1.Which of the following tasks may be delegated to the nursing assistant?
a. checking the cervix of the patient who is less likely to deliver soon
b. administering oxygen to the mother who has decreasing oxygen
satura- tions
c. providing ice chips for a mother who complains of a dry mouth
d. Tearing off a strip of paper from the fetal heart rate monitor and putting
it in the chart: C- When working in L&D the UAP can help with ADLs.
They cannot be delegated tasks that require formulating a care plan,
taking off orders, or administering medications
2.Which of the following situations would most likely warrant contact with
a physician for further orders for care or treatment?
A. A patient has a 3rd degree perineal laceration after delivery
B. A patient has lost 100 mL of blood with delivery
,C. A patient has a boggy uterus that does not firm with massage
D. A patient is having rectal pain: C. When caring for postpartum patients,
the nurse must be familiar with what conditions are common
occurrences following de- livery and what situations warrant a call to
the physician for further help. Postpartum complications often include
infection, blood clots, and hemorrhage. Excess bleeding may occur
when the uterus is boggy and it does not firm up with massage.
3.Following removal of the epidural, the patient develops a severe headache
when she sits up in bed. The physician has instructed the patient that she
will need a blood patch. Which best describes this procedure?
A. Removing blood from a vein in the patient and injecting it into the
epidural space in the back
B. Placement of a large bandage over the site of the epidural insertion.
C. Replacement of the epidural catheter into the same space for long-
term control
,D. Placement of a nerve block in the spinal column at the location of the
affected epidural space: A- When CSF leaks out of the epidural space a
severe headache in the patient can occur. A blood patch can be
performed by a physician to close the site. The small amount of blood is
withdrawn from the mother's arm and the blood clots in the space.
4.Which of the patients described should the nurse see first?
A. 20 yr old patient who just had her first baby and doesn't know how
to breastfeed
B. 27 yr old diabetic patient who delivered her second child yesterday
and needs her morning dose of insulin
C. 24 yr old patient who has had a large amount of lochia and has
developed a hematoma on her perineum
, D. 30 yr old patient who needs to take a shower and eat breakfast before
the physician comes to dismiss her: C. A patient with a hematoma is at
risk of hemorrhage and the nurse should assess her first
5.On the first following delivery, the physician ordered a hemoglobin level
for the patient; the result was 9.9 g/dL. The physician did not list any other
orders in the patient's chart since that time. Which response of the nurse is
most appropriate>
A. call the physician and ask if he wants a blood transfusion for the patient
B. ask the physician about the hemoglobin level when he comes in for
rounds
C. Contact the laboratory and ask them to repeat the test
D. continue to monitor the patient and document the result: B. A
postpartum patient is at risk of hemorrhage following delivery; often the
physician will order a hemoglobin level 1-2 days after delivery to check
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