ch 22 nursing mngmnt of at risk pp

Question 1

review of a primaprous woman’s labor and birth record reveals a prolonged second stage of labor and extended time in the stirrups. based on an interpretation of these findings, the nurse would be especially alert for which condition?

Answer 1

thrombophlebitis

Question 2

the nurse is conducting a class for postpartum women about mood disorders. the nurse describes a transient, self limiting mood disorder that affects mothers after birth. the nurse determines that the women understood the description when they identify the condition as postpartum:

Answer 2

blues

Question 3

a woman who is two weeks postpartum call the clinic and says her left breast hurts. after further assessment on the phone, the nurse suspects mastitis. in addition to pain, the nurse would question the woman about which symptoms?

Answer 3

hardening of the are in the affected breast

Question 4

a nurse is developing a program to help reduce the risk of late postpartum hemorrhage in clients in the labor and birth unit. which measure would the nurse emphasize as part of this program?

Answer 4

inspecting the placenta after delivery for intactness

Question 5

a multiparty client develops thrombophlebitis after birth. which assessment findings would lead the nurse to intervene immediately?

Answer 5

dyspnea, diaphoresis, hypotension, and chest pain

Question 6

a client experienced prolonged labor with prolonged PROM. the nurse would be alert for which condition of the mother and newborn?

Answer 6

infection

Question 7

when assessing the pp woman, the nurse uses indicators other than pulse rate and bp for pp hemorrhage because:

Answer 7

these measurements may not change until the blood loss is large

Question 8

a nurse is assessing a pp client. which finding would cause the greatest amount of concern?

Answer 8

sharp, stabbing chest pain with shortness of breath

Question 9

a woman who is experiencing pp hemorrhage is extremely apprehensive and diaphoretic. the woman’s extremities are cool and her capillary refil time is increased. based on this assessement, the nurse suspects that the client is experiencing approx. how much blood loss?

Answer 9

60%

Question 10

a pp client is prescribed medication therapy as part of the treatment plan for pp hemorrhage. which medication would the nurse expect to administer?

Answer 10

methylgenovine

Question 11

a client is experiencing pp hemorrhage and the nurse begins to massage her fundus. which action would be most appropriate for the nurse to do when massaging the woman’s fundus?

Answer 11

wait until the uterus is firm to express clots

Question 12

after teaching a woman with pp infection about care after discharge, which client statement indicates the need for additional teaching?

Answer 12

when i put on a new pad, ill start at the back and go forward

Question 13

a nurse is making a home visit to a pp client. which finding would lead the nurse to suspect that a woman is experiencing pp psychosis?

Answer 13

delirium

Question 14

a nurse is reviewing a journal article on the causes of pp hemorrhage. which condition would the nurse most likely find as the most common cause?

Answer 14

uterine atony

Question 15

a pp woman is diagnosed with endometritis. the nurse interprets this as an infection involving which area? select all that apply

Answer 15

-endometrium
-decidua
-myometrium

Question 16

a group of nurses are reviewing information about mastitis and its causes in an effort to develop a teaching program on prevention for pp women. the nurse demonstrates understanding of the information when they focus the teaching on way to minimize risk of exposure to which organism?

Answer 16

s. aureus

Question 17

a home health care nurse is assessing a pp woman who was discharged two days ago. the woman tell her nurse she has a low grade fever and feels lousy. which finding would lead the nurse to suspect endometritis? select all that apply

Answer 17

-lower abdominal tenderness
-anorexia

Question 18

a pp client comes to the clinic for her routine 6 week visit. the nurse assesses the client and suspects that she is experiencing subinvolution based on which finding?

Answer 18

moderate lochia serosa

Question 19

assessment of a pp client reveals a firm uterus with a bright red bleeding and a localized bluish bulging area just under the skin at the perineum. the woman also reports severe pelvic pain and is experiencing problems with voiding. the nurse suspects which condition?

Answer 19

hematoma

Question 20

a pp woman is prescribed oxytocin to stimulate the uterus to contract. which action would be most appropriate for the nurse to do?

Answer 20

piggyback the iv infusion into a primary line

Question 21

assessment of a pp woman experiencing pp hemorrhage reveals mild shock. which finding would the nurse expect to assess? select all that apply

Answer 21

-diaphoresis
-cool extremities

Question 22

a nurse is providing a refresher class for a group of pp nurses. the nurse reviews the risk factors associated with pp hemorrhage. the group demonstrates understanding of the information when they identify which risk factors associated with uterine tone? select all that apply

Answer 22

-rapid labor
-hydramnios

Question 23

a nurse is massaging a pp clients fundus and placed the non dominant hand on the area above the symphysis pubis based on the understanding that this action:

Answer 23

helps support the lower uterine segment

Question 24

a nurse is developing a plan of care for a woman who is at risk for thromboembolism. which measure would the nurse include as the most cost effective method for prevention?

Answer 24

early ambulation

Question 25

a pp woman who developed deep vein thrombosis is being discharged on anticoagulant therapy. after teaching the woman about this treatment, the nurse determines that additional teaching is needed when the woman makes which statement?

Answer 25

i can take ibuprofen if i have any pain

Question 26

the nurse is developing a discharge teaching plan for a pp woman who has developed a pp infection. which measures would the nurse most likely include in this teaching plan? select all that apply.

Answer 26

-taking the prescribed antibiotic until it is finished -washing hands before and after perineal care -handling perineal pads by the edges

Question 27

a nurse is assessing a pp client who is at home. which statement by the client would lead the nurse to suspect that the client may be developing pp depression?

Answer 27

i’m feeling so guilty and worthless lately

Question 28

as part of an in-service program to a group of home health care nurses who care for pp women, a nurse is describing pp depression. the nurse determines that the teaching was successful when the group identifies that this condition becomes evident at which time after birth of the newborn?

Answer 28

within the first 6 weeks

Question 29

a nurse suspects that a client may be developing disseminated intravascular coagulation. the woman has a history of placental abruption during birth. which finding would help to support the nurses suspicion?

Answer 29

appearance of petechiae

Question 30

on a follow up visit to the clinic, a nurse suspects that a pp client is experiencing pp psychosis. which finding would most likely lead the nurse to suspect this condition?

Answer 30

delusional beliefs

Question 31

a nurse is assessing a client who gave birth vaginal about 4 hours ago. the client tells the nurse that she changed her perineal pad an hour ago. on inspection, the nurse notes that the pad is now saturated. the uterus is firm and approx at the level of the umbilicus. further inspection of the perineum reveals an area, bluish in color and bulging just under the skin surface. what should the nurse do next?

Answer 31

notify the heath care provider

Question 32

a nurse is providing education to a woman who is experiencing pp hemorrhage and is to receive a utertonic agent. the nurse determines that additional teaching is needed when the woman identifies which drug as possibles being prescribed as treatment?

Answer 32

magnesium sulfate