NUR 2633 EXAM STUDY GUIDE RASMUSSEN COLLEGE MATERNAL CHILD HEALTH NURSING

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RASMUSSEN COLLEGE MATERNAL CHILD HEALTH NURSING NUR 2633 EXAM STUDY GUIDE 1. The perinatal nurse is caring for a woman in the immediate post birth period. Assessment reveals that the woman... is experiencing profuse bleeding. The most likely etiology for the bleeding is: A. Uterine atony. B. Uterine inversion. C. Vaginal hematoma. D. Vaginal laceration. ANS: A Uterine atony is marked hypotonia of the uterus. It is the leading cause of postpartum hemorrhage. Uterine inversion may lead to hemorrhage, but it is not the most likely source of this client’s bleeding. Furthermore, if the woman were experiencing a uterine inversion, it would be evidenced by the presence of a large, red, rounded mass protruding from the introitus. A vaginal hematoma may be associated with hemorrhage. However, the most likely clinical finding would be pain, not the presence of profuse bleeding. A vaginal laceration may cause hemorrhage, but it is more likely that profuse bleeding would result from uterine atony. A vaginal laceration should be suspected if vaginal bleeding continues in the presence of a firm, contracted uterine fundus. 2. A primary nursing responsibility when caring for a woman experiencing an obstetric hemorrhage associated with uterine atony is to: A. Establish venous access. B. Perform fundal massage. C. Prepare the woman for surgical intervention. D. Catheterize the bladder. ANS: B The initial management of excessive postpartum bleeding is firm massage of the uterine fundus. Although establishing venous access may be a necessary intervention, the initial intervention would be fundal massage. The woman may need surgical intervention to treat her postpartum hemorrhage, but the initial nursing intervention would be to assess the uterus. After uterine massage the nurse may want to catheterize the client to eliminate any bladder distention that may be preventing the uterus from contracting properly. 3. In helping bereaved parents cope and move on, nurses should keep in mind that: A. A perinatal or parental grief support group is more likely to be helpful if the needs of the parents are matched with the focus of the group. B. When pictures of the infant are taken for keepsakes, no close-ups should be taken of any congenital anomalies. C. No significant differences exist in grieving individuals from various cultures, ethnic groups, and religions. D. In emergency situations nurses who are so disposed must resist the temptation to baptize the infant in the absence of a priest or minister. ANS: A A perinatal or parental grief support group is more likely to be helpful if the needs of the parents are matched with the focus of the group. For example, a religious-based group may not work for nonreligious parents. Close-up pictures of the baby must be taken as the infant was, congenital anomalies and all. Although death and grieving are events shared by all people, mourning rituals, traditions, and taboos vary by culture, ethnicity, and religion. Differences must be respected. Baptism for some religious groups can be performed by a layperson such as a nurse in an emergency situation when a priest is not available. 4. Medications used to manage postpartum hemorrhage (PPH) include (choose all that apply): A. Pitocin. B. Methergine. C. Terbutaline. D. Hem abate. E. Magnesium sulfate. ANS: A, B, D Pitocin, Methergine, and Hem abate are all used to manage PPH. Terbutaline and magnesium sulfate are tocolytics; relaxation of the uterus causes or worsens PPH. 5. Complicated bereavement: A. Occurs when, in multiple births, one child dies, and the other or others live. B. Is a state in which the parents are ambivalent, as with an abortion. C. Is an extremely intense grief reaction that persists for a long time. D. Is felt by the family of adolescent mothers who lose their babies. ANS: C [Show More]

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