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Author Question: The patient has delivered a 4200g fetus. The physician performed a midline episiotomy, which ... (Read 37 times)

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The patient has delivered a 4200g fetus. The physician performed a midline episiotomy, which extended into a third-degree laceration. The patient asks the nurse where she tore. Which response is best? The episiotomy extended and tore:
 
  1. Through your rectal mucosa.
  2. Up near your urethra.
  3. Into the muscle layer.
  4. Through your rectal sphincter.

Question 2

A telephone triage nurse gets a call from a postpartum client who is concerned about jaundice. The client's newborn is 37 hours old. What data point should the nurse gather first?
 
  1. Stool characteristics
  2. Fluid intake
  3. Skin color
  4. Bilirubin level



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Mholman93

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Answer to Question 1

4
Rationale 1: A fourth-degree laceration is through the rectal mucosa.
Rationale 2: A periurethral laceration is near the urethra.
Rationale 3: A first-degree laceration involves only the skin. A second-degree laceration involves skin and muscle.
Rationale 4: A third-degree laceration includes the rectal sphincter.

Answer to Question 2

3
Explanation: 3. Jaundice (icterus) is the yellowish coloration of the skin and sclera caused by the presence of bilirubin in elevated concentrations. Inspection of the skin would be the first step in assessing for jaundice.





 

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