A nurse is caring for a client who is 1 hr postpartum and has uterine atony. The client is exhibiting a large amount of vaginal bleeding. Which of the following actions should the nurse take?
Avoid performing sterile vaginal examinations.
Anticipate a prescription for misoprostol.
Obtain a specimen for a Kleihauer-Betke test.
Administer betamethasone IM.
The Correct Answer is B
Rationale:
A. Avoiding sterile vaginal examinations is not the appropriate action for managing uterine atony and postpartum hemorrhage. Vaginal examinations may be necessary to assess the degree of cervical dilation and to identify potential causes of bleeding.
B. Anticipating a prescription for misoprostol is appropriate for managing uterine atony and postpartum hemorrhage. Misoprostol is a prostaglandin analog that helps to promote uterine contractions and control bleeding.
C. Obtaining a specimen for a Kleihauer-Betke test is not the priority action in this situation. The Kleihauer-Betke test is used to estimate the amount of fetal-maternal hemorrhage in Rh-negative mothers.
D. Administering betamethasone IM is not indicated for the management of uterine atony and postpartum hemorrhage. Betamethasone is a corticosteroid used to promote fetal lung maturity when preterm birth is anticipated.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Dinoprostone vaginal inserts (e.g., Cervidil) should be kept frozen until use and do not require thawing or warming before insertion. Allowing the medication to reach room temperature is unnecessary and could compromise its stability and effectiveness.
B. Verifying that informed consent is obtained is essential before administering dinoprostone. The client must understand the purpose, potential risks, and alternatives to labor induction, ensuring ethical and legal standards are met.
C. Semi-Fowler’s positioning may be used during labor but is not a priority immediately after insertion. Positioning is secondary to consent and safety considerations.
D. Instructing the client to avoid urinary elimination is not required for dinoprostone administration and does not impact the safety or effectiveness of labor induction.
Correct Answer is A
Explanation
A. "The car seat should be positioned in the car at a 45-degree angle." This statement is correct and indicates an understanding of car seat safety. Positioning the car seat at a 45-degree angle helps prevent the newborn's head from flopping forward, which could obstruct the airway. Proper positioning ensures both safety and comfort during travel.
B. "My baby will need a car seat challenge test before discharge." This statement is incorrect for a newborn delivered at 38 weeks of gestation. A car seat challenge test is typically required for premature infants (less than 37 weeks gestation) or those with specific health conditions to ensure they can tolerate sitting in a car seat without respiratory or cardiac issues.
C. "When my baby is 1 year old, I can turn their car seat facing forward." Incorrect. It is recommended to keep infants in a rear-facing car seat until they reach the maximum height or weight limit recommended by the car seat manufacturer, typically well beyond the first year of life.
D. “I can use a sleep sack to keep my baby warm in the car seat." While using a sleep sack can keep a baby warm, it's important not to use any additional padding or blankets in the car seat as they can interfere with the proper harness fit and increase the risk of injury in the event of a crash.
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