Part of the health assessment of a newborn includes observation of the neonate's breathing pattern. A full-term newborn's breathing pattern is predominantly:

Abdominal with synchronous chest movements.

Chest breathing with nasal flaring.

Diaphragmatic with chest retraction.

Deep with a regular rhythm.

Answer and Explanation

The Correct Answer is A

A) Abdominal with synchronous chest movements:
Newborns primarily exhibit abdominal breathing, meaning that the diaphragm does most of the work while the chest movements are less pronounced. This is normal for full-term neonates, and the chest and abdomen move in a synchronous manner as the baby breathes. This pattern is indicative of an immature respiratory system that is still developing, but it is completely normal in the early stages of life.

B) Chest breathing with nasal flaring:
While some chest movement is observed in newborns, the primary pattern of breathing is abdominal. Nasal flaring is generally an abnormal sign in newborns and may indicate respiratory distress, such as when there is an obstruction in the airway or a need for increased oxygen intake. It is not considered a normal, healthy breathing pattern in newborns.

C) Diaphragmatic with chest retraction:
Diaphragmatic breathing is normal, but chest retraction is not. Retractions occur when there is increased effort to breathe, and they typically indicate respiratory distress or obstruction. In a healthy, full-term newborn, retractions should not be present. This type of breathing would require further investigation to rule out conditions like respiratory distress syndrome or infection.

D) Deep with a regular rhythm:
Newborns may have irregular breathing patterns, including periods of apnea (a few seconds without breathing) and slight irregularity in rhythm, especially during sleep. Deep, regular breathing without any irregularities is not typical in a newborn, and any consistent deep breathing would require further observation to rule out any potential underlying issues.

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Correct Answer is ["A","B","C","E"]

Explanation

A) The urethra, bladder, and urinary meatus are edematous:
Postpartum women often experience edema in the urethra, bladder, and urinary meatus due to the pressure exerted during delivery. This swelling can make it difficult for the woman to feel the urge to urinate, even when her bladder is full. Encouraging her to urinate every 2 hours helps prevent overdistension of the bladder, which can lead to urinary retention and other complications.

B) She has decreased sensitivity to fluid pressures after a vaginal birth:
After childbirth, especially a vaginal birth, the pelvic floor and surrounding tissues can be numb or less sensitive due to trauma, swelling, and the effects of anesthesia. This decreased sensitivity makes it harder for the woman to sense when she needs to urinate. Encouraging regular voiding even without the urge helps to prevent urinary retention, which is common in the immediate postpartum period.

C) At 12 hours postpartum, she will begin diuresing:
Diuresis, the process of excreting excess fluid retained during pregnancy, typically begins within 12 hours postpartum. This increased urine output can make it even more important for the mother to void regularly to prevent urinary retention. If the bladder is not emptied regularly, it can lead to discomfort and increase the risk of complications like bladder distention or infection.

D) There is no cause for concern as long as the patient urinates once per shift:
This is not true. A postpartum woman should void more frequently than once per shift (which is about every 8 hours). Urinating only once every shift can lead to urinary retention, bladder overdistension, and possible infection. The recommendation to urinate every 2 hours helps ensure proper bladder emptying and reduces the risk of complications.

E) A full bladder can lead to postpartum hemorrhage:
A full bladder can indeed contribute to postpartum hemorrhage (PPH). An overdistended bladder can displace the uterus, preventing it from contracting effectively after delivery. This can increase the risk of excessive bleeding. Regular voiding helps prevent bladder distention and supports uterine contraction, thereby reducing the risk of hemorrhage.

A. Assess the woman's fundus and massage it if boggy B. Assess the woman's pulse and BP for signs of hypovolemic shock C. Call the woman's primary healthcare provider D. Begin an IV infusion of Ringer's lactate solution and administer oxytocin

Correct Answer is A

Explanation

A) Assess the woman's fundus and massage it if boggy:
A saturated pad within 15 minutes after delivery suggests a hemorrhage, and the first priority in this situation is to assess the fundus. If the fundus is boggy (soft and not contracted), it is a sign of uterine atony, which is the most common cause of postpartum hemorrhage. Massaging the fundus helps stimulate uterine contraction, which can help stop the bleeding.

B) Assess the woman's pulse and BP for signs of hypovolemic shock:
While it is important to monitor vital signs for signs of hypovolemic shock (e.g., increased heart rate, decreased blood pressure, and pale skin), this action would not be the first priority in managing a postpartum hemorrhage. The immediate focus should be on stopping the bleeding by addressing uterine atony. Hypovolemic shock assessment is important, but it comes after the initial steps of managing hemorrhage.

C) Call the woman's primary healthcare provider:
Calling the provider may be necessary if the bleeding does not stop after initial interventions. However, it should not be the first action. The nurse should first assess the uterus and attempt to stop the bleeding by massaging the fundus before calling the provider.

D) Begin an IV infusion of Ringer's lactate solution and administer oxytocin:
Starting an IV infusion and administering oxytocin may be part of the treatment for postpartum hemorrhage, but the first action should be to assess and manage the fundus. Oxytocin can help contract the uterus, but massaging the fundus is the immediate intervention. Intravenous fluids and medications should be initiated once the uterus is assessed and massaged, especially if bleeding persists.

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Part of the health assessment of a newborn includes observation of the neonate's breathing pattern. A full-term newborn's breathing pattern is predominantly:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is ["A","B","C","E"]

Explanation

While assessing a patient who gave birth 5 hours ago, the nurse finds that the woman has completely saturated: pad within 15 minutes. What is the nurse's first action?

Correct Answer is A

Explanation

The nurse is going to administer a dose of Vitamin K (Aquamephyton) 0.5mg IM to a newborn. Available: Vitamin K 1 mg/1ml. How many mLs would the nurse administer? (Please answer numerically only)

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Which nursing action is most appropriate to correct a boggy uterus that is displaced above and to the right of the umbilicus?

The laboratory results for a postpartum woman are as follows: blood type: A + rubella: non-immune hematocrit: 30% GBS: negative How would the nurse best interpret these data?

Which finding 12 hours after birth requires further assessment?