The nurse has received an end of shift report on the postpartum ...

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The nurse has received an end of shift report on the postpartum unit. Which patient should she see first?
 
  1. Multip, second day post-cesarean, moderate lochia serosa
  2. Primip, day of delivery, fundus firm 2 cm above umbilicus
  3. Multip, first postpartum day, 4 cm diastasis recti abdominis
  4. Primip, first postpartum day, hypoactive bowel sounds all quadrants

Question 2

One day after giving birth vaginally, a patient develops painful vesicular lesions on her perineum and vulva. She is diagnosed with a primary herpes simplex II infection. The expected care for her neonate includes:
 
  1. Meticulous hand washing and antibiotic eye ointment administration.
  2. Intravenous acyclovir (Zovirax) and contact precautions.
  3. Cultures of blood and CSF and serial chest X-rays every 12 hours.
  4. Parental rooming-in and four intramuscular injections of penicillin.

[Viet Thy]

Answer to Question 1

Correct Answer: 2
Rationale 1: This patient is not experiencing any unexpected findings.
Rationale 2: This patient is the top priority. The fundus should not be positioned above the umbilicus after delivery. This high location could indicate an overdistended bladder or uterine atony and excessive bleeding.
Rationale 3: This finding is normal, especially in a multiparous patient.
Rationale 4: Bowel sounds are often decreased after delivery.

Answer to Question 2

Correct Answer: 2
Rationale 1: Although meticulous hand washing by staff and parents is important, antibiotic eye ointment is used for conjunctivitis of gonorrhea or Chlamydia.
Rationale 2: These are appropriate cares for an infant at risk for developing herpes simplex II infection.
Rationale 3: These cultures are appropriate, but chest X-rays are not indicated. Chest X-rays are obtained if the neonate is thought to have group B strep pneumonia.
Rationale 4: Parental rooming-in is encouraged, but penicillin does not treat viral illness. Penicillin is the drug of choice for syphilis infections.

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Thank you

[Viet Thy]

No problemo