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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A: the interval between contractions
Encouraging a laboring woman to push during the interval between contractions is not appropriate. During this time, the uterus is not contracting, and pushing would be ineffective and exhausting for the woman. The intervals are meant for rest and recovery to prepare for the next contraction.
Choice B: whenever she feels the need
While it is important to listen to the laboring woman’s instincts, pushing should be coordinated with contractions for maximum effectiveness. Pushing whenever she feels the need might not align with the contractions, leading to ineffective efforts and increased fatigue.
Choice C: second-stage of labor
The second stage of labor is the most appropriate time for the nurse to encourage a laboring woman to push. This stage begins when the cervix is fully dilated to 10 centimeters and ends with the birth of the baby. During this stage, contractions are strong and frequent, providing the necessary force to help push the baby through the birth canal.
Choice D: first-stage of labor
The first stage of labor involves the dilation and effacement of the cervix and is not the appropriate time for pushing. Pushing during this stage can cause unnecessary strain and may lead to complications. The focus during the first stage should be on managing contractions and conserving energy for the second stage.
Correct Answer is C
Explanation
Choice A. Accelerations are normal responses that indicate the fetus is healthy and active. Accelerations occur when the fetal heart rate increases in response to stimuli. •
Choice B. Late decelerations are nonreassuring patterns that indicate fetal hypoxia due to placental insufficiency. Late decelerations occur when the placental blood flow decreases due to uterine contractions during labor, causing the fetal heart rate to decrease. •
Choice C. Variable decelerations are nonreassuring patterns that indicate fetal hypoxia due to umbilical cord compression. Variable decelerations occur when the umbilical cord is trapped by the cervical opening or the fetal body part, twisted, or knotted, causing the fetal oxygen supply to be impaired and the fetal heart rate to drop sharply. •
Choice D. Early decelerations are reassuring patterns that indicate a neural reflex due to fetal head compression. Early decelerations occur when the fetal head is compressed by uterine contractions during labor, causing the parasympathetic nervous system to be stimulated and the heart rate to decrease. The correct answer is C. Variable decelerations are the most common pattern that indicates a problem with the umbilical cord and requires urgent intervention.
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