When a woman is admitted to the labor and delivery unit, she tells the nurse that she is anxious about delivery, the welfare of her infant, and how Quickly she will recover. A frustrated patient in labor has been affected by decreased uterine muscle tone and reports, My doctor wont induce my labor because of some silly score. dilated but contractions are becoming shorter and less frequent. Which IV fluid
2. What is the most appropriate action for the nurse
age, her infant is at risk for: A client with a missed abortion at 29 weeks gestation is admitted
ANS: The most appropriate initial action would be to: Which of the following is a characteristic of a reassuring fetal
The client should be told to avoid: The nurse is changing the ties of the client with a tracheotomy. Record a baseline fetal heart rate. This chapter provides a sample NCLEX-RN exam with detailed explanations for each of the answers to help you practice. A client being treated with sodium warfarin has a Protime of 120 seconds. Cervical dilation. The first action the nurse should take is: In evaluating the effectiveness of IV Pitocin for a client with secondary
It is also performed when certain pregnancy-related conditions require the placement of internal monitors such as fetal scalp electrodes and uterine pressure catheters. Alternate hot and cold packs to affected joints. A schedule of strenuous exercise will improve muscle strength. A diabetic multigravida is scheduled for an amniocentesis at 32 weeks
MSC: NCLEX: Physiological Integrity: Reduction of Risk, DIF: Cognitive Level: Comprehension REF: Page 193 OBJ: 6 should administer this medication: Cataracts result in opacity of the crystalline lens. In anticipation of complications of anesthesia and narcotic
Which of the following statements would the nurse expect
Pearson uses appropriate physical, administrative and technical security measures to protect personal information from unauthorized access, use and disclosure. What is the most appropriate pain relief intervention for a woman in precipitate labor? ANS: D ", "I will use an electric razor for shaving.". d. Grieving related to loss of expected birth experience. 6 months. This potential space forms early in pregnancy and is filled with serous fluid during the first few weeks of pregnancy. MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease, DIF: Cognitive Level: Knowledge REF: Page 175 OBJ: 3 the anemia? Ask the parent/guardian to leave the room when assessments
A client with an abdominal cholecystectomy returns from surgery with
c. Risk for ineffective parenting related to emergency cesarean section Induction can be attempted as a VBAC after a horizontal cesarean incision but is contraindicated with a classic (vertical) incision. A new mother is distressed and tearful about the elevated dome over her infants posterior, fontanelle. The primiparous patient has asked the nurse why her cervix has only changed from 1 to 2 cm in 3 hours of contractions occurring every 5 minutes. KEY: Nursing Process Step: Implementation Which response by the nurse indicates
MSC: NCLEX: Physiological Integrity: Reduction of Risk, DIF: Cognitive Level: Application REF: Page 175- The client is complaining
TOP: Emergencies During ChildbirthProlapsed Umbilical Cord b. (d) What happens to the image as the object is moved toward the focal point? Which of the following statements by the
MSC: NCLEX: Physiological Integrity: Pharmacological Therapies, DIF: Cognitive Level: Knowledge REF: Page 174 OBJ: 3 Which response would
ANS: C The
in which position? Name three things that you should do for classes with pointer member variables. L/S ratio is 1:1 and the presence of phosphatidylglycerol is noted. TOP: Laminaria KEY: Nursing Process Step: N/A A warm saline bolus is instilled in the uterus to float the fetus to relieve pressure on the cord. continuous observation because: Hallucinogenic drugs create both stimulant and depressant
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort, DIF: Cognitive Level: Application REF: Page 195 OBJ: 8 The nurse caring for a client in the neonatal intensive care unit administers
The most common complications are impaired placental exchange and uterine rupture, but water intoxication can occur due to fluid retention. Occasionally, we may sponsor a contest or drawing. 35-year-old multigravida with history of precipitate birth. The nurse is assessing the deep tendon reflexes of a client with preeclampsia. of the following would the nurse inquire about as a part of the assessment? Which of the following would be the priority nursing diagnosis for the
The nurse knows that the purpose of the medication is to: A client with a severe corneal ulcer has an order for Gentamycin
the test: A client with hypothyroidism asks the nurse if she will still need
vessels are dissolving. TOP: Induction KEY: Nursing Process Step: Data Collection unit during the first phase of labor. reveals that the client's cervix is 8cm dilated, with complete effacement. ", "While I'm in the shower, I'll allow the water to run over
What is the cause? What kind of magic number do I need? When using the rod-hook device, the end of the rod that remains outside of the vagina is typically held with the non-dominant hand. As the client reaches 8cm dilation, the nurse notes late decelerations
", "The pain and itching are due to the infection you had before the
The client arrives in the emergency department after a motor vehicle accident. interventions would be of highest priority for this client? begun when: She has back pain and a bloody discharge. Oligohydramnios d. Urinary frequency. Leave the client alone until he calms down. a. Placenta previa a. be assigned to a private room if only one is available? While Pearson does not sell personal information, as defined in Nevada law, Nevada residents may email a request for no sale of their personal information to NevadaDesignatedRequest@pearson.com. purpura (ATP). A labor dysfunction due to decreased uterine muscle tone occurs in a patient who is dilated to. Participation is voluntary. of nausea and vomiting for the past 3 days. blood type A negative. The RN with 2 weeks of experience in postpartum, The RN with 3 years of experience in labor and delivery, The RN with 10 years of experience in surgery, The RN with 1 year of experience in the neonatal intensive care unit. "Have you noticed a change in sleeping habits
", "I will eat a snack around three o'clock each afternoon. her to make? clean the pin. TOP: Laminaria KEY: Nursing Process Step: N/A Which
To facilitate removal, the nurse should instruct the client to: Perform the Valsalva maneuver as the catheter is advanced, Turn his head to the left side and hyperextend the neck, Take slow, deep breaths as the catheter is removed, Turn his head to the right while maintaining a sniffing position. Elevations in human chorionic gonadotrophin decrease the need for insulin. Which of the following
20. walker. An amniotomy is a procedure performed to release fluid from the amniotic sac to induce labor during childbirth. MSC: NCLEX: Physiological Integrity: Reduction of Risk, DIF: Cognitive Level: Application REF: Page 183 OBJ: 8 Cross), Educational Research: Competencies for Analysis and Applications (Gay L. R.; Mills Geoffrey E.; Airasian Peter W.), Brunner and Suddarth's Textbook of Medical-Surgical Nursing (Janice L. Hinkle; Kerry H. Cheever), Campbell Biology (Jane B. Reece; Lisa A. Urry; Michael L. Cain; Steven A. Wasserman; Peter V. Minorsky), Give Me Liberty! ANS: B What is the nurses initial action? The physician has ordered a thyroid scan to confirm the diagnosis. d. The fundus is assessed only once every shift. An elderly client with an abdominal surgery is admitted to the unit
the area below the patella with the blunt side of the reflex hammer. A client who has glaucoma is to have miotic eyedrops instilled in
TOP: Preterm Labor KEY: Nursing Process Step: Evaluation Painful and poorly coordinated contractions occur with hypertonic labor. 8. with 75% effacement. Explain the interprofessional team strategies for enhancing care coordination and communication to enhance the performance of amniotomies and improve outcomes. doctor? to breastfeed her infant. MSC: NCLEX: Physiological Integrity: Pharmacological Therapies, Copyright 2023 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01, labor and begins to have contractions every 90 seconds. a. Maternal gynecoid pelvis diet selection would be suited to the client? The cervical ripening procedure should be explained to the woman and her family. b. Which category of medication prevents the formation
The journal of maternal-fetal [PubMed PMID: 29334294], Ruamsap K,Panichkul P, The Effect of Early Versus Late Amniotomy on The Course of Labor. A client with a total knee replacement has a CPM (continuous passive
Which statement is true regarding the measurement of the duration of contractions? What is the nurses initial action? drug orders should the nurse question? European journal of obstetrics, gynecology, and reproductive biology. What will the nurse expect when caring for this patient? KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation, DIF: Cognitive Level: Application REF: Page 176 OBJ: 3 are being performed. What are the rationales for labor induction? likely time for her to conceive. Which
Amniotomy, also known as artificial rupture of membranes (AROM) or colloquially known as "breaking the water," is the intentional rupture of the amniotic sac by an obstetrical provider. After insertion of the prostaglandin gel, the woman remains on bed rest for 1 to 2 hours and is monitored for uterine contractions. the need for additional teaching? The tube will allow for equalization of the lung expansion. A woman with hypotonic labor dysfunction will be encouraged to change position frequently to enhance contractions. The narcotic count has been incorrect on the unit for the past 3 days. Administer meperidine (Demerol) 75mg IV push. a vaginal exam and determines that the client's cervix is 5cm dilated
ANS: A, B, E A pulsating structure is felt during a vaginal examination of a woman in labor. Assisting the patient to ambulate Pearson may use third party web trend analytical services, including Google Analytics, to collect visitor information, such as IP addresses, browser types, referring pages, pages visited and time spent on a particular site. TOP: Emergencies During ChildbirthProlapsed Umbilical Cord TOP: Hypotonic Labor Dysfunction KEY: Nursing Process Step: Data Collection 1 months ago. should be used when administering the drops? Which of the following
if the: When assessing a laboring client, the nurse finds a prolapsed cord. Which of the following
: an American History (Eric Foner), Civilization and its Discontents (Sigmund Freud), The Methodology of the Social Sciences (Max Weber), Forecasting, Time Series, and Regression (Richard T. O'Connell; Anne B. Koehler), Brunner and Suddarth's Textbook of Medical-Surgical Nursing (Janice L. Hinkle; Kerry H. Cheever), Campbell Biology (Jane B. Reece; Lisa A. Urry; Michael L. Cain; Steven A. Wasserman; Peter V. Minorsky), NURS 303 Chapter Test bank California State University Northridge, What nursing assessment should be reported immediat. The nurse is assigned to care for the client with a Steinmen pin. External version is most likely to be done in which of these situations? Where required by applicable law, express or implied consent to marketing exists and has not been withdrawn. A vaginal exam reveals that the cervix is 4cm dilated, with intact
c. Amniotic fluid is watery and pale green. ANS: A client with diabetes? MSC: NCLEX: Physiological Integrity: Reduction of Risk, DIF: Cognitive Level: Comprehension REF: Page 194 OBJ: 5 The other options are contraindications for labor induction. on the perineum. MSC: NCLEX: Health Promotion and Maintenance, DIF: Cognitive Level: Application REF: Page 192 OBJ: 5 A vaginal exam reveals that she
This activity reviews the indications, contraindications, and technique involved in performing an amniotomy and highlights the role of the interprofessional team in the monitoring of the fetus and the mother. The emergency room is flooded with clients injured in a tornado. c. Flecks of vernix in the amniotic fluid By reducing blood flow to the uterus TOP: Obstetric ProceduresInduction of Labor OBJ: 6 TOP: Abnormal Labor her child to have the treatment. following best explains the functions of the lens? To conduct business and deliver products and services, Pearson collects and uses personal information in several ways in connection with this site, including: For inquiries and questions, we collect the inquiry or question, together with name, contact details (email address, phone number and mailing address) and any other additional information voluntarily submitted to us through a Contact Us form or an email. After confirmation of both fetal presentation and engagement, the practitioner can proceed with artificial rupture of membranes.[6][7]. The nurse wears gloves when providing care. OBJ: 2 | 5 TOP: Abnormal Labor laminaria Women who have cesarean births usually need greater support than those who have vaginal births. MSC: NCLEX: Physiological Integrity: Pharmacological Therapies, DIF: Cognitive Level: Knowledge REF: Page 174 OBJ: 3 TOP: Premature Rupture of Membranes KEY: Nursing Process Step: Data Collection "You are having an allergic reaction. 29. - Amniotic fluid is watery and pale green. suspects vitamin B12 deficiency anemia. KEY: Nursing Process Step: Implementation Pearson may provide personal information to a third party service provider on a restricted basis to provide marketing solely on behalf of Pearson or an affiliate or customer for whom Pearson is a service provider. Which nursing observation should be promptly reported maternal vital signs t 100.7 pulse 102 r 20 a. Fetal heart rate is regular at 154 beats/min. of 180/96. d. Instruct patient to ambulate immediately afterward. The elderly client is admitted to the emergency room. which of the following colors? The primary physiological alteration in the development of asthma
MSC: NCLEX: Physiological Integrity: Pharmacological Therapies, Copyright 2023 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01, labor and begins to have contractions every 90 seconds. MSC: NCLEX: Physiological Integrity: Reduction of Risk, DIF: Cognitive Level: Knowledge REF: Page 176 OBJ: 1 ANS: A nerve root inflammation. What is the lowest Bishop score the patient should have prior to induction? A client in the prenatal clinic is assessed to have a blood pressure
as she completes the early phase of labor? cancer, The client who returned from placement of iridium seeds for prostate cancer. 1 para 0 in labor. TOP: Obstetric ProceduresForceps Delivery c. Stimulating the nipples Following an amniotomy, the nursing assessment that should be reported immediately is _____. Hamburger pattie, green beans, French fries, and iced
A client elects to have epidural anesthesia to relieve the discomfort
Cover the insertion site with a Vaseline gauze. TOP: Postamniotomy Care KEY: Nursing Process Step: Data Collection What
Which instruction should be given to the client who is fitted for a behind-the-ear
Place the fruit next to the bed for easy access by the client, Tell the family members to take the fruit home. Which assessments must be made just before the amniotomy is performed? . The client is complaining of severe
This should be reported immediately. of the management of chest tubes? Emptying the Foley catheter of the preeclamptic client, Ambulating the client with a fractured hip. What nursing assessment should be reported immediately after an amniotomy? ANS: A, B, C the morning rounds, the nurse finds an O2 sat of 76%. A client with osteoarthritis has a prescription for Celebrex (celecoxib). Which of the following indicates that the client's ECT has
I can unsubscribe at any time. tie. with cortisone via a centrally placed venous catheter. During the admission assessment, the nurse notes that the infant is crying vigorously. Transmission is highly likely, so the client should wear a mask at all
(b) Is the image real or virtual? a fractured hip. gtt. with: Which assignment should not be performed by the licensed practical nurse? Journal of the Medical Association of Thailand = Chotmaihet thangphaet. The
at a right angle to the bed, Hips are slightly elevated above the bed and the legs are suspended at
Which is the best method
The nurse: The teenager with a fiberglass cast asks the nurse if it will be
An infant's Apgar score is 9 at 5 minutes. e. Edematous labia. Gestational diabetes is not a contraindication for labor induction. in Bryant's traction. What nursing assessment should be reported immediately after an amniotomy? Revista latino-americana de enfermagem. TOP: Hypotonic Labor Dysfunction KEY: Nursing Process Step: Data Collection ANS: A, B, C The nurse instructs the client to dangle her legs as the nurse strikes
Which statement indicates that the client knows when the peak action
The nurse is aware that a nonstress test can be ordered for this client to: Show the effect of contractions on fetal heart rate. The client should be taught that the medication
After the immediate flow of amniotic fluid ceases, and there is no palpable cord in the vagina, the vaginal hand then can be removed. d. Apply suction to the nipples with a breast pump. (enoxaparin) injections after discharge. Newborn skin is easily traumatized by washing. Editor's Note: You may also be interested in newer versions of this book and related titles: A 43-year-old African American male is admitted with sickle cell anemia. What would the nurse planning discharge instruction teach the woman to do? When
A client is admitted to the unit 2 hours after an explosion causes burns
What is this labor pattern considered? c. Increased blood pressure 24. time. of polio. the child's: Hips are resting on the bed, with the legs suspended
for infections spread by contact? Application of a short inclusive spica cast, Stabilization with a plaster-of-Paris cast. Which information in the health history is most likely related
A 25-year-old male is admitted in sickle cell crisis. Which statement is true regarding precautions
The nurse instructs the client to place her arms loosely at her side as
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, DIF: Cognitive Level: Comprehension REF: Page 175 OBJ: 2 of the following indicates that the client has experienced toxicity to this
Notify the charge nurse immediately. (Select all that apply,), A woman is preparing for administration of a cervical ripening agent. TOP: Induction KEY: Nursing Process Step: Data Collection Before administering eyedrops, the nurse should recognize
This is done to start or speed up labour. Nursing Considerations Obtaining Baseline Information The fetal heart rate (FHR) is assessed with auscultation or electronic monitoring to identify a reassuring rate and pattern before amniotomy is done. The client has recently returned from having a thyroidectomy. The client is receiving IV glucocorticoids
A client with leukemia is receiving Trimetrexate. 12. a. To collect
Which client
This procedure has several indications and is commonly performed during labor management. ailment. used for the epidural. Which equipment would assist the client with a total hip replacement with
The nurse
In assessing
To help her maintain
MSC: NCLEX: Physiological Integrity, DIF: Cognitive Level: Application REF: Page 180 OBJ: 3 A gravida III para II is admitted to the labor unit. If the fetal presentation is unknown or not fully engaged, the risk for cord prolapse is increased. "I will make sure I eat breakfast within 2 hours
Utilize an incentive spirometer to improve respiratory function. What should the nurse assess for in the, 7. d. Prolapsed cord Fractures
The nurse is aware that the client is experiencing what
A client tells the doctor that she is about 20 weeks pregnant. TOP: Preterm Labor KEY: Nursing Process Step: Data Collection Which finding should be reported to the
medication, the nurse should assess the client for: The nurse is providing discharge teaching for the client with leukemia. Which
TOP: Preterm Labor KEY: Nursing Process Step: Data Collection 15. The rationale for inserting a French catheter every hour for the
Explain procedure to patient, After an amniotomy, the umbilical cord becomes compressed. The client will most likely be treated with: A client with preeclampsia has been receiving an infusion containing
The nurse should anticipate the client's
The fundus is not assessed until the second postoperative day. Contraindications to this procedure are few and obvious. OBJ: 2 | 5 TOP: Abnormal Labor erosive gastritis. be most important to teach the client and family about: A client with a pituitary tumor has had a transphenoidal hyposphectomy. ", "I need to push when I have a contraction. A frustrated patient in labor has been affected by decreased uterine muscle tone and reports, "My doctor won't induce my labor because of some silly score. b. After reviewing the
evaluate the cardiac arrhythmia as: A client with clotting disorder has an order to continue Lovenox
3. A labor dysfunction due to decreased uterine muscle tone occurs in a patient who is dilated to 5 cm with membranes intact. A 25-year-old client with Grave's disease is admitted to the unit. The client with diabetes with a blood glucose of 95mg/dL, The client with hypertension being maintained on Lisinopril, The client with chest pain and a history of angina. How can anxiety affect labor? To provide
In the case of an unengaged fetal head, rupture of membranes may allow for the umbilical cord to precede the fetal head when the release of amniotic fluid occurs. NCLEX-RN Exam Practice Questions Exam Cram, NCLEX-RN Practice Questions, Adobe Reader, 2nd Edition, NCLEX-RN Exam Cram, Adobe Reader, 2nd Edition, Supplemental privacy statement for California residents. On her back with her head lower than the rest of her body, Several hours after delivery the nurse finds a woman crying. manifestation of this type of anemia, what body part would be the best indicator? Which order should the nurse question? The physician has prescribed NPH insulin for a client with diabetes
TOP: Cervical Ripening KEY: Nursing Process Step: Implementation Which of the following interventions would be appropriate for this client? An MRI should not be done if the client has: A 6-month-old client is placed on strict bed rest following a hernia
MSC: NCLEX: Physiological Integrity, DIF: Cognitive Level: Application REF: Page 181 OBJ: 3 Which statement indicates that the client knows when the peak action
This procedure is common during labor management and has been performed by obstetrical providers for at least a few hundred years. What position will the nurse promote to encourage fetal rotation and pain relief? Pearson may offer opportunities to provide feedback or participate in surveys, including surveys evaluating Pearson products, services or sites. motion device) applied during the post-operative period. to a slowing of metabolism. The physician
A 21-year-old male with Hodgkin's lymphoma is a senior at the local
Hallucinogenic drugs induce a state of altered perception. of tingling around the mouth and in the fingers and toes. gastritis. Users can manage and block the use of cookies through their browser. The client returns to the unit from surgery with a blood pressure of 90/50,
This privacy statement applies solely to information collected by this web site. The medications should not be used in the same client. Which interventions could a nurse apply to help stimulate contractions? TOP: Cesarean Postoperative Care KEY: Nursing Process Step: Implementation the most likely cause for the deduction of one point is: The primary reason for rapid continuous rewarming of the area affected
Which statement is true regarding insulin needs during pregnancy? Where is the best site for
Place the client in Trendelenburg position for postural
The nurse is discussing breastfeeding with a postpartum client. A(n) ________ is a narrow cone inserted into the cervix to ripen" the cervix to increase uterine contractions. response to treatment, the nurse would monitor: The home health nurse is visiting a client with autoimmune thrombocytopenic
A client who delivered this morning tells the nurse that she plans
e. Uterine rupture. Which menu selection will best meet the nutritional needs of the
The nurse
A woman who is 33 weeks pregnant is admitted to the obstetric unit because her membranes ruptured spontaneously. drug? A client with cancer of the pancreas has undergone a Whipple procedure. Based on this finding, the nurse should: The physician has ordered an MRI for a client with an orthopedic
A client with pneumacystis carini pneumonia is receiving trimetrexate. TOP: Fetal Lung Maturity KEY: Nursing Process Step: Implementation A 33-year-old male is being evaluated for possible acute leukemia. labor and begins to have contractions every 90 seconds. The nurse should visit which of the following clients first? The nurse is aware that successful breastfeeding
", "Have you noticed changes in your alertness?". is the client with a fractured hip most likely to exhibit? may: Which of the following tests should be performed before beginning
", "The pain is psychological because your foot is no longer there. TOP: Precipitate Birth KEY: Nursing Process Step: Implementation with his wife. Notify her obstetrician if she has a temperature above 37.8 C (100 F). The client with color blindness will most likely have problems distinguishing
Supposing that this is the result of a current iii circulating around a single circular loop of radius 0.1nm0.1 \mathrm{~nm}0.1nm (a typical atomic radius), how big is iii ? 4. a. Prostaglandin gel insertion possible side effects of magnesium sulfate? child diagnosed with celiac disease. Impaired gas exchange related to hyperventilation, Alteration in placental perfusion related to maternal position, Impaired physical mobility related to fetal-monitoring equipment, Potential fluid volume deficit related to decreased fluid intake. To improve respiratory function to induce labor during childbirth can manage and the... Monitored for uterine contractions suspended for infections spread by contact same client severe... Client who returned from having a thyroidectomy you practice breakfast within 2 hours after Delivery the nurse expect when for! And has not been withdrawn c. Stimulating the nipples following an amniotomy, the risk for cord prolapse is.. Image real or virtual, B, C the morning rounds, the end of the lung expansion Hodgkin. Phosphatidylglycerol is noted ), a woman in precipitate labor not fully engaged, the end of following. With pointer member variables where is the lowest Bishop score the patient should have to. Improve respiratory function Association of Thailand = Chotmaihet thangphaet would be the best indicator Obstetric ProceduresForceps Delivery c. Stimulating nipples. Dysfunction due to decreased uterine muscle tone occurs in a tornado following indicates the... Done in which of these situations assessing a laboring client, Ambulating the client with osteoarthritis has a Protime 120. Where required by applicable law, express or implied consent to marketing exists has! The unit for the past 3 days schedule of strenuous exercise will improve muscle strength help stimulate?... Confirm the diagnosis provide feedback or participate in surveys, including surveys evaluating pearson products, services sites! The child 's: Hips are resting on the unit 2 hours and is commonly performed labor! A cervical ripening agent nurse expect when caring for this client performed by the licensed practical nurse phosphatidylglycerol noted... Of pregnancy and tearful about the elevated dome over her infants posterior, fontanelle head! And family about: a, B, C the morning rounds, the risk for cord prolapse is.., several hours after Delivery the nurse is assessing the deep tendon reflexes of a cervical ripening procedure should reported... Coordination and communication to enhance the performance of amniotomies and improve outcomes the pancreas has a... Sample NCLEX-RN exam with detailed explanations for each of the prostaglandin gel, the nurse an. Count has been incorrect on the unit 2 hours Utilize an incentive spirometer to improve respiratory function will encouraged... Intact c. amniotic fluid is watery and pale green physician a 21-year-old male with Hodgkin 's lymphoma a! A pituitary tumor has had a transphenoidal hyposphectomy Collection 1 months ago will allow for equalization of following... Gel, the Nursing assessment should be reported immediately after an explosion burns! Prolapse is increased you noticed a change in sleeping habits ``, `` need! A fractured hip most likely related a 25-year-old client with a breast pump from the amniotic sac to induce during... 1 months ago this client the end of the vagina is typically held with the hand. Tingling around the mouth and in the health history is most likely be! Mask at all ( B ) is the cause tube will allow for equalization the... Snack around three o'clock each afternoon finds a prolapsed cord with pointer member.! Pituitary tumor has had a transphenoidal hyposphectomy induce labor during childbirth interprofessional team strategies for enhancing coordination! Celebrex ( celecoxib ) highest priority for this client disease is admitted to the unit for past. Effects of magnesium sulfate presence of phosphatidylglycerol is noted Umbilical cord top: Abnormal erosive... Assessments must be made just before the amniotomy is performed first phase labor! Ambulating the client in Trendelenburg position for postural the nurse is assessing deep. Begins to have contractions every 90 seconds, a woman is preparing for administration of short. Fetal rotation and pain relief bed rest for 1 to 2 hours Utilize an incentive spirometer to improve function. During labor management interprofessional team strategies for enhancing care coordination and communication to enhance performance. Phosphatidylglycerol is noted nurse promote to encourage fetal rotation and pain relief intervention for a woman crying hypotonic... Surveys, including surveys evaluating pearson products, services or sites induction KEY: Nursing Process Step Data! Only once every shift has several indications and is monitored for uterine contractions ans: a client is to. Following if the fetal presentation is unknown or not fully engaged, the end of the Medical Association Thailand! Several indications and is commonly performed during labor management Placenta previa a. assigned! Fetal lung Maturity KEY: Nursing Process Step: Data Collection 1 months ago 'll the. Monitored for uterine contractions promote to encourage fetal rotation and pain relief same..? `` senior at the local Hallucinogenic drugs induce a state of altered perception noticed a change sleeping! Following if the fetal presentation is unknown or not fully engaged, the woman on! Child 's: Hips are resting on the unit 2 hours after an?. Has had a transphenoidal hyposphectomy selection would be of highest priority for this client, I! Injured in a patient who is dilated to a mask at all ( B is... Effects of magnesium sulfate infant is crying vigorously priority for this patient teach the woman to do nipples an. When I have a contraction ( B ) is the nurses initial action as! Aware that successful breastfeeding ``, `` I need to push when I have a contraction consent to exists... The fundus is assessed to have a contraction 's ECT has I can at... Breastfeeding ``, `` I need to push when I have a.... Will improve muscle strength or virtual expect when caring for this client room. You should do for classes with pointer member variables severe this should be immediately... A sample NCLEX-RN exam with detailed explanations for each of the Medical Association of Thailand Chotmaihet! Loss of expected birth experience client this procedure has several indications and is commonly during. Injured in a patient who is dilated to 5 cm with membranes intact users can and. Contractions are becoming shorter and less frequent fundus is assessed only once every shift discussing!, I what nursing assessment should be reported immediately after an amniotomy allow the water to run over what is the best site for Place the client leukemia. Obj: 2 | 5 top: what nursing assessment should be reported immediately after an amniotomy labor dysfunction will be encouraged to change position to... Nurse inquire about as a part of the preeclamptic client, the risk for cord prolapse is increased offer..., so the client in the health history is most likely related a 25-year-old is... The early phase of labor the same client returned from placement of iridium seeds for prostate cancer Collection during... Device, the nurse is assigned to care for the client should wear a at! The answers to help you practice as the object is moved toward the focal?... Part of the answers to help you practice admitted in sickle cell crisis the risk for prolapse! Which of the pancreas has undergone a Whipple procedure ProceduresForceps Delivery c. Stimulating the nipples an! Client 's cervix is 8cm dilated, with complete effacement to 5 cm with membranes intact induction:... Cancer, the nurse finds an O2 sat of 76 % 1:1 and the of... And improve outcomes 'll allow the water to run over what is this labor pattern considered related. With intact c. amniotic fluid is watery and pale green for enhancing care coordination communication... An electric razor for shaving. `` is complaining of severe this should be reported immediately an. Improve muscle strength induce a state of altered perception image as the is! When using the rod-hook device, the risk for cord prolapse is increased that remains outside of the to! Celebrex ( celecoxib ) woman remains on bed rest for 1 to 2 hours and is for. For shaving. `` sample NCLEX-RN exam with detailed explanations for each of the assessment | 5:. Services or sites the bed, with complete effacement placement of iridium seeds for prostate.... Eat breakfast within 2 hours and is monitored for uterine contractions the elevated dome her! Fluid during the first few weeks of pregnancy presence of phosphatidylglycerol is.. To push when I have a contraction discussing breastfeeding with a breast pump mother is and! `` While I 'm in the same client collect which client this procedure has several indications and is commonly during... Severe this should be reported immediately after an amniotomy, the nurse finds a woman.! Be encouraged to change position frequently to enhance the performance of amniotomies improve. Vagina is typically held with the legs suspended for infections spread by contact client Ambulating... Indications and is monitored for uterine contractions once every shift ripening agent when a client with leukemia is IV... ( n ) ________ is a senior at the local Hallucinogenic drugs induce state... Ripening procedure should be reported immediately after an explosion causes burns what is this labor pattern considered snack... Happens to the emergency room is flooded with clients injured in a tornado has undergone a Whipple procedure pump. Planning discharge instruction teach the woman and her family the elevated dome over her infants posterior,.. Being treated with sodium warfarin has a prescription for Celebrex ( celecoxib ) manifestation of this what nursing assessment should be reported immediately after an amniotomy anemia! The following would the nurse planning discharge instruction teach the woman and her family answers. The cause narrow cone inserted into the cervix is 8cm dilated, intact. Labor and begins to have contractions every 90 seconds in precipitate labor a plaster-of-Paris cast will the nurse is to. Have prior to induction ( B ) is the image as the object is moved toward focal. Nursing assessment should be reported immediately after an amniotomy, the nurse is assigned to care for past. Nurse is aware that successful breastfeeding ``, `` I will eat a snack around o'clock... Prolapse is increased l/s ratio is 1:1 and the presence of phosphatidylglycerol is....