c13.rtf - Chapter 13 Nursing Care During Labor and Birth...

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Chapter 13: Nursing Care During Labor and Birth MULTIPLE CHOICE 1. The nurse is preparing to perform Leopold’s maneuvers. Why are Leopold’s maneuvers used by practitioners? a. To determine the status of the membranes b. To determine cervical dilation and effacement c. To determine the best location to assess the fetal heart rate d. To determine whether the fetus is in the posterior position ANS: C Leopold’s maneuvers are often performed before assessing the fetal heart rate (FHR). These maneuvers help identify the best location to obtain the FHR. A Nitrazine or ferning test can be performed to determine the status of the fetal membranes. Dilation and effacement are best determined by vaginal examination. Assessment of fetal position is more accurate with vaginal examination. PTS: 1 DIF: Cognitive Level: Application REF: 227 OBJ: Nursing Process Step: Planning MSC: Client Needs: Health Promotion and Maintenance 2. Which comfort measure should a nurse use to assist a laboring woman to relax? a. Recommend frequent position changes. b. Palpate her filling bladder every 15 minutes. c. Offer warm wet cloths to use on the client’s face and neck. d. Keep the room lights lit so the client and her coach can see everything. ANS: A Frequent maternal position changes reduce the discomfort from constant pressure and promote fetal descent. A full bladder intensifies labor pain. The bladder should be emptied every 2 hours. Women in labor get hot and perspire. Cool cloths are much better. Soft indirect lighting is more soothing than irritating bright lights. PTS: 1 DIF: Cognitive Level: Application REF: 236 OBJ: Nursing Process Step: Implementation MSC: Client Needs: Physiologic Integrity 3. Which assessment finding could indicate hemorrhage in the postpartum patient? a. Elevated pulse rate b. Elevated blood pressure c. Firm fundus at the midline d. Saturation of two perineal pads in 4 hours ANS: A An increasing pulse rate is an early sign of excessive blood loss. If the blood volume were diminishing, the blood pressure would decrease. A firm fundus indicates that the uterus is contracting and compressing the open blood vessels at the placental site. Saturation of one pad within the first hour is the maximum normal amount of lochial flow. Two pads within 4 hours is within normal limits. PTS: 1 DIF: Cognitive Level: Analysis REF: 224
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OBJ: Nursing Process Step: Assessment MSC: Client Needs: Physiologic Integrity 4. Which is an essential part of nursing care for a laboring client? a. Helping the woman manage the pain b. Eliminating the pain associated with labor c. Feeling comfortable with the predictable nature of intrapartal care d. Sharing personal experiences regarding labor and birth to decrease her anxiety ANS: A Helping a client manage the pain is an essential part of nursing care because pain is an expected part of normal labor and cannot be fully relieved. Labor pain cannot be fully relieved. The labor nurse should always be assessing for unpredictable occurrences.
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