The nurse is assigned to care for the postpartum client during her shift.
The nurse knows one of the most common risk factors for early (PPH) postpartum hemorrhage is uterine atony. When providing care, the nurse would plan to:.

Have the client void frequently.

Massage the uterus.

Have the client in a side-lying position for comfort.

Keep the patient on strict bed rest for 24 hours to avoid stress on the uterus.

Answer and Explanation

The Correct Answer is B

Massaging the uterus helps it contract and prevent excessive bleeding after delivery. Uterine atony is a condition where the uterus does not contract enough to clamp the blood vessels that supply the placenta, leading to postpartum hemorrhage. Uterine massage is one of the interventions to treat uterine atony and restore uterine tone.

Choice A is wrong because having the client void frequently does not directly affect the uterine contraction. However, a full bladder can interfere with uterine contraction and cause displacement of the uterus, so it is important to monitor the bladder status and empty it as needed.

Choice C is wrong because having the client in a side-lying position for comfort does not help with uterine contraction. However, this position may be beneficial for other reasons, such as reducing edema and pain in the perineal area.

Choice D is wrong because keeping the patient on strict bed rest for 24 hours to avoid stress on the uterus does not help with uterine contraction. In fact, early ambulation after delivery can help prevent thromboembolic complications and promote recovery.

Normal ranges for postpartum blood loss are less than 500 mL for vaginal delivery and less than 1000 mL for cesarean delivery. Postpartum hemorrhage is defined as blood loss greater than or equal to 1000 mL or blood loss accompanied by signs or symptoms of hypovolemia within 24 hours after birth.

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Correct Answer is B

Explanation

The correct answer is choice B. Taking mineral oil each night is not recommended for pregnant women who have hemorrhoids because it can interfere with the absorption of fat-soluble vitamins and cause diarrhea, which can worsen hemorrhoids.

The patient should avoid laxatives and stool softeners unless prescribed by a health care provider.

Choice A is wrong because walking at least a mile a day can help improve blood circulation and prevent constipation, which are both beneficial for hemorrhoid management.

Choice C is wrong because including foods high in fiber in the diet can help soften stools and prevent straining, which can aggravate hemorrhoids.

Choice D is wrong because drinking one extra glass of water before breakfast each morning can help hydrate the body and prevent dehydration, which can cause hard stools and increase pressure on the anal veins.

The nurse should teach the patient other strategies for hemorrhoid management, such as applying ice packs or witch hazel pads to the affected area, using sitz baths or warm water baths, avoiding prolonged sitting or standing, and wearing cotton underwear.

The nurse should also advise the patient to report any signs of infection or bleeding to the health care provider.

A. Rubella immunization should be given in the early postpartum period. B. Gamma globulin should be given when the client is admitted in labor. C. Gamma globulin should be given at next visit. D. Rubella immunization should be given at next visit.

Correct Answer is A

Explanation

Rubella immunization should be given in the early postpartum period.This is because rubella infection during pregnancy can cause serious birth defects or miscarriage, and rubella vaccine is contraindicated during pregnancy.Therefore, the best time to vaccinate a woman who is not immune to rubella is after she delivers her baby.

Choice B is wrong because gamma globulin is not effective for preventing rubella infection or congenital rubella syndrome (CRS).Gamma globulin is a preparation of antibodies that can provide temporary protection against some infections, but it does not induce lasting immunity.

Choice C is wrong because gamma globulin should not be given at the next visit for the same reason as choice B.Moreover, gamma globulin can interfere with the response to live vaccines such as rubella vaccine, so it should not be given within 3 months before or after vaccination.

Choice D is wrong because rubella immunization should not be given at the next visit or during pregnancy, as it can pose a risk to the fetus.Rubella vaccine is a live attenuated virus vaccine that can cross the placenta and infect the fetus.The risk of CRS from vaccination during pregnancy is low, but it cannot be ruled out completely.Therefore, women who receive rubella vaccine should avoid pregnancy for at least 4 weeks after vaccination.

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The nurse is assigned to care for the postpartum client during her shift. The nurse knows one of the most common risk factors for early (PPH) postpartum hemorrhage is uterine atony. When providing care, the nurse would plan to:.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is B

Explanation

A 14-year-old client who is pregnant has a low result from a rubella serology test.Which notation should be made on this client’s care plan?

Correct Answer is A

Explanation

The nurse instructs a postpartum patient in the use of a sitz bath. Which action by the patient indicates that the teaching was effective?

A patient who is 42 weeks pregnant is admitted to the hospital in active labor.The patient is upset and says to the nurse, "I haven't felt the baby move for about three or four hours." The fetal heart rate is ranging between 136 and 143. Which action should the nurse take?

The mother visits her infant in the nursery. The nurse shows the mother how to place her finger in the palm of the baby’s hand so that the baby will squeeze her finger.This behavior on the nurse’s part reflects an understanding of which principle?

A nurse is providing information to a patient regarding contraception methods. Which statement by the patient indicates a need for further teaching regarding use of copper intrauterine device (IUD)?

When a pregnant patient has genital herpes, for which complication is the patient at higher risk than the general population?

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A nurse is caring for a patient who is 40 weeks pregnant. Which finding would indicate the need for a cesarean delivery?

The nurse is assigned to care for the postpartum client during her shift.
The nurse knows one of the most common risk factors for early (PPH) postpartum hemorrhage is uterine atony. When providing care, the nurse would plan to:.