A woman gave birth vaginally to a 9-pound, 12-ounce girl yesterday. Her primary health care provider has written orders for perineal ice packs, use of a sitz bath tid, and a stool softener. What information is most closely correlated with these orders?

The woman had a vacuum-assisted birth.

The woman is a gravida 2, para 2.

The woman has an episiotomy.

The woman received epidural anesthesia.

Answer and Explanation

The Correct Answer is C

A. The woman had a vacuum-assisted birth. While vacuum-assisted births can cause perineal trauma, the specific orders for ice packs, sitz baths, and stool softeners are more directly related to an episiotomy, which involves a surgical incision that requires careful postpartum care.

B. The woman is a gravida 2, para 2. This information indicates the woman's obstetric history but does not directly correlate with the need for perineal ice packs, sitz baths, and stool softeners. These orders are more specific to perineal trauma or surgical intervention.

C. The woman has an episiotomy. An episiotomy involves a surgical cut made at the opening of the vagina during childbirth, which can cause significant perineal pain and swelling. The orders for perineal ice packs, sitz baths, and stool softeners are intended to manage pain, reduce swelling, and prevent constipation, which can be particularly uncomfortable with perineal stitches.

D. The woman received epidural anesthesia. While epidural anesthesia is a common pain management technique during labor, it does not necessitate the use of perineal ice packs, sitz baths, or stool softeners postpartum. These orders are more indicative of perineal trauma or surgical intervention such as an episiotomy.

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Correct Answer is A

Explanation

Choice A reason:

One side effect of oxytocin stimulation is hypertonic contractions. This can be detrimental to the fetus because it causes a reduction of placental blood flow. Placental blood flow is essential for delivering oxygen and nutrients to the fetus and removing waste products. Hypertonic contractions are too frequent, too long, or too strong, and they can reduce the time for the placenta to refill with blood between contractions. This can lead to fetal hypoxia, acidosis, and distress.

Choice B reason:

One side effect of oxytocin stimulation is hypertonic contractions. This can be detrimental to the fetus because it produces a prolapsed cord. This is incorrect because a prolapsed cord is not caused by hypertonic contractions, but by other factors such as a low-lying placenta, a premature rupture of membranes, a small or preterm fetus, or an abnormal presentation. A prolapsed cord occurs when the umbilical cord slips through the cervix and into the vagina before or during delivery. This can compress the cord and cut off the blood supply to the fetus, resulting in fetal bradycardia and possible death.

Choice C reason:

One side effect of oxytocin stimulation is hypertonic contractions. This can be detrimental to the fetus because it increases maternal renal blood flow. This is incorrect because hypertonic contractions do not affect maternal renal blood flow directly. Maternal renal blood flow is influenced by factors such as maternal blood pressure, hydration, cardiac output, and renal function. Hypertonic contractions may cause maternal dehydration, which can reduce renal blood flow, but this is not a direct effect of oxytocin stimulation.

Choice D reason:

One side effect of oxytocin stimulation is hypertonic contractions. This can be detrimental to the fetus because it decreases maternal blood pressure. This is incorrect because hypertonic contractions do not cause maternal hypotension, but rather hypertension. Hypertension is a common side effect of oxytocin stimulation, as oxytocin causes vasoconstriction and increases the sensitivity of the vascular smooth muscle to catecholamines. Hypertension can lead to complications such as preeclampsia, eclampsia, and placental abruption.

A. 10% to 15% of their birth weight. B. 20% of their birth weight. C. 15% to 18% of their birth weight. D. 5% to 10% of their birth weight.

Correct Answer is D

Explanation

Choice A reason:

10% to 15% of their birth weight. This is incorrect because this range is too high for a normal newborn weight loss. Losing more than 10% of their birth weight may indicate dehydration, inadequate feeding, or other problems. • Choice B reason:

20% of their birth weight. This is incorrect because this percentage is way too high for a normal newborn weight loss. Losing 20% of their birth weight would be a serious sign of illness or malnutrition. • Choice C reason:

15% to 18% of their birth weight. This is incorrect because this range is also too high for a normal newborn weight loss. Losing 15% to 18% of their birth weight would be a cause for concern and require further evaluation. • Choice D reason:

5% to 10% of their birth weight. This is correct because this range is within the normal limits for a newborn weight loss. Newborns lose some weight as a result of insufficient caloric intake, fluid loss, and metabolic adjustments in the first week after birth. They usually regain their birth weight by the second week.

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A woman gave birth vaginally to a 9-pound, 12-ounce girl yesterday. Her primary health care provider has written orders for perineal ice packs, use of a sitz bath tid, and a stool softener. What information is most closely correlated with these orders?

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Naxlex Comprehensive Predictor Exams

One side effect of oxytocin stimulation is hypertonic contractions. This can be detrimental to the fetus because

Correct Answer is A

Explanation

A mother is upset because her newborn has lost 6 ounces since birth 2 days ago. The nurse informs the mother that it is normal for a newborn to lose which percentage of their birth weight within the first week of life?

Correct Answer is D

Explanation

A nurse is caring for a client who is 2 hours postpartum following a vaginal birth. Which of the following findings indicates the client's bladder is distended?

A nurse is caring for a client who is at 40 weeks gestation and is in active labor. The client has 6 cm of cervical dilation and 100% cervical effacement. The nurse obtains the client's blood pressure reading as 82/52 mm Hg. Which of the following nursing interventions should the nurse perform?

The correct answer is choice A, which is to ensure that conductive heat loss from the infant is minimal

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A woman received 50 mcg of fentanyl intravenously 1 hour before delivery. What drug should the nurse have readily available?

After an amniotomy, which action by the nurse takes priority?

The nurse notices while holding him upright that a 1-day-old newborn has a significantly indented anterior fontanelle. She immediately brings it to the attention of the physician. What does this finding most likely indicate?