Maternity Ch. 21

Front 1

the perinatal nurse is caring for a woman in te immediate postbirth period. assessment reveals that the woman is experiencing profuse bleeding. the most likely etiology for the bleeding is

Back 1

uterine atony

Front 2

a primary nursing responsibility when caring for a womanexperiencing an obstetric hemorrhage associated with uterine atony is to

Back 2

perform fundal massage

Front 3

the perinatal nurse caring for the postpartum woman understands that late postpartum hemorrhage (PPH) is most likely caused by

Back 3

subinvolution of the placental site

Front 4

which woman is at greatest risk for early postpartum hemorrhage (PPH)?

Back 4

a woman with severe preeclampsia who is receiving magnesium sulfate and whose labor is being induced

Front 5

the first and most important nursing intervention when a nurse observes profuse postpartum bleeding is to

Back 5

palpate the uterus and massage it if it is boddy

Front 6

when caring fora postpartum woman experiencing hemorrhagic shock, the nurse recognizes that the most objective and least invasive assessment of adequate organ perfusion and oxygenation is

Back 6

urinary output of at least 30mL/hr

Front 7

one of the first symptoms of puerperal infection assess for in the postpartum woman is

Back 7

temp of 38 C or higher on 2 successive days starting 24 hours after birth

Front 8

the perinatal nurse assisting with establishing lactation is aware that acute mastitis can be minimized by

Back 8

using proper breastfeeding techniques

Front 9

nurses need to know the basic definitions and incidence data abot postpartum hemorrhage (PPH). for instance

Back 9

traditionally PPH has been classified as early or late with respect to birth

Front 10

a woman who has recently gien brith complainsof pain and tenderness in her leg. on physical examination the nurse notices warmth and redness over an enlarged, hardened area. the nurse should suspect ______ and should confirm the diagnosis by ______.

Back 10

thrombophlebitis; using real-time andcolor doppler ultrasound

Front 11

what PPH conditions are considered medicalemergencies that require immediate treatment

Back 11

inversion of the uterus and hypovolemic shock

Front 12

what infetion is contracted mostly by first-time mothers who are breatfeeding

Back 12

mastitis

Front 13

despite popular belief, there is a rare tpye of hemophilia that affects women of childbearing age. von villebrand disease is the most common of the hereditary bleeding disorders and can affect males and females alike. it results from a factor VIII deficiency and platelet dysfunction. although factor viii levels increase naturally during pregnancy, there is an increasedrisk for PPH from birth until 4 weeks after delivery as levels of von willebrand factor and factor VIII decrease. the treatment that shouldbe considered first for the client with conwillebrand disease who experiences a PPH is

Back 13

desmopression

Front 14

the nurse should be aware that a pessary would be most effective in the treatment of what disorder

Back 14

uterine prolapse

Front 15

amother in latemiddle age who is certain she is not pregnant tells the nurse during an office visit that she has urinary problems and sensations of bearing down and of something in her vagina.the nurse would realize that the client most likely is suffering from

Back 15

cystoceles and/or rectoceles

Front 16

the prevelence of urinary incontinence increases as women age, with more than one thrid of women in the US suffering from some form of this disorder. the symptoms of mild to moderate UI can be successfully decreased by a number of strategies. which of theseshould the nurse instruct the client to use first

Back 16

bladder training and pelvice muscle exercises

Front 17

when a woman is diagnosed with PPD with psychotic features, one of the main concerns is that she may

Back 17

harm her infant

Front 18

according to beck's studies,what risk factor for PPD is likely to have the greatest efect on the woman's condition

Back 18

prental depression

Front 19

to provide adequate postpartum care, the nurse should be aware that PPD without psychotic features

Back 19

is distinguished by irritability, severe anxiety, and panic attacks

Front 20

to provide adequate postpartum care, the nurse should be aware that PPD with psychotic features

Back 20

may include bipolar disorder

Front 21

with shortened hospital stays, new mothers are often discharged before they begin to experience symptoms of the baby blues or postpartum depression. as part of the discharge teaching, te nurse can prepare the mother for this adjutment to her new role by instructing her regarding self care activites to help prevent PPD. the most accurate statement as related to these activities is

Back 21

realize that his is a common occurrence that affects many women

Front 22

a newborn in the NICU is dying as a result of a massive infection. the parents speak to the neonatologist, who informs them of their son's prognosis. when the father sees his son, he says " he looks just fine to me. i cant understand what all this is about." the most appropriate response by the nurse would be

Back 22

"this must be a difficult time for you. tell me how your doing"

Front 23

after giving birth to a stillborn infant, the woman turns to the nurse and says, " i just finished painting the baby's room. do you think that caused my baby to die?" the nurse's best response to this woman is

Back 23

i can understand your need to find an answer to what caused this. what else are you thinking about

Front 24

which options for saying goodby would the nurse want to discuss with a woman who is diagnosed with having a stillborn baby girl

Back 24

when your baby is born, would you like to see and hold her

Front 25

a woman exerienced a miscariage at 10 weeks of gestation and had a dilation and curettage (D&C). she states that she is just fine and wants to go home as soon as possible. while you are assessing her responses to her loss, she tells your that she had purchases some baby things and had picked out a name. on the basis of your assessment of her responses, what nursing intervention would you use first

Back 25

ask her what name she had picked out for her baby

Front 26

a woman is diagnosed with having a stillborn. at first, she appears stunned by the news, cries a little, and then asks you to call her mother. the phase of bereavement the woman is experiencing is called

Back 26

acute distress

Front 27

during the intial acut distress phase of grieving, parents still must make unexpected and unwanted decisions about funeral arrangements and even naming the baby. the nurse's role should be to

Back 27

make sure the parents themselves approve the final decisions

Front 28

the nurse caring for a family during a loss may notice that survival guilt sometimes is felt at the death of an infant by the child's

Back 28

grandparents

Front 29

complicated bereavement

Back 29

is an extremely intense grief reaction that persists for a long time

Front 30

early postpartum hemorrhage is defined as a blood loss greater than

Back 30

500 mL in the first 24 hours after a vaginal delivery

Front 31

a woman delivered a 9 pound, 10 oz baby 1 hour ago. when you arrive to perform her 15 minute assessment, she tells you that she "feels all wet underneath." you discover that both pads are completely saturated and that she is lying in a 6 inch diameter puddle of blood. what is your first action

Back 31

assess the fundus for frimness

Front 32

a steady trickle ofbright red blood from the vagina in the presence of a firm fundus suggests

Back 32

laceration of the genital tract

Front 33

which instructions should be included in the discharge teaching plan to assist the patient in recognizing early signs of complications

Back 33

nootify the hysician of any increase in the amount of lochia ora return to bright red bleeding

Front 34

if nonsurgical treatment for late PPH is ineffective, which surgical procedure is appropriate to correct the cause of this condition

Back 34

D&C

Front 35

a mother with mastitis is concerned about breastfeeding while she has an active infection. the nurse should explain that

Back 35

the organism that case mastitis are not passed to the milk

Front 36

which condition is a transient, self-limiting mood disorder that affects new mothers after childbirth

Back 36

postpartum blues

Front 37

anxiety disorders are the most common mental disorders that affect women. while providing care to the maternity patient, the nurse should be aware that one of these disorders is likely to be trigered by the process of labor and birth. this disorder is

Back 37

PTSD

Front 38

medications used to manage PPH include (SATA)

Back 38

pitocin

methergine

hemabate

Front 39

possible alternative and complementary therapies for PPD for breastfeeding mothers include (SATA)

Back 39

acupressure

aromatherapy

yoga

Front 40

a. palpation

b. auscultation

c. inspection

d. observation

e. measurement

40. pulse oximetry

41. heart sounds

42. arterial pulses

43. skin color, tmperature, turgor

44. presence or absence of anxiety

Back 40

40. E

41. B

42. A

43. C

44. D