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Exhibits

The nurse is reviewing the clients' chart.

Click to highlight areas of client history and physical that increase the risk for postpartum hemorrhage.

36-year-old client who is gravida 5, para 5, transferred to the postpartum unit 1 hour after delivery of a 9 lb 1 oz (4.1 kg) female. She was in labor for 25 hours and forceps were used to assist with the delivery. She was given an epidural for anesthesia that was effective. The labor and delivery nurse reported that the client had a 4th degree laceration, and her pain was currently at a 4 on a 0 to 10 pain scale. Her vital signs were stable, and she was catheterized for 500 mL of light yellow urine just prior to delivery. Her spouse was at the bedside for delivery and appeared supportive. Blood type A+. Estimated blood loss was 600 ml. after delivery.

gravida 5, para 5

delivery of a 9 lb 1 oz (4.1 kg) female

She was in labor for 25 hours and forceps were used to assist with the delivery

4th degree laceration

her pain was currently at a 4 on a 0 to 10 pain scale.

Her vital signs were stable, and she was catheterized for 500 mL of light yellow urine

Estimated blood loss was 600 ml. after delivery.

She was given an epidural for anesthesia that was effective.

Answer and Explanation

The Correct Answer is ["A","B","C","D"]

36-year-old client who is gravida 5, para 5, transferred to the postpartum unit 1 hour after delivery of a 9 lb 1 oz (4.1 kg) female. She was in labor for 25 hours and forceps were used to assist with the delivery. She was given an epidural for anesthesia that was effective. The labor and delivery nurse reported that the client had a 4th degree laceration, and her pain was currently at a 4 on a 0 to 10 pain scale. Her vital signs were stable, and she was catheterized for 500 mL of light yellow urine just prior to delivery. Her spouse was at the bedside for delivery and appeared supportive. Blood type A+. Estimated blood loss was 600 ml. after delivery.

Rationale:

Gravida 5, Para 5 (G5P5): Having multiple pregnancies can increase the risk of uterine atony and hemorrhage after delivery. Each subsequent pregnancy may carry a higher risk for complications.

Prolonged Labor (25 hours): Prolonged labor is associated with increased uterine fatigue and can lead to uterine atony, which is a primary cause of PPH.

Delivery of a 9 lb 1 oz (4.1 kg): Macrosomia can lead to complications during birth, such as maternal and/or fetal trauma, which in turn may increase the likelihood of PPH.

Use of Forceps: The use of forceps during delivery can lead to trauma and lacerations, which may contribute to increased bleeding, especially with a 4th degree laceration.

4th Degree Laceration: This type of laceration extends through the anal sphincter and can lead to significant bleeding. It also increases the risk of infection and other complications.

Estimated Blood Loss of 600 mL: While this is within the normal range for delivery, it may be concerning in the context of the other risk factors and warrants careful monitoring for additional bleeding.

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Free Nursing Study Resources

Correct Answer is B

Explanation

A. While close living quarters may contribute to disease spread, it is not the most direct source of contamination related to diarrhea.

B. Drinking water contaminated by sewage is a significant concern during disasters, often leading to gastrointestinal illnesses such as diarrhea due to pathogens.

C. Nosocomial transmission is less likely in a disaster medical area if proper infection control measures are in place.

D. Food contamination from floodwaters is a possibility, but drinking contaminated water poses a more immediate and severe risk for diarrhea.

A. Apply baby lotion to the skin twice daily. B. Keep the nails trimmed short. C. Allow the child to wear only 100% cotton clothing. D. Bathe the child daily with bath oil.

Correct Answer is B

Explanation

A. While applying lotion can help keep the skin moisturized, it may not prevent scratching or bleeding from lesions.

B. Keeping the nails trimmed short is essential to prevent the child from scratching the lesions, which can lead to further irritation and potential infection. Short nails reduce the risk of breaking the skin and causing bleeding.

C. While cotton clothing is less irritating and may help manage eczema, ensuring that the child does not scratch the lesions is more critical in this scenario.

D. Daily baths can be beneficial, but they should not be done excessively as they can further dry the skin. Bath oils may help, but they do not directly address the issue of scratching.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client arrives at a hurricane disaster medical area seeking treatment for diarrhea. Which source of contamination should the nurse consider when interviewing the client about exposure?

Correct Answer is B

Explanation

The nurse is assessing a 4-year-old client with eczema. The child's skin is dry and scaly, and the parent reports that the child frequently scratches the lesions on the skin to the point of causing bleeding. Which guideline is indicated for care of this child?

Correct Answer is B

Explanation

A client with septic shock develops disseminated intravascular coagulation (DIC). Which pathophysiologic process should the nurse recognize as the cause of the coagulation problem?

Exhibits Complete the diagram by dragging from the choices area to specify condition the client is most likely experiencing, two actions the nurse should take to address that condition, and two parameters the nurse to assess the client's progress.

In caring for a client who is receiving linezolid IV for nosocomial pneumonia, which assessment finding is most important for the nurse to report to the healthcare provider?

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