A patient had a cesarean birth 3 days ago. She has tenderness, ...

[segrsyd]

A patient had a cesarean birth 3 days ago. She has tenderness, localized heat, and redness of the left leg. She is afebrile. As a result of these symptoms, the nurse recognizes that the patient will most likely be:
 
  1. Encouraged to ambulate freely.
  2. Given aspirin 650 mg by mouth.
  3. Given Methergine IM.
  4. Placed on bed rest.

Question 2

The nurse is caring for laboring clients. Which women are experiencing problems related to a critical factor of labor? Note: Credit will be given only for all correct choices and no incorrect choices. Select all that apply.
 
  1. Woman at 7 cm, fetus in general flexion
  2. Woman at 3 cm, fetus in longitudinal lie
  3. Woman at 4 cm, fetus with transverse lie
  4. Woman at 6 cm, fetus at -2 station, mild contractions
  5. Woman at 5 cm, fetal presenting part is right shoulder

[sokh]

Answer to Question 1

4
Rationale 1: Ambulation would increase the inflammation.
Rationale 2: Aspirin 650 mg by mouth has anticoagulant properties, but usually is not necessary unless complications occur.
Rationale 3: Methergine is given only for postpartum hemorrhage, and would only cause vasoconstriction of an already inflamed vessel.
Rationale 4: These symptoms indicate the presence of superficial thrombophlebitis. The treatment involves bed rest, elevation of the affected limb, analgesics, and use of elastic support hose.

Answer to Question 2

3, 4, 5
Explanation: 3. A transverse lie occurs when the cephalocaudal axis of the fetal spine is at a right angle to the woman's spine and is associated with a shoulder presentation and can lead to complications in the later stages of labor.
4. Station refers to the relationship of the presenting part to an imaginary line drawn between the ischial spines of the maternal pelvis. If the presenting part is higher than the ischial spines, a negative number is assigned, noting centimeters above zero station. A -2 station is high in the pelvis. Contractions should be strong to cause fetal descent. Mild contractions will not move the baby down or open the cervix. This client is experiencing a problem between the maternal pelvis and the presenting part.
5. When the fetal shoulder is the presenting part, the fetus is in a transverse lie and the acromion process of the scapula is the landmark. This type of presentation occurs less than 1 of the time. This client is experiencing a problem between the maternal pelvis and the presenting part.

[segrsyd]

Thank you

[sokh]

No problemo