OB and mental 2 Flashcards
A pt states that she believes she is pregnant. What probable signs of pregnancy does the nurse expect to see? SATA
1) Amenorrhea
2) Abdominal enlargement
3) Fetal movement
4) Breast tenderness
5) Positive pregnancy test
6) Urinary frequency
2,5
the primary healthcare provider will identify
Presumptive sign-pt can feel or state
Positive sign-fetal HR, fetal movement,ultrasound
A client in 1st trimester has been attending educational sessions on pregnancy. What statements indicate understanding? SATA
a)Good food sources of iron includes spinach, raisins, and dark chocolate
b)I will eat at least 40 grams of protein a day.
c)Swimming is an acceptable exercise for me while I am pregnant
d) I can gain 2 pounds (0.9 kg) per week during my first trimester
e) I need to stay out of hot tubs while pregnant
a,c,e
b- should increase protein intake to 71 grams per da
c-1st trimester, total 1-4 lb total
A client in her third trimester has a routine prenatal visit. The nurse notes a weight gain of 4 pounds (1.8 kg) in a week. What action should the nurse take?
a) Check urine for protein.
b) Educate on proper weight gain during pregnancy
c) Send client to the labor and delivery unit.
a
We are worried about pre-eclampsia, so we need to check the client’s BP and check urine for protein.
1st 1-4lb total
2nd 1lb per week
3rd No more than 1lb
What interventions should the nurse provide when caring for a client prescribed oxytocin IV? SATA
a) Label IV bag and IV tubing with oxytocin sticker.
b) Monitor for late decelerations
c) Position client supine.
d) Piggyback oxytocin at the lowest primary IV site.
e) Provide one one-on-one care.
a,b,d,e
c-flat on their back is contraindication
A client diagnosed with mastitis about treatment. The client states she wants to continue breastfeeding. What interventions should the nurse include? SATA
a) Get plenty of bed rest.
b) Wear a support bra.
c) Place chilled cabbage leaves on breasts.
d) Take antibiotics prior to breastfeeding
e) Offer the unaffected breast first at each feeding
a,b
The nurse is developing the plan of care for a mania. Which interventions should the nurse include? SATA
a) Give one cigarette to client at a time
b) Discuss delusional belief with client
c) Have finger foods available at mealtime
d) Give high calorie fluids between meals
e) Provide soothing music in room during waking hours
a,c,d
They have no control or awareness of these hazards. If they smoke, only give the client one or two cigarettes at a time, or the client will light a whole pack at once.
Which signs/symptoms expect to see in a client diagnosed with schizophrenia? SATA
a) Auditory hallucinations
b) Grandiose delusions
c) Religious preaching all the time.
d) Flat affect
e) Abstract reasoning
a,b,c,d
Religiosity is common. The client may carry a bible all of the time and preach to everyone all of the time.
A primary healthcare provider has prescribed restraints for a violent adult client. Which measures would the nurse provide as proper interventions for this client? SATA
a) Observe the client in restraints every hour
b) Ensure that circulation to extremities is not compromised.
c) Assist client with needs related to nutrition and elimination
d) Provide help with personal hygiene
e) Renew restraint prescription in 4 hours if needed
b,c,d,e
a-should be observed every 15 minutes.
The nurse is planning care for a client with Alzheimer’s Disease. What interventions should the nurse include? SATA
a) Encourage participation in light exercise.
b) Identify doors with pictures
c) Monitor food intake.
d) Assign unlicensed assistive personnel to bathe client daily.
e) Reminisce about successful and unsuccessful life events.
f) Weigh weekly
a,b,c,f
f-the client can easily forget to eat and drink. This is one reason the client should be weighed weekly as well.
d-Have the client dress in their own clothes whenever possible and perform their own activities of daily living for as long as possible. This helps to maintain self-esteem.
A nurse in mental health is attempting to develop a therapeutic relationship with a pt. What action should the nurse take?
a) Set limits for the relationship
b) Promote the use of transference by the pt
c) Instruct the pt on how he should behave
d) Engage in friendly interactions with pt
a
The nurse should set professional boundaries through limit setting regarding when and where to meet, roles of the relationship, personal space, and other parameters
b
feelings about a significant person to the nurse so they should not use this
A home health nurse drives up to the house who has schizophrenia with manic episodes. the client is sitting on his front porch wit a shotgun in his arms. which of the ff actions should the nurse take?
a. honk the horn to get the client’s attention
b. calmly speak the client’s name out of the car window
c. keep driving in a path that is going away from the client’s house
d. stop the car in the client’s driveway and call the authorities.
c
This is an appropriate action for the nurse to take as it removes her from immediate danger.
a,b,d
These action draws the client’s attention to the nurse and increases the risk for injury.
A pt who has schizophrenia and is experiencing a hallucination. Which of the following actions should the nurse take?
a) act to the pt if the hallucination is real
b) ask the pt direct questions about the hallucination
c) Tell the pt that the hallucination is not a part of reality
b
Asking the client direct questions about the hallucination provides important data to identify the client’s risk level and current mental status.
c-Telling the client that the hallucination is not real will increase the client’s anxiety level and is therefore not an action the nurse should take.
A pt who is experiencing mania. Which medication should be used to reduce the pt’s mania?
a) Fluvastatin
b) Carbamazepine
c) Lorazepam
d) Propranolol
b
an antiseizure medication and a mood stabilizer, is prescribed to treat and prevent mania in clients who have bipolar disorder
c-a sedative, hypnotic medication is used to treat anxiety
d- is used to treat hypertension and other heart conditions, as well as certain anxiety disorders
What disorer should the nurse suggest offering the guided imagery therapy to?
PSTD
Sleep disorders, anxiety, and pain.
to relieve the anxiety associated with those disorder
A client who has paranoid personality disorder. Which of the following findings should the nurse expect? SATA
A. believes that others are deceiving him
B. desires to be the center of attention
C. views himself as inferior to others
D. demonstrates a grandiose sense of self-importance
E. persistently holds onto grudges
a,e
deceiving-騙す
grudges-恨み
b-histrionic personality
c-avoidant personality
worries constantly about being criticized, and does not fully engage in new interpersonal relationships. inferior-劣った
A pt who has chronic anxiety for discharge from the psychiatric unit. What instructions should the nurse include in the discharge plan?
a) Contact crisis counselor once a week
b) Identify anxiety-producing situations
c) Eliminate stress and anxiety from daily life
b
Treatment for anxiety disorders includes helping the client recognize signs that her anxiety level is rising and the triggers that cause this type of reaction. The nurse should include this information so the client can limit anxiety-provoking situations or intervene early to reduce anxiety levels.
What are the s/s of acute cocaine toxicity?
Tremors
Agitation
Fever
HTN
Ventricular dysrhythmias
A client who has a personality disorder and demonstrates manipulative behavior. Which of the following interventions is appropriate to include in the plan of care?
a) Allow manipulation so as to not raise the client’s anxiety.
b) Create a strict schedule for the client’s activities to discourage manipulation.
c) Institute consequences result from manipulative behavior.
d) Bargain with the client to discourage manipulative behavior.
c
Institute=star using
Consequences=punishment
Uterine atony(hypotonia of the uterus)?
What this cuses?
PPH is defined as?
a) uterus doesn’t contract properly after delivery
hypotonia=floppy
b) PPH
c) cesarean birth 1L loss, virginal birth 500mL
10% decrease hematocrit
