Nursing interventions and care
Total Questions : 5
Showing 5 questions, Sign in for moreA nurse is caring for a client who had a prolonged and obstructed labor and is at risk for developing a ruptured uterus.
Which of the following signs should alert the nurse to this complication?
Explanation
A ruptured uterus can cause the baby to slip into the mother’s abdomen, which can stop or slow down labor.A ruptured uterus can also cause severe bleeding, shock, and fetal distress.
A nurse is preparing a client for an emergency cesarean section due to prolonged and obstructed labor.
Which of the following actions should the nurse take first?
Explanation
Informed consent is a legal and ethical requirement for any surgical procedure, including emergency cesarean section.It implies that the patient accepts the intervention willingly after comprehending adequate information about the associated risks and benefits.Informed consent also respects the patient’s autonomy and right to self-determination.
Therefore, obtaining informed consent from the client or her partner should be the first action that the nurse takes before an emergency cesarean section.
A nurse is monitoring a client who had a prolonged and obstructed labor and delivered a healthy newborn by vacuum extraction.
Which of the following interventions should the nurse implement to prevent infection in the client?
Explanation
This intervention can help prevent infection in the client by improving blood circulation, reducing edema, and promoting wound healing.Early ambulation and hydration can also prevent other complications such as thromboembolism, constipation, and urinary retention.
A nurse is providing oxygen therapy to a client who had a prolonged and obstructed labor and is experiencing respiratory distress.
Which of the following oxygen delivery devices should the nurse use to provide the highest concentration of oxygen?
Explanation
This is because a non-rebreather mask can deliver high concentrations of oxygen (approximately 70% O2) to a client who is experiencing respiratory distress.A non-rebreather mask has a reservoir bag that fills with oxygen and a valve that prevents the exhaled air from mixing with the oxygen in the bag.
A nurse is educating a client who had a prolonged and obstructed labor and a cesarean section about maternal-fetal bonding after delivery.
Which of the following statements by the client indicates an understanding of the teaching?
Explanation
This statement indicates that the client understands the importance of maternal-fetal bonding after delivery, which is the emotional, cognitive, and behavioral connection that mothers develop toward their babies.Skin-to-skin contact is one of the ways to promote bonding and attachment between the mother and the baby.
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