Its About Women Health Quiz

Uterine atony is a loss of tone in the uterine musculature. Normally, contraction of the uterine muscle compresses the vessels and reduces flow. This increases the likelihood of coagulation and prevents bleeds. Thus, lack of uterine muscle contraction can cause an acute hemorrhage.

Vitamin K is administered to a neonate prophylactically to prevent a transient deficiency of coagulation factors. This is because newborns have low levels of vitamin K, which is necessary for blood clotting. Administering vitamin K helps prevent bleeding disorders in neonates.

The nurse should consider softness as a normal finding when palpating a neonate's anterior fontanel. The anterior fontanel is a soft spot on the baby's head where the skull bones have not yet fully fused. It is expected to feel soft and slightly sunken. Bulging, complete closure, and depression are not normal findings and may indicate abnormalities or health concerns.

Increasing the rate of IV fluids is an effective initial measure necessary to replace lost fluid volume that occus in uterine inversion caused by hemorrhage. Blood products might also be necessary, but generally take some time to obtain from the blood bank. Oxygen would be given to increase perfussion to tissues, but does not restore circulating volume. An oxytocic drug will help to limit further bleeding, but will not limit the condition because it is an assessment rather than an intervention.

Vernix caseosa is the correct answer because it is the term used to describe the white, cheesy protective coating that covers the skin of newborn babies. It is composed of desquamated epithelial cells and sebum, and it helps to protect the baby's skin from the amniotic fluid while in the womb.

Applying an ice pack to the perineum is the most appropriate intervention to promote comfort and decrease the edema in this situation. Ice helps to reduce swelling and inflammation by constricting blood vessels and numbing the area. By applying an ice pack to the perineum, the nurse can help alleviate discomfort and reduce the edema in the client's perineum and labia. This intervention is commonly used after vaginal delivery to provide relief and promote healing.

The collaborative plan of care for postpartum depression (PPD) includes the use of antidepressant medications and psychotherapy. Antidepressant medications help to alleviate the symptoms of depression, while psychotherapy provides emotional support and helps the client develop coping strategies. This combination approach has been found to be effective in treating PPD. Hypnotic agents may not be appropriate for treating PPD, as they are typically used for sleep disorders and not specifically for depression. Removing the infant from the home is not a recommended treatment for PPD.

Paternal engrossment refers to the process in which a father develops a strong emotional bond and attachment to his newborn. Discussing the similarity between his ears and the newborn's ears indicates that the father is actively engaging with the baby and showing an interest in their physical features. This behavior demonstrates a level of emotional connection and involvement, which is a characteristic of paternal engrossment.

The correct answer is to assess the infant's blood sugar level. Slight tremors of the extremities, a high-pitched cry, and an exaggerated Moro reflex are signs of hypoglycemia in a newborn. Assessing the infant's blood sugar level is important to determine if the baby is experiencing low blood sugar levels, which can be life-threatening if not treated promptly.

The woman with a neoplasm requiring chemotherapy should be advised to bottle feed her child because chemotherapy drugs can be passed through breast milk and may harm the baby. It is safer for the baby to be bottle fed in this situation to avoid any potential risks.

Adequate fluid intake (up to 3000 ml per day) prevents urinary stasis, dilutes urine, and flushes out waste products, all of which help to prevent UTI. Bedrest is of no value in preventing UTI.

Babinski reflex is one of the normal reflexes in infants. Reflexes are responses that occur when the body receives a certain stimulus. The Babinski reflex occurs after the sole of the foot has been firmly stroked. The big toe then moves upward or toward the top surface of the foot. The other toes fan out.

The nurse should ask the client to discuss her birth experience because the client's crying for no reason may indicate postpartum blues or postpartum depression. By allowing the client to talk about her birth experience, the nurse can assess her emotional well-being and determine if further intervention or support is needed. It is important for the nurse to provide a safe and supportive environment for the client to express her feelings and concerns.

The correct answer is betamethasone (Celestone®) 12 mg IM every 24 hours for 2 doses. This medication and dosage are commonly used for antenatal corticosteroid therapy to promote fetal lung maturation in preterm labor. The administration of betamethasone helps to accelerate the production of surfactant in the fetal lungs, reducing the risk of respiratory distress syndrome and other complications associated with premature birth. The timing and dosage of the medication are important to ensure its effectiveness in improving neonatal outcomes.

Breast tissue increases in the early postpartum period as milk forms. During pregnancy, the breasts undergo changes in preparation for breastfeeding. After delivery, the hormone prolactin stimulates milk production, causing the breast tissue to increase in size. This is a normal physiological process and not a cause for concern. It is important for the nurse to reassure the client that her breast growth is a normal part of postpartum recovery.

Uterine atony accounts for 80 to 90% of all early (within first 24 hours) hemorrhage. The client's age does not increase the incidence of postpartum hemorrhage. Endometritis could cause late postpartm hemorrhage, not early postpartum hemorrhage.

The nurse should instruct the client to come to the clinic immediately because heavy, bright red bleeding 18 days postpartum is not normal and could indicate a postpartum complication. It is important for the nurse to assess the client's condition and provide appropriate care and treatment.

The nurse recognizes that the client is egocentric because egocentrism is a characteristic of adolescence where individuals tend to be self-centered and focused on their own thoughts and feelings. This may pose a challenge when it comes to parenting a newborn as the client may struggle to prioritize the needs and well-being of the baby over their own.

When teaching a mother who is HIV positive, it is important to include the information that breastfeeding is contraindicated. This means that the mother should not breastfeed her baby because HIV can be transmitted through breast milk. Instead, she should be advised to use formula feeding as a safe alternative to ensure that the baby does not become infected with HIV.

A perineal hematoma refers to the accumulation of blood in the perineal area, which is the region between the vagina and the anus. Severe vulvar pain is the most characteristic finding of a perineal hematoma because the hematoma causes pressure and swelling in the area, leading to intense discomfort and pain. Lethargy, positive Homan's sign, and fever are not specifically associated with a perineal hematoma and may indicate other medical conditions.

The nursing diagnosis of "Infection" is the highest priority because the client's symptoms, including a hard, red, warm nodule in the breast, a high temperature of 104.6F, and a recent history of mastitis, indicate a possible infection. Infections can quickly worsen and lead to serious complications if not treated promptly. Therefore, addressing the infection should be the priority to prevent further harm to the client and promote healing.

The best response by the nurse is to advise the client to perform hand hygiene before caring for her children and after toileting and perineal care. This is because hand hygiene is crucial in preventing the spread of infection. While taking antibiotics will help treat the infection, it does not eliminate the need for proper hand hygiene. Wearing a mask is not necessary unless the client is experiencing respiratory symptoms. Having the husband provide all the care for the children may not be practical or necessary if proper hand hygiene is practiced.

The correct answer is "Your stretch marks will fade to pale white over the next 3 to 6 months." This is the most accurate response because stretch marks typically fade over time, becoming less noticeable and often turning pale white. It is important to note that while they may become less visible, they may not completely disappear. Keeping the skin hydrated can help lighten the color of the stretch marks, but it is not a guarantee that they will go away entirely.

Based on the labor history provided, the mother was positive for group B streptococcal (GBS) infection and did not receive antibiotics during labor. GBS infection can be transmitted to the newborn during delivery, and without antibiotic treatment, the newborn is at risk of developing an infection. One of the signs of infection in a newborn is temperature instability, which can manifest as either hypothermia or hyperthermia. Therefore, the nurse should closely observe the infant for temperature instability as a potential indicator of infection.

Engorgement is a common occurrence when a mother's milk comes in after delivery. Wearing a supportive bra can help alleviate the discomfort and prevent further engorgement. This response by the nurse is appropriate because it provides a practical solution to prevent or minimize the occurrence of engorgement.

A temperature of 100.2F is considered a low-grade fever and is a common occurrence after childbirth. Encouraging the intake of water and other fluids helps to prevent dehydration, which is important for the postpartum recovery process. It also helps to regulate body temperature. Therefore, encouraging fluid intake is an appropriate nursing intervention in this situation. Requesting an infectious disease consult or notifying the doctor for medication like acetaminophen is not necessary for a low-grade fever after childbirth. Providing cool compresses may provide temporary relief, but it does not address the underlying issue of dehydration.

The client repeatedly telling her husband that she wanted a girl suggests that she may have a preference for a female child and may not be fully attached or accepting of her male infant. This could indicate a potential issue with the client's attachment to her baby and may warrant further assessment and support from the nurse.

Chicken and dumplings would be the most appropriate meal for the nurse to give the Muslim woman after the delivery of her baby. This is because chicken and dumplings is a dish that does not contain any pork, which is forbidden in Islam. Since the woman is Muslim, it is important to consider her dietary restrictions and provide her with a meal that aligns with her religious beliefs.

In the postpartum period, it is important for the client to increase their protein and caloric intake. This is because the body requires additional energy and nutrients for recovery and breastfeeding. Protein is essential for tissue repair and growth, while an increase in calories helps to meet the increased energy demands. Therefore, increasing protein and caloric intake is crucial for the client's overall health and well-being during this period.

Immunoglobulin G (IgG) is a type of antibody that is placentally transferred from the mother to the fetus during pregnancy. This transfer allows the neonate to acquire antibodies against bacterial and viral agents, providing passive immunity in the early stages of life. Unlike the other options, IgG is detectable at birth and crosses the placenta. It is synthesized by the mother and transferred to the fetus, offering protection against various pathogens.

The nurse should ask the client when the last time they changed their perineal pad because this will provide information about the rate of bleeding. If the pad is saturated quickly after being changed, it could indicate excessive bleeding and may require further assessment and intervention. This question helps the nurse determine the significance of the finding and assess the client's postpartum bleeding.

Placenta accreta is a placental anomaly where the placenta is deeply attached to the uterus. In this condition, the placenta's villi attach too firmly to the uterine wall, making it difficult to separate during childbirth. This can lead to complications such as heavy bleeding after delivery. Placenta accreta is usually diagnosed during pregnancy and may require medical intervention or a planned cesarean delivery to minimize the risks associated with detachment.

The nurse explains that the abdominal muscles, which separate during pregnancy, will regain their pre-pregnancy tone with exercise. This means that with regular exercise and strengthening of the abdominal muscles, the client's stomach will become flatter and more toned, resembling her pre-pregnancy appearance. This is a common and expected process after childbirth.

Based on the assessment findings, the nurse should document the findings. The firm and located halfway between the client's umbilicus and symphysis pubis indicates that the uterus is in a normal position and is adequately contracting. There is no indication of bladder distension or increased vaginal bleeding, so there is no immediate action required. Therefore, the nurse should document the findings for future reference and monitoring.

The correct answer is to closely reinspect the perineum. The client's report of continuing perineal pain and rectal pressure after receiving analgesic medication and ice application suggests that there may be an underlying issue with the perineum. By closely reinspect the perineum, the nurse can assess for any signs of trauma, infection, or other complications that may be causing the pain and pressure. This will help guide further interventions and ensure the client's well-being.

When inspecting the umbilical cord, a nurse should identify the presence of two arteries and one vein. This is because the umbilical cord contains blood vessels that connect the fetus to the placenta. The two arteries carry deoxygenated blood from the fetus to the placenta, while the one vein carries oxygenated blood from the placenta to the fetus. It is important for the nurse to identify these blood vessels correctly to ensure the proper functioning and health of the newborn.

The direct Coombs test is used to detect these antibodies or complement proteins that are bound to the surface of red blood cells; a blood sample is taken and the RBCs are washed (removing the patient's own plasma) and then incubated with anti-human globulin (also known as "Coombs reagent").

After delivery, it is important for the nurse to monitor the client's temperature and be aware that it may be lower than normal. However, the key point in this question is that any elevation in temperature above 100.4F after the first 24 hours should be a cause for suspicion of postpartum infection. This is because an elevated temperature can be a sign of infection, and postpartum women are at a higher risk for developing infections due to the changes that occur in their bodies during pregnancy and childbirth. Therefore, it is crucial for the nurse to be vigilant and monitor for any signs of infection in the postpartum client.

The correct answer is "Elevating the client’s head 30 degrees before beginning the assessment." This is because elevating the client's head 30 degrees is not necessary for uterine assessment. It does not affect the palpation of the fundus or the assessment of the lower uterine segment. Therefore, the student nurse needs more education about this aspect of uterine assessment.

The nurse appropriately adds the "related to" statement of "Increased glucose metabolism secondary to hyperinsulinemia" because infants born to mothers with type 1 diabetes mellitus are at risk for developing hyperinsulinemia due to exposure to high levels of glucose in utero. Hyperinsulinemia can lead to increased glucose metabolism and utilization by the infant's body, which can result in altered nutrition and decreased body requirements.

Inflammation of the membrane lining the abdominal wall and covering the abdominal organs.

Women normally have less lochia after cesarean births. This is because during a cesarean section, the uterus is manually emptied, reducing the amount of blood and tissue that needs to be expelled postpartum. Additionally, the incision made during the surgery may result in less uterine contractions, which can also decrease the amount of lochia. It is important for the nurse to provide this information to the client to reassure her that her experience is normal and expected.

Retained placental fragments are a cause of late-postpartum hemorrhage (which occurs anytime ater the first 24 hours post delivery). The retained fragments undergo necrosis, forming fibrin deposits. These deposits form polyps, which eventually detach from the myometrium, causing hemorrhage.
Uterine atony, DIC, and lacerations are causes of early postpartum hemorrhage.

birth control pill containing progesterone and estrogen COC can cause a decrease in milk volume and might affect the quality of milk.

A rapid, thready pulse could indicate hemorrhage in the postpartum period. Hemorrhage is a potential complication after delivery, and a rapid, thready pulse may be a sign of excessive bleeding. It is important to monitor the pulse and other vital signs closely in the postpartum period to detect any signs of hemorrhage and take appropriate interventions.

A hematoma is a collection of blood in the pelvic tissue caused by damage to a blood vessel wall without tissue laceration. A client with gestational diabetes is more prone to have a large infant that could cause tissue trauma during delivery. This client was also delivered with forceps, which is another high-risk factor for developing a postpartum hematoma. Increasing maternal age and delivery of an SGA infant do not increase risk of hematoma formation.

On the second postpartum day, a nurse would expect to palpate the fundus 2 cm below the umbilicus. This is because after childbirth, the fundus (the top portion of the uterus) gradually descends as the uterus involutes and returns to its pre-pregnancy size. By the second postpartum day, the fundus should be located approximately 2 cm below the umbilicus as it continues to shrink.

The correct answer is "Most women who bottle feed their infants can expect their periods to return within 6 to 10 weeks after birth." This response is the most accurate because it provides a general timeframe for when the client can expect her menstrual cycle to return. It acknowledges that there may be some variation among individuals, but provides a reasonable estimate based on common experiences.

On the fifth postpartum day, a nurse would expect to find lochia serosa when assessing a client's lochia. Lochia serosa is the third stage of lochia, which occurs around days 4-10 after childbirth. It is characterized by a pinkish-brown color and a thinner consistency compared to lochia rubra. This stage indicates the healing process of the uterus after childbirth. Lochia alba is the final stage, which occurs around days 10-14, and is characterized by a yellowish-white color. Absence of lochia would not be expected on the fifth postpartum day as it is a normal occurrence after childbirth.

A fourth-degree perineal laceration is a severe tear that extends through the vaginal wall, perineal muscles, and anal sphincter. This type of injury can cause significant pain and discomfort, especially during bowel movements. Instructing the client on a high-fiber diet and administering stool softeners can help prevent constipation and straining, which can worsen the pain and delay healing. This intervention promotes regular bowel movements and reduces the risk of complications such as infection and dehiscence.