When membranes are ruptured, the fluid is green in color. The ...

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When membranes are ruptured, the fluid is green in color. The nurse knows that this meconium-stained fluid must be reported because at delivery
 
  a. the baby will need prophylactic antibiotics
  b. the mother will need prophylactic antibiotics
  c. the baby will need double the amount of eye ointment
  d. the baby will need suctioning prior to the delivery of the shoulders

Question 2

For women who have a history of sexual abuse, a number of traumatic memories may be triggered during labor. The woman may fight the labor process and react with pain or anger.
 
  Alternately she may become a passive player and emotionally absent herself from the process. The nurse is in a unique position of being able to assist the woman to asso-ciate the sensations of labor with the process of childbirth and not the past abuse. The nurse can implement a number of care measures to help the woman view the childbirth experience in a positive manner. Which intervention would be key for the nurse to use while providing care? a. Telling the woman to relax and that it won't hurt much
  b. Limiting the number of procedures that invade her body
  c. Reassuring the woman that as the nurse you know what is best
  d. Allowing unlimited care providers to be with the woman

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Answer to Question 1

D
As soon as the head delivers, the infant must have the nose and mouth suctioned prior to taking its first breath to prevent chance of further aspiration. The baby needing eye ointment refers to exposure to gonococcal infections, but the dose is not doubled in that event. Prophylactic antibiotics is not a standard of care, unless the neonate is symptomatic for aspiration. Remember, meconium stool is sterile. Also, prophylactic antibiotics for mother is not a standard of care.

Answer to Question 2

B

Feedback
A The nurse should always avoid words and phrases that may result in the patient's recalling the phrases of her abuser (e.g., Relax, this won't hurt or Just open your legs.)
B The number of invasive procedures such as vaginal examinations, internal mon-itoring, and intravenous therapy should be limited as much as possible.
C The woman's sense of control should be maintained at all times. The nurse should explain procedures at the woman's pace and wait for permission to pro-ceed.
D Protecting the woman's environment by providing privacy and limiting the number of staff who observe the woman will help to make her feel safe.

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Excellent