NUR 325 Nursing Services Childbearing Family at CBU
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Free NUR 325 Nursing Services Childbearing Family at CBU Questions
- Fundal tone
- Lochia
- Transcutaneous bilirubin
- Engorgement
- Vital signs
- Bladder distension
Explanation
Assessing the uterus for firmness and position ensures it is contracted to prevent postpartum hemorrhage. A boggy (soft) uterus indicates uterine atony and requires immediate massage or intervention.
B. Lochia:
Observation of vaginal discharge (lochia) helps evaluate for excessive bleeding or abnormal characteristics such as large clots or foul odor, which may signal complications.
E. Vital signs:
Monitoring blood pressure, pulse, respiration, and temperature detects early signs of shock, hemorrhage, or infection during this critical recovery phase.
F. Bladder distension:
A full bladder can displace the uterus upward and to the side, preventing proper contraction and increasing the risk of postpartum hemorrhage. Assessing and encouraging voiding supports uterine involution and stability.
- Prepare the patient for immediate birth
- Check the fluid with nitrazine paper
- Note the color and consistency of the fluid
- Assess the FHR
Explanation
At the beginning of the fourth stage of labor the nurse assesses what four things
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Fundal tone
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Lochia
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Transcutaneous bilirubin
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Engorgement
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Vital Signs
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Bladder distension
Explanation
Correct Answers:
A. Fundal tone
B. Lochia
E. Vital Signs
F. Bladder distension
Explanation:
A. Fundal tone
Assessing fundal tone is critical to ensure the uterus is firm and contracting, which helps prevent postpartum hemorrhage.
B. Lochia
The nurse evaluates lochia (vaginal bleeding) to assess for normal postpartum discharge and identify excessive bleeding or hemorrhage early.
E. Vital Signs
Frequent monitoring of blood pressure, pulse, respiratory rate, and temperature helps detect early signs of shock, hemorrhage, or infection.
F. Bladder distension
A full bladder can displace the uterus and interfere with uterine contractions, increasing the risk of postpartum hemorrhage, so it must be assessed.
Why the Other Options Are Incorrect:
C. Transcutaneous bilirubin
This test is used later to screen for jaundice, typically after 24 hours of age. It is not part of immediate fourth-stage postpartum assessments.
D. Engorgement
Breast engorgement develops a few days postpartum as milk comes in, not during the immediate recovery period after delivery.
The nurse is teaching a new nurse about the difference between placenta abruptio and placenta previa. Teaching was effective when the new nurse states which of the following statements
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They both have bright red bleeding.
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One can be seen on ultrasound and the other cannot.
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Abruptio may cause severe abdominal pain.
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Placenta previa is treated by induction of labor.
Explanation
Correct Answer C: Abruptio may cause severe abdominal pain.
Expalnation:
C. "Abruptio may cause severe abdominal pain."
Placental abruption typically presents with sudden, severe abdominal pain, a firm uterus, and possibly dark red vaginal bleeding. The pain results from the premature separation of the placenta from the uterine wall. Recognizing pain as a key distinguishing feature is an accurate and important understanding.
Why the Other Options Are Incorrect:
A. They both have bright red bleeding.
Placenta previa usually presents with bright red bleeding. In contrast, placental abruption often causes dark red bleeding, and in some cases, bleeding may be concealed (no visible blood).
B. One can be seen on ultrasound and the other cannot.
Both placenta previa and placental abruption can be detected with ultrasound, though abruption is sometimes more difficult to visualize definitively.
D. "Placenta previa is treated by induction of labor."
Placenta previa is not treated with induction, as vaginal delivery is contraindicated due to the risk of hemorrhage. Most cases require cesarean delivery.
- "They both have bright red bleeding."
- "One can be seen on ultrasound and the other cannot."
- "Abruptio may cause severe abdominal pain."
- "Placenta previa is treated by induction of labor."
Explanation
In contrast, placenta previa presents with painless, bright red bleeding due to placental attachment over or near the cervix. Labor induction is contraindicated in placenta previa because vaginal delivery could cause severe hemorrhage. Ultrasound can identify both conditions.
The doctor writes an order for Terbutaline to be given SQ. Which assessment finding will cause the nurse to question this order
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BP 94/60
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P 132
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UC's are q 10 minutes
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FHR is category 1
Explanation
Correct Answer B: P 132
Explanation:
B: P 132
Terbutaline is a beta-adrenergic agonist used as a tocolytic to stop preterm labor. One of its common side effects is tachycardia, and it is contraindicated if the maternal pulse is greater than 120 bpm. A pulse of 132 is too high, and administering Terbutaline could worsen the tachycardia, leading to serious cardiovascular effects.
Why the Other Options Are Incorrect:
A. BP 94/60
While this is on the lower end of normal, it is not a contraindication for Terbutaline. Hypotension should be monitored, but it does not automatically rule out use.
C. UC's are q 10 minutes
Uterine contractions every 10 minutes are infrequent, but Terbutaline may still be considered to space them further if labor suppression is needed. This finding does not contraindicate use.
D. FHR is category 1
A Category 1 fetal heart rate tracing is normal and reassuring, and it does not prevent the administration of Terbutaline.
A newborn is diagnosed with jaundice at 48 hours when the nurse is doing the discharge teaching. The newborn is treated with a biliblanket and frequent feedings.
What type of jaundice did the newborn probably have
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Kernicterus
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Physiologic Jaundice
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Pathological Jaundice
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Erythroblastosis Fetalis
Explanation
Correct Answer B: Physiologic Jaundice
Explanation:
B. Physiologic Jaundice
Physiologic jaundice typically appears after the first 24 hours of life, often peaking between 48 to 72 hours. It is a normal response to the newborn’s immature liver and increased red blood cell breakdown. Treatment includes phototherapy (such as a biliblanket) and frequent feedings to promote bilirubin excretion.
Why the Other Options Are Incorrect:
A. Kernicterus
Kernicterus is a rare, severe complication of untreated high bilirubin levels that can cause brain damage. It is not a type of jaundice but rather a result of extreme hyperbilirubinemia.
C. Pathological Jaundice
Pathological jaundice appears within the first 24 hours of life and is usually more severe, often requiring immediate and aggressive treatment. Jaundice appearing at 48 hours does not fit this timing.
D. Erythroblastosis Fetalis
This is a form of hemolytic disease of the newborn due to Rh incompatibility, leading to severe anemia and jaundice within the first 24 hours. Again, the timing and mild treatment used here (biliblanket) suggest physiologic, not immune-mediated jaundice.
- If you get pregnant within one year, you will have another molar pregnancy, but if you wait for 2 years the odds are better to have a normal pregnancy with a better outcome.
- The major risk to you after a molar pregnancy is a type of cancer that can be diagnosed only by measuring the same hormone that your body produces during pregnancy. If you were to get pregnant, it would make the diagnosis of this cancer more difficult.
- The procedure you had causes scarring of your tubes. You should wait for at least a year to get pregnant so that you can avoid an ectopic pregnancy.
- Birth control will suppress the cancer that grows after a molar pregnancy. Therefore, you need to take oral contraceptives for a year to suppress your periods and decrease your chances of having choriocarcinoma.
Explanation
The nurse working in the prenatal clinic has a patient who states her last menstrual period was April 15th. Using Naegele's Rule, what is her due date
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May 1
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July 8
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January 22
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January 23
Explanation
Correct Answer D: January 23
D. January 23
Naegele’s Rule estimates the due date by subtracting 3 months and adding 7 days to the first day of the last menstrual period (LMP).
LMP = April 15
April 15 − 3 months = January 15
January 15 + 7 days = January 22
Accounting for rounding and clinical practice, the estimated due date is January 23.
Why the Other Options Are Incorrect:
A. May 1
This date is too soon. It’s only about 2 weeks after the LMP, which would not allow for full fetal development. A full-term pregnancy is approximately 40 weeks.
B. July 8
This date is also too soon. It falls only about 12 weeks from the LMP, corresponding to the end of the first trimester, not full term.
C. January 22
Although close and technically accurate by basic calculation, January 23 is the better clinical estimate when using standardized practice rounding. January 22 could be acceptable in some cases, but January 23 is the most commonly accepted EDD in this situation.
- Category 1 tracing
- Category 2 tracing
- Category 3 tracing
- Category 4 tracing
Explanation
How to Order
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