Chapter 32 Contemporary Maternal Newborn Nursing Care Maternal Newborn Nursing Care Nurse, Family, 8th Edition

Chapter 32 Contemporary Maternal Newborn Nursing Care Maternal Newborn Nursing Care Nurse, Family, 8th Edition

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

Question 1

Type: MCMA

The nurse is preparing a community education class on healthy pregnancy. Which statements should be included?

Standard Text: Select all that apply.

1. Eating a well-balanced diet helps prevent pregnancy complications.
2. Stress management and support systems are important in pregnancy.
3. Prenatal care can be obtained at any point in the pregnancy.
4. Complications during a prior pregnancy do not recur.
5. Exercising regularly facilitates feeling better in pregnancy.

Correct Answer: 1,2,5

Rationale 1: Good overall nutrition helps reduce the incidence of many pregnancy complications, including anemia, preterm labor, and delivery complications such as shoulder dystocia.

Rationale 2: Patients with high stress levels and poor support systems are more likely to develop postpartum depression and have problems parenting.

Rationale 3: Early and regular prenatal care is important to provide education that can help prevent complications, and to detect complications as they develop.

Rationale 4: Many complications of pregnancy have a tendency to recur, including postpartum hemorrhage, postpartum depression, preterm labor, and premature rupture of membranes.

Rationale 5: Regular exercise during pregnancy helps prevent hypertension and gestational diabetes, helps reduce length of labor, and helps patients feel good.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: LO01: Identify the nurse’s impact in both the hospital and community-based settings in assessing predisposing factors of postpartum complications, implementing preventive care, and teaching for self-help.

 

Question 2

Type: MCSA

A patient is 3 days postop from a cesarean birth. She has tenderness, localized heat, and redness of the left leg. She is afebrile. As a result of these symptoms, she most likely will be:

1. Encouraged to ambulate freely.
2. Given aspirin 650 mg by mouth.
3. Given Methergine IM.
4. Placed on bed rest.

Correct Answer: 4

Rationale 1: That would increase the inflammation.

Rationale 2: Aspirin 650 mg by mouth has anticoagulant properties, but usually is not necessary unless complications occur.

Rationale 3: Methergine is given only for postpartum hemorrhage, and would only cause vasoconstriction of an already inflamed vessel.

Rationale 4: These symptoms indicate the presence of superficial thrombophlebitis. The treatment involves bed rest and elevation of the affected limb, analgesics, and use of elastic support hose.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Diagnosis

Learning Outcome: LO01: Identify the nurse’s impact in both the hospital and community-based settings in assessing predisposing factors of postpartum complications, implementing preventive care, and teaching for self-help.

 

Question 3

Type: MCSA

The nurse is assisting a multiparous woman to the bathroom for the first time since her delivery 3 hours ago. When the patient stands up, blood runs down her legs and pools on the floor. The patient turns pale and feels weak. The first action of the nurse is to:

1. Assist the patient to empty her bladder.
2. Help the patient back to bed to check her fundus.
3. Assess her blood pressure and pulse.
4. Begin an IV of Lactated Ringer’s infusion.

Correct Answer: 2

Rationale 1: The patient might be experiencing a postpartum hemorrhage. Her fundus is not contracting well. Although this might be due to a full bladder, the best first step is to massage the fundus.

Rationale 2: Massaging the fundus is the top priority because of the excessive blood loss. If the fundus is boggy, fundal massage may stimulate toning of the uterus and prevent further blood loss.

Rationale 3: Massaging the fundus is the top priority because of the excessive blood loss. Blood pressure and pulse do not change until 1000–2000 ml of blood has been lost. Massaging the fundus will prevent further blood loss.

Rationale 4: Massaging the fundus is the top priority because of the excessive blood loss. An IV might need to be started if the patient becomes symptomatic.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: LO02: Explain the causes, contributing factors, signs and symptoms, clinical therapy, and nursing interventions for early and late postpartum hemorrhage.

 

Question 4

Type: MCMA

A patient is experiencing excessive bleeding immediately after the birth of her newborn. After speeding up the IV fluids containing oxytocin, with no noticeable decrease in the bleeding, the nurse should anticipate the physician requesting which medications?

Standard Text: Select all that apply.

1. Methergine
2. Stadol
3. Misoprostol
4. Betamethasone

Correct Answer: 1,3

Rationale 1: Methergine is a drug of choice for postpartum hemorrhage.

Rationale 2: Stadol is an analgesic, and is not used for postpartum hemorrhage.

Rationale 3: Misoprostol is commonly administered rectally for postpartum hemorrhage.

Rationale 4: Betamethasone is a glucocorticoid used for preterm labor in an attempt to decrease respiratory distress in the preterm infant.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: LO02: Explain the causes, contributing factors, signs and symptoms, clinical therapy, and nursing interventions for early and late postpartum hemorrhage.