CH 16 OB

A woman who is 12 hours postpartum had a pulse rate around 80 beats per minute during pregnancy. Now, the nurse finds a pulse of 66 beats per minute. Which of these actions should the nurse take?

• Document the finding, as it is a normal finding at this time.
• Contact the primary care provider, as it indicates early DIC.
• Contact the primary care provider, as it is a first sign of postpartum eclampsia.
• Obtain a prescription for a CBC, as it suggests postpartum anemia.

A client who has just given birth to a healthy newborn required an episiotomy. Which action would the nurse implement immediately after birth to decrease the client's pain from the procedure?

• Offer warm blankets.
• Encourage the woman to void.
• Apply an ice pack to the site.
• Offer a warm sitz bath.

A postpartum client has a fourth-degree perineal laceration. The nurse would expect which medication to be prescribed?

• ferrous sulfate
• methylergonovine
• docusate
• bromocriptine

A nurse is observing a new mother interacting with her newborn. Which statement would alert the nurse to the potential for impaired bonding between mother and newborn?

• "You have your daddy's eyes."
• "He looks like a frog to me."
• "Where did you get all that hair?"
• "He seems to sleep a lot."

After a normal labor and birth, a client is discharged from the hospital 12 hours later. When the community health nurse makes a home visit 2 days later, which finding would alert the nurse to the need for further intervention?

• presence of lochia serosa
• frequent scant voidings
• fundus firm, below umbilicus
• milk filling in both breasts

A primipara client who is bottle feeding her baby begins to experience breast engorgement on her third postpartum day. Which instruction by the nurse would be rmost appropriate to aid in relieving her discomfort?

• "Express some milk from your breasts every so often to relieve the distention."
• "Remove your bra to relieve the pressure on your sensitive nipple.s and breasts."
• "Apply ice packs to your breasts to reduce the amount of milk being produced."
• "Take several warm showers daily to stimulate the milk let-down reflex."

The nurse administers Rho(D) immune globulin to an Rh-negative client after birth of an Rh- positive newborn based on the understanding that this drug will prevent her from:

• becoming Rh positive.
• developing Rh sensitivity.
• developing AB antigens in her blood.
• becoming pregnant with an Rh-positive fetus.

Which factor in a client's history would alert the nurse to an increased risk for postpartum hemorrhage?

• multiparity, age of mother, operative birth
• size of placenta, small baby, operative birth
• uterine atony, placenta previa, operative procedures
• prematurity, infection, length of labor

When teaching parents about their newborn, the nurse describes the development of a close emotional attraction to a newborn by the parents during the first 30 to 60 minutes after birth. The nurse refers to this process by which term?

• reciprocity
• engrossment
• bonding
• attachment

A nurse is reviewing the policies of a facility related to bonding and attachment with newborns. Which practice would the nurse identify as needing to be changed?

• allowing unlimited visiting hours on maternity units
• offering round-the-clock nursery care for all infants
• promoting rooming-in
• encouraging infant contact immediately after birth