On examining a woman who gave birth 5 hours ago, the nurse finds that the woman has completely saturated a perineal pad within 15 minutes. The nurse's first action is to:
massage the woman's fundus.
Begin an intravenous (IV) infusion of Ringer's lactate solution.
Call the woman's primary health care provider.
Assess the woman's vital signs.
The Correct Answer is A
The nurse's first action should be to massage the woman's fundus. A completely saturated perineal pad within 15 minutes after giving birth indicates excessive bleeding, which is also known as postpartum hemorrhage (PPH). Massaging the uterus (fundus) can help it to contract, reduce bleeding, and prevent further blood loss. Once the fundus has been massaged, the nurse should assess the woman's vital signs and continue to monitor her for signs of continued bleeding. If bleeding persists despite massage, the nurse should begin an intravenous (IV) infusion of Ringer's lactate solution and call the woman's primary healthcare provider.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Infants of diabetic mothers (IDM) are at risk of hypoglycemia because they have been exposed to high levels of glucose in utero. The fetus responds to this high glucose level by producing high levels of insulin to regulate the glucose level. After delivery, the glucose supply from the mother is cut off and the infant's insulin levels remain high, leading to hypoglycemia.
Additionally, the infant's ability to produce glucose is immature and may not be sufficient to maintain normal blood glucose levels, especially if the infant is premature or small for gestational age. Therefore, IDM requires close monitoring of their blood glucose levels to prevent and treat hypoglycemia.
Correct Answer is A
Explanation
One of the most important principles of effective health education is to involve the target audience in the planning process. By involving the target audience in the planning process, the nurse can gain a better understanding of their needs, priorities, and concerns related to health and wellness. This, in turn, can help the nurse develop education goals that are relevant, engaging, and effective at improving health outcomes.
Asking the formal leadership of a community what the learning needs are, using the expertise of professional nurses who are skilled at assessing needs, or interviewing physicians to determine the highest need based on diagnoses can all be useful strategies for gathering information about community health needs. However, none of these strategies are as effective at identifying the specific needs and priorities of the target audience as asking the target audience directly.
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