with photos of the fetus can help them process the loss and remember their baby.
- Offer support and comfort to the grieving family.
Methicillin-Resistant Staphylococcus Aureus (MRSA) in Pregnancy
- Contact precautions are essential for pregnant clients with MRSA to prevent transmission.
- The nurse should protect themselves and others by using appropriate personal protective equipment (PPE).
Constipation During Pregnancy
- Lentils are a good source of fiber and can alleviate constipation.
- Encourage clients to consume high-fiber foods and fluids throughout pregnancy.
Breastfeeding Frequency
- Allow the baby to feed at least every 3 hours.
- Encourage breastfeeding on demand whenever the infant displays signs of hunger.
Dinoprostone Insert for Labor Induction
- Always obtain informed consent from the client before administering any medication or procedure.
- The nurse should ensure the client understands the risks and benefits of dinoprostone insertion.
Fertility Treatment Options
- Maintaining a healthy weight is crucial for fertility in both partners.
- Encourage couples to discuss their weight and other lifestyle factors with a healthcare provider.
Labor Initiation and Postpartum Hemorrhage Risk
- A client at 80% effaced and 8 cm dilated is in advanced labor and at an increased risk for postpartum hemorrhage.
- The nurse should monitor the client closely and be prepared for potential interventions.
Newborn Assessment Following Full-Term Birth
- Subconjunctival hemorrhage (bleeding in the white of the eye) is a benign finding in newborns, but it should be reported to the provider.
- The nurse should document the finding and notify the provider for further evaluation.
Late Decelerations in Fetal Heart Rate (FHR)
- Late decelerations can indicate fetal distress.
- Discontinue the oxytocin infusion, administer oxygen, and notify the provider.
- Monitor the FHR closely and prepare for potential interventions.
Maternal Cytomegalovirus (CMV)
- CMV can be transmitted via saliva and urine of the newborn.
- Educate nurses about the importance of handwashing and proper hygiene measures to prevent transmission.
Postpartum Hemorrhage Assessment and Intervention
- Massage the client's fundus to promote uterine contraction and reduce bleeding. If the bleeding persists, prompt intervention is necessary.
- Notify the provider immediately and anticipate interventions such as IV fluids, uterotonics, and potentially surgical management.
Endometritis - Postpartum Infection
- Endometritis is an infection of the uterine lining.
- Uterine tenderness is a classic symptom of endometritis and should be reported to the provider.
Contraindication for Contraction Stress Test (CST)
- A previous classical incision (C-section) is a contraindication for CST as it increases the risk of uterine rupture.
- The nurse should perform a thorough assessment of the client's history and discuss alternative methods for fetal monitoring.
Third-Degree Perineal Laceration and Suppositories
- A third-degree perineal laceration involves damage to the anal sphincter, making it difficult to administer rectal suppositories.
- The nurse should consult with the primary care provider about appropriate pain management options.
Severe Vomiting in Early Pregnancy
- Severe vomiting, especially during the first trimester, can indicate hyperemesis gravidarum. This requires urgent attention.
- The nurse should assess the client's hydration status, weight, and electrolyte levels.
Digoxin Management in Pregnancy
- Ensure the client is taking the medication as prescribed.
- Monitor the client's heart rate and potassium levels, as digoxin can affect both.
Nägele's Rule for Estimating Due Date
- To calculate the estimated due date, add 7 days to the first day of the last menstrual period (LMP) and subtract 3 months.
- For a LMP of August 10th the due date is May 17th.
Bladder Distention Postpartum
- Assist the client to the bathroom as soon as possible to encourage bladder emptying.
- Ensure adequate hydration.
Delaying Antibiotic Ophthalmic Ointment
- An antibiotic eye ointment is routinely given after birth to prevent eye infections.
- Delaying the ointment allows the healthcare provider to assess the newborn's eyes for potential infections.
Post Cesarean Vaginal Bleeding
- Evaluate urinary output to rule out a full bladder, which can contribute to bleeding.
- Monitor vital signs and notify the provider if bleeding persists.
Postpartum Hemorrhage Risk Factors
- Vacuum-assisted delivery, uterine atony, and labor induction with oxytocin all increase the risk of postpartum hemorrhage.
- The nurse should monitor clients who have these factors closely.
Trichomoniasis During Pregnancy
- Trichomoniasis is a vaginal infection that can lead to a malodorous discharge.
- The nurse should assess for symptoms, advise the client about treatment, and encourage partner notification.
Epidural Anesthesia Adverse Effect
- Hypotension is a potential adverse effect of epidural anesthesia that can occur due to vasodilation.
- The nurse should monitor BP closely, administer fluids, and notify the provider if the client's BP is low.
Peripartum Cardiomyopathy
- Peripartum cardiomyopathy is a cardiac condition that can occur during pregnancy or up to 5 months postpartum.
- Assess BP twice daily and monitor the client for signs of heart failure.
Gestational Diabetes Assessment
- A fasting blood glucose of 180 mg/dL is significantly higher than the normal range.
- This finding warrants immediate reporting to the provider and further investigation.
Pyelonephritis During Pregnancy
- Flank pain is a common symptom of pyelonephritis.
- The nurse should conduct a thorough assessment, including vital signs, pain level, and urinary symptoms.
Protruding Umbilical Cord After Rupture of Membranes
- A protruding umbilical cord is a medical emergency, as it can compromise fetal blood flow.
- The nurse should immediately call for assistance, notify the provider, and cover the cord with a sterile saline-saturated towel to avoid drying.
Myelomeningocele Care Immediately After Birth
- Cleanse the site with povidone-iodine to prevent infection.
- Ensure proper padding and positioning to prevent further injury or irritation to the site.
Newborn Status Decline
- Oxygen saturation of 89% is below the normal range for a newborn.
- This finding indicates respiratory distress and warrants immediate attention. The nurse should notify the provider and monitor vital signs closely.
PlastiBell Circumcision Technique
- The nurse should educate parents about the potential complication of a dark red color at the end of the penis and advise them to contact the provider if this occurs.
- The nurse should also instruct the parents on how to care for the circumcision site properly.
Hepatitis B Vaccine Administration
- Inject the hepatitis B vaccine into the vastus lateralis muscle, which is in the thigh, of the right thigh to avoid the sciatic nerve.
Sore Nipples During Breastfeeding
- Assessment of the newborn's latch is crucial because an improper latch can cause pain and discomfort for the mother.
- Correct latch techniques should be taught to the client.
Tubal Ligation
- Although it is a permanent method of contraception, tubal ligation doesn't prevent ovulation.
- Ovulation continues, but fertilized eggs can't reach the uterus.
Home Safety for Newborns
- Wash the newborn's face with plain water. Avoid soaps or lotions, as they can irritate the newborn's delicate skin.
Postpartum Assessment - Report to Provider
- Cool clammy skin is a sign of potential hypothermia and dehydration.
- The nurse should report this finding to the provider for prompt management.
McRoberts Maneuver for Shoulder Dystocia
- Instruct the client to pull their knees toward their abdomen. This helps to rotate the pelvic inlet, allowing the anterior shoulder to deliver.
Hypotension After Epidural Anesthesia
- Turn the client to a side-lying position to improve venous return and increase blood pressure.
- Monitor vital signs closely and notify the provider.
Fourth-Degree Perineal Laceration
- Providing a cool sitz bath can help to reduce pain and promote healing.
- The nurse should also teach the client about proper perineal care and hygiene.
Uterine Atony and Postpartum Hemorrhage
- Anticipate a prescription for misoprostol, a uterotonic medication that helps contract the uterus.
- Monitor the client closely for signs of continued bleeding and prepare for intervention.
Neonatal Abstinence Syndrome (NAS) Care
- Maintain a low-stimulation environment to minimize stress on the infant.
- Instruct the parent to avoid breastfeeding until the infant is stable and the provider has approved.
- Perform Ballard newborn screening each shift to assess the infant's neurodevelopmental status.
- Weigh the newborn daily to monitor weight gain and hydration.
- Swaddle the newborn with flexed extremities to provide comfort and reduce anxiety.
Leopold Maneuvers Sequence
- 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.
Postpartum Deep Vein Thrombosis (DVT) Assessment
- Leukocytosis, redness in the extremity, increased warmth in the extremity, tachycardia, and decreased extremity edema are signs of potential worsening DVT.
- Scant lochia rubra is a sign of improving DVT.
Preeclampsia Assessment
- A platelet count of 90,000/mm3, hematuria, positive clonus, proteinuria 2+, BUN 40 mg/dL are signs of potential worsening preeclampsia.
- Leukorrhea is a sign of potential improvement.
Postpartum Hemmorhage
- Lateral deviation of the uterus, a large amount of lochia rubra, and uterine tone requiring follow-up in the next 30 minutes or sooner
Misoprostol Administration Assessment
- Blood pressure 80/50 mm Hg, Cloudy urine, Moderate lochia rubra, and Fundus at the level of the umbilicus, are findings that require immediate attention and may indicate a worsening postpartum hemorrhage.
- A fundus firm to palpation is a positive sign that the medication is working.
Neonatal Abstinence Syndrome Assessment
- Regurgitation, mottling, continuous high-pitched cry, respiratory rate 70/min, loose stools, are all possible signs of potential worsening NAS.
- Transient strabismus is a sign of potential improvement.
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