Maternity Nursing Chap 14

Question 1

The first 1 to 2 hours after birth are called the ________.

Answer 1

-fourth stage of labor

Question 2

The nursing care management approach of _________ has one nurse caring for both the mother and her infant. It is also called __________ care or __________ care.

Answer 2

• couplet care
• mother and baby
• single room maternity

Question 3

___________ is a classification of medications that stimulates contraction of the uterine smooth muscle.

Answer 3

-oxytocic

Question 4

________ is the failure of the uterine muscle to contract firmly. It is the most frequent cause of __________ following childbirth.

Answer 4

• uterine atony

- excessive bleeding (hemorrhage)

Question 5

A ________ is a perineal treatment that involves sitting in warm water for approximately 20 mins to soothe and cleanse the site and increase blood flow, thereby enhancing healing.

Answer 5

-sitz bath

Question 6

Painful cramps experienced by many women when the uterus contracts after childbirth are called _________.

Answer 6

-afterpains (afterbirth pains)

Question 7

__________ is the dilation of the blood vessels supplying the intestines as a result of the rapid decrease in intraabdominal pressure after birth. It causes blood to pool in the viscera and thereby contributes to the development of _________ when the woman who has recently given birth stands up.

Answer 7

• splanchnic engorgement

- orthostatic hypotension

Question 8

A complaint of pain in calf muscles when dorsiflexion of the foot is forced is called __________. The presence of pain can be associated with the presence of a thrombophlebitis.

Answer 8

-positive Homans’ signs

Question 9

__________ exercises can assist women to regain pelvic muscle tone that is often lost when pelvic tissues are stretched and torn during pregnancy and birth.

Answer 9

-kegel

Question 10

___________ is the swelling breast tissue caused by increased blood and lymph supply to the breasts preceding lactation.

Answer 10

-engorgement

Question 11

_________ vaccine can be given to postpartum women whose antibody titer is lower than 1:8 or whose enzyme immunoassay value is lower than 0.8. It is used to prevent nonimmune women from contracting this TORCH infection during a subsequent pregnancy.

Answer 11

-rubella

Question 12

__________, also referred to as RhoGAM, is a medication given within 72 hours of birth to Rh-negative, antibody (Coombs’)-negative women who have given birth to Rh-positive newborns to prevent the formation of maternal sensitization. The _________ test may be performed if a large fetomaternal transfusion is suspected to determine the amount of fetal blood present in the maternal circulation more accurately so the correct dosage of RhoGAM can be given.

Answer 12

• Rh immune globulin

- Kleihauer-Betke

Question 13

Reasons for breastfeeding in fourth stage of labor:

Answer 13

• it takes advantage of the infant’s alert state during the first period of reactivity
• aids in contraction of the uterus to prevent hemorrhage
• is a good opportunity to instruct the mother and assess breasts
• facilitates the bonding and attachment process
• stimulates infant’s bowel so bilirubin-containing meconium is passed

Question 14

Measures to assist with voiding:

Answer 14

• help her to assume an upright position on bedpain or in bathroom
• listen to running water
• put hands in warm water
• pour water over perineum with peri bottle
• stand in shower or sit in a sitz bath
• put spirits of peppermint in bedpan
• provide analgesics

Question 15

Measures to prevent thrombophlebitis:

Answer 15

• have woman exercise legs with active ROM of knees, ankles, feet, and toes
• wear support hose
• keep well hydrated

Question 16

Measures for bottle feeding mother to suppress lactation and relieve discomfort of engorgement:

Answer 16

• have woman wear supportive bra or breast binder continuously for at least the first 72 hours postpartum
• avoid stimulating breasts (no warm water during shower, no infant sucking, no pumping or removal of milk from the breasts)
• apply ice packs or cabbage leaves intermittently to relieve soreness
• use a mild analgesic

Question 17

What are the 2 major interventions to prevent postpartum hemorrhage in early postpartum period?

Answer 17

• maintain uterine tone: massage fundus if boggy, expel clots when fundus is firm, administer oxytocic medications, have woman breastfeed
• prevent bladder distention

Question 18

True or False: The effectiveness of the rubella vaccine might be reduced if a postpartum woman receives both Rh immunoglobulin and a rubella vaccine.

Answer 18

True

Question 19

True or False: Before sitting down in a sitz bath, the woman should relax her gluteal muscles to reduce discomfort when entering the bath and then tighten them after she is sitting in the bath.

Answer 19

False–Tighten gluteal muscles and keeping them tightened when entering the bath and then relaxing them after she is in the bath

Question 20

True or False: Tucks are used to soothe sore hemorrhoids.

Answer 20

True

Question 21

True or False: Medications such as estrogen and bromocriptine (Parlodel) are often used to suppress lactation for the bottle feeding woman.

Answer 21

False–These are no longer used.

Question 22

True or False: The most common cause of excessive bleeding after birth is unrepaired vaginal or cervical lacerations.

Answer 22

False–most common cause is uterine atony, failure of the uterine muscle to contract firmly.

Question 23

True or False: Ice packs are most effective in minimizing perineal edema during the first 36 hours following birth.

Answer 23

False–The first 24 hours to decrease and then after to provide anesthetic effect.

Question 24

True or False: An appropriate time to administer pain medication to a breastfeeding woman would be immediately after a feeding session.

Answer 24

True

Question 25

True or False: Rubella vaccine should not be given to a woman who is breastfeeding her infant.

Answer 25

False–It’s not communicable in breast milk and can be given to breastfeeding mothers.

Question 26

True or False: A woman should be expected to void at least 250 mL of urine spontaneously within 2 hours following vaginal birth.

Answer 26

False–within 6 to 8 hours

Question 27

True or False: Chinese women often avoid the use of hormonal methods as a primary method of contraception.

Answer 27

True

Question 28

True or False: A depressed postpartum woman who is experiencing suicidal ideation should call the warm line that she learned about at discharge.

Answer 28

False–This is not a crisis intervention line. Usually relates to infant feeding, crying, sibling rivalry.

Question 29

Recovery room nurse report:

Answer 29

-outline essential information that should be reported regarding the condition of the woman and her new baby and the significant events and finding from her prenatal and childbirth periods

Question 30

Measures to prevent transmission of infection from person to person:

Answer 30

-include clean environment, handwashing, use of Standard Precautions, proper care and use of equipment

Question 31

Infection prevention measures to teach the woman:

Answer 31

• teach avoidance of walking barefoot
• use of hand washing
• hygienic measures (general, breast, perineal)
• prevention of bladder infection
• measures to enhance resistance to infection, including nutrition and rest