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Test Bank Ricci Essentials of Maternity Chapter 16 With Rationales.

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Test Bank - Essentials of Maternity, Newborn, and Women's Health Nursing (4th Edition) Chapter 16: Nursing Management during the Postpartum Period 1. A woman who is 12 hours postpartum had a pulse rate around 80 bpm ...

Test Bank - Essentials of Maternity, Newborn, and Women's Health Nursing (4th Edition) Chapter 16: Nursing Management during the Postpartum Period 1. A woman who is 12 hours postpartum had a pulse rate around 80 bpm during pregnancy. Now, the nurse finds a pulse of 60 bpm. Which of these actions should the nurse take? A) Document the finding, as it is a normal finding at this time. B) Contact the physician, as it indicates early DIC. C) Contact the physician, as it is a first sign of postpartum eclampsia. D) Obtain an order for a CBC, as it suggests postpartum anemia. Answer: A Explanation: Pulse rates of 60 to 80 beats per minute (bpm) at rest are normal during the first week after birth. This pulse rate is called puerperal bradycardia. Tachycardia in the postpartum woman can suggest anxiety, excitement, fatigue, pain, excessive blood loss or delayed hemorrhage, infection, or underlying cardiac problems. Any pulse rate higher than 100 bpm warrants further investigation to rule out complications. p. 524 2. To decrease the pain associated with an episiotomy immediately after birth, which action by the nurse would be most appropriate? A) Offer warm blankets. B) Encourage the woman to void. C) Apply an ice pack to the site. D) Offer a warm sits bath. Answer: C Explanation: During the early postpartum period, the perineal tissue surrounding the episiotomy is typically edematous and slightly bruised. The normal episiotomy site should not have redness, discharge, or edema. Commonly, an ice pack is the first measure used after a vaginal birth to relieve perineal discomfort from edema, an episiotomy, or a laceration. An ice pack seems to minimize edema, reduce inflammation, decrease capillary permeability, and reduce nerve conduction to the site. p. 528, 536 3. A postpartum client has a fourth-degree perineal laceration. The nurse would expect which of the following medications to be ordered? A) Ferrous sulfate (Feosol) B) Methylergonovine (Methergine) C) Docusate (Colace) D) Bromocriptine (Parlodel)

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