A 38-week primigravida who works as a secretary and sits at a computer 8 hours each
day tells the nurse that her feet have begun to swell. Which
... [Show More] instruction would be most
effective in preventing pooling of blood in the lower extremities? - Move about every
hour
Pooling of blood in the lower extremities results from the enlarged uterus exerting
pressure on the pelvic veins. Moving about every hour will straighten out the pelvic
veins and increase venous return.
A 26-year-old, gravida 2, para 1 client is admitted to the hospital at 28-weeks gestation
in preterm labor. She is given 3 doses of terbutaline sulfate (Brethine) 0.25 mg
subcutaneously to stop her labor contractions. The nurse plans to monitor for which
primary side effect of terbutaline sulfate? - Tachycardia and a feeling of nervousness
Terbutaline sulfate (Brethine), a beta-sympathomimetic drug, stimulates beta-adrenergic
receptors in the uterine muscle to stop contractions. The beta-adrenergic agonist
properties of the drug may cause tachycardia, increased cardiac output, restlessness,
headache, and a feeling of "nervousness".
When do the anterior and posterior fontanels close? - anterior fontanel closes at 12 to
18 months and the posterior by the end of the second month.
When assessing a client who is at 12-weeks gestation, the nurse recommends that she
and her husband consider attending childbirth preparation classes. When is the best
time for the couple to attend these classes? - 30 weeks gestation
at 30 weeks gestation is closest (of the options) to the time parents would be ready for
such classes. Learning is facilitated by an interested pupil! The couple is most
interested in childbirth toward the end of the pregnancy when they are psychologically
ready for the termination of the pregnancy, and the birth of their child is an immediate
concern.
The nurse should encourage the laboring client to begin pushing when.. - the cervix is
completely dilated.
Pushing begins with the second stage of labor, i.e., when the cervix is completely
dilated at 10 cm (C). If pushing begins before the cervix is completely dilated the cervix
can become edematous and may never completely dilate, necessitating an operative
delivery. Many primigravidas begin active labor 100% effaced and then proceed to
dilate.
The nurse instructs a laboring client to use accelerated-blow breathing. The client
begins to complain of tingling fingers and dizziness. What action should the nurse take?
- Have the client breathe into her cupped handsTingling fingers and dizziness are signs of hyperventilation (blowing off too much carbon
dioxide). Hyperventilation is treated by retaining carbon dioxide. This can be facilitated
by breathing into a paper bag or cupped hands.
Twenty-four hours after admission to the newborn nursery, a full-term male infant
develops localized edema on the right side of his head. The nurse knows that, in the
newborn, an accumulation of blood between the periosteum and skull which does not
cross the suture line is a newborn variation known as.. - a cephalhematoma, caused by
forceps trauma and may last up to 8 weeks.
Cephalhematoma, a slight abnormal variation of the newborn, usually arises within the
first 24 hours after delivery. Trauma from delivery causes capillary bleeding between the
periosteum and the skull.
When does the head return to its normal shape? - 7-10 days
What did Nurse theorist Reva Rubin describe? - The initial postpartal period as the
"taking-in phase," which is characterized by maternal reliance on others to satisfy the
needs for comfort, rest, nourishment, and closeness to families and the newborn.
A couple, concerned because the woman has not been able to conceive, is referred to a
healthcare provider for a fertility workup and a hysterosalpingography is scheduled.
Which postprocedure complaint indicates that the fallopian tubes are patent? - Shoulder
pain
If the tubes are patent (open), pain is referred to the shoulder from a subdiaphragmatic
collection of peritoneal dye/gas.
Which nursing intervention is most helpful in relieving postpartum uterine contractions or
"afterpains?" - Lying prone with a pillow on the abdomen
Lying prone keeps the fundus contracted and is especially useful with multiparas, who
commonly experience afterpains due to lack of uterine tone.
Which maternal behavior is the nurse most likely to see when a new mother receives
her infant for the first time? - Her arems and hands recieve the infant and she then
traces the infant's profile with her fingertips.
Attachment/bonding theory indicates that most mothers will demonstrate behaviors
described in during the first visit with the newborn, which may be at delivery or later.
A client at 32-weeks gestation is hospitalized with severe pregnancy-induced
hypertension (PIH), and magnesium sulfate is prescribed to control the symptoms.
Which assessment finding indicates the therapeutic drug level has been achieved? - A
decreased in respiratory rate from 24 to 16 [Show Less]