A nurse in a provider's office is reinforcing teaching with a client who is pregnant and is scheduled for a nonstress test. Which of the following statements should the nurse make?

"You will not be able to eat or drink anything for 8 hours prior to the test."

"You will be required to lie flat on your back for the duration of the test

"You will receive medication through an IV line to stimulate contractions."

"You will press the provided button when you feel the baby moving during the test.

Answer and Explanation

The Correct Answer is D

(a) "You will not be able to eat or drink anything for 8 hours prior to the test."
There are no fasting requirements for a nonstress test. The client can eat and drink normally before the test. Nonstress tests do not require the same preparation as some other medical tests, such as fasting or dietary restrictions.

(b) "You will be required to lie flat on your back for the duration of the test."
Lying flat on the back can cause supine hypotension syndrome in pregnant women, which can lead to decreased blood flow to the fetus. Instead, clients are typically positioned in a semi-Fowler's or lateral position to avoid this issue.

(c) "You will receive medication through an IV line to stimulate contractions."
This describes a contraction stress test, not a nonstress test. A nonstress test involves monitoring the fetal heart rate in response to natural fetal movements without inducing contractions through medication.

(d) "You will press the provided button when you feel the baby moving during the test."
During a nonstress test, the client is instructed to press a button whenever they feel fetal movement. This helps the healthcare provider correlate fetal movements with changes in the fetal heart rate, which can indicate fetal well-being.

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Correct Answer is A

Explanation

(A) Retained placental fragments:
Retained placental fragments can lead to postpartum hemorrhage (PPH) due to incomplete expulsion of the placenta or membranes, which can cause ongoing bleeding. Failure of the uterus to contract effectively after childbirth to compress blood vessels at the placental site can result in excessive bleeding. This is a significant risk factor for PPH and requires prompt intervention to prevent complications.

(B) Urinary tract infection:
While urinary tract infections (UTIs) can occur in the postpartum period, they are not typically considered significant risk factors for postpartum hemorrhage. UTIs are more commonly associated with symptoms such as dysuria, frequency, and urgency.

(C) Oligohydramnios:
Oligohydramnios, a condition characterized by decreased amniotic fluid volume, is not a direct risk factor for postpartum hemorrhage. Oligohydramnios may be associated with other pregnancy complications but is not directly related to the risk of postpartum hemorrhage.

(D) Breech presentation:
While breech presentation (when the baby's buttocks or feet are positioned to deliver first) may increase the risk of complications during labor and delivery, it is not specifically linked to postpartum hemorrhage. Breech presentation may necessitate interventions such as cesarean section delivery to reduce the risk of birth-related complications, but it is not a direct risk factor for postpartum hemorrhage.

A. Apply elastic stockings before the client gets out of bed B. Have the client ambulate as often as possible. C. Apply warm, moist packs to the client's lower legs D. Administer NSAIDs every 4 to 6 hr.

Correct Answer is B

Explanation

(A) Apply elastic stockings before the client gets out of bed:
While elastic stockings can help prevent thrombophlebitis by promoting venous return and reducing the risk of blood pooling in the legs, applying them before the client gets out of bed may not be as effective as ambulation in preventing stasis and clot formation.

(B) Have the client ambulate as often as possible:
Ambulation helps prevent thrombophlebitis (inflammation of a vein with clot formation) by promoting blood circulation in the lower extremities. Moving the legs and walking encourage the calf muscles to contract, which aids in pushing blood back towards the heart, reducing the risk of blood stasis and clot formation.

(C) Apply warm, moist packs to the client's lower legs:
Applying warm, moist packs to the lower legs may provide comfort and relaxation, but it is not a primary measure for preventing thrombophlebitis. In fact, warm compresses may dilate blood vessels and potentially increase the risk of thrombosis in some cases.

(D) Administer NSAIDs every 4 to 6 hr:
Nonsteroidal anti-inflammatory drugs (NSAIDs) are not typically used for preventing thrombophlebitis. While NSAIDs can help manage pain and inflammation, they do not directly address the underlying mechanisms of thrombus formation or prevent blood stasis. Additionally, frequent administration of NSAIDs may carry risks of gastrointestinal bleeding and renal complications.

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