Following a cesarean birth, a patient is prescribed to receive ...

[Mimi]

Following a cesarean birth, a patient is prescribed to receive intravenous fluids. At which time should the nurse anticipate that this patient will be able to resume an oral intake?
 
  A) 24 hours postprocedure
  B) 48 hours postprocedure
  C) When bladder tone returns
  D) When bowel sounds return

Question 2

A patient who has been in labor for 20 hours is being prepared for an emergent cesarean birth. Which action will help ensure the patient's fluid status during the procedure?
 
  A) Provide with a clear liquid tray.
  B) Encourage intake with ice chips.
  C) Initial intravenous fluid therapy.
  D) Administer an antiemetic as prescribed.

[momtoalll]

Answer to Question 1

D
Feedback:
Patients are kept at nothing by mouth status for a period of time after surgery until intestinal peristalsis has returned. To establish this is returning, the patient's abdomen should be assessed at least once every 8 hours for bowel sounds because this demonstrates air and fluid are moving through the intestines. As soon as bowel sounds return, IV fluid therapy is usually discontinued and the patient can slowly begin oral intake with fluids. Oral intake may or may not be permitted 24 to 48 hours after the procedure. Oral intake is not contingent on bladder tone.

Answer to Question 2

C
Feedback:
A patient who enters surgery with a lower than usual blood volume will experience the effect of surgical blood loss more than a patient who has a normal blood volume. A patient who has had a long labor before a cesarean birth is scheduled may fall into this category, because the patient may have had little to eat or drink for almost 24 hours. Intravenous fluid replacement needs to be initiated preoperatively and continued postoperatively to prevent a serious fluid or electrolyte imbalance. Since surgery is imminent, the patient should be kept at nothing by mouth status, which means no ice chips or clear liquids. An antiemetic is not indicated for the patient at this time.