A nurse is preparing to perform Leopold maneuvers on a client who is at 36 weeks of gestation. Identify the sequence of actions the nurse should take.

Position the client supine with knees flexed and place a small, rolled towel under one of their hips.

Palpate the fetal part positioned above the symphysis pubis.

Instruct the client to empty their bladder.

Palpate the fetal part positioned in the fundus.

Palpate the fetal parts along both sides of the uterus.

Answer and Explanation

The Correct Answer is C, A, D, E, B

The Leopold maneuvers are a common and systematic way to determine the position of a fetus inside the woman’s uterus. They are typically performed at prenatal examinations during the third trimester of pregnancy. Here is the correct sequence of actions a nurse should take: Instruct the client to empty their bladder. This is done to make the examination easier and more comfortable for the client ©. Position the client supine with knees flexed and place a small, rolled towel under one of their hips. This position helps relax the abdominal muscles and displaces the uterus to the side, reducing the risk of supine hypotensive syndrome (a). Palpate the fetal part positioned in the fundus. This helps determine the fetal lie and presentation (d). Palpate the fetal parts along both sides of the uterus. This helps identify the location of the fetal back and small parts (e). Palpate the fetal part positioned above the symphysis pubis. This helps determine the fetal attitude and degree of extension or flexion of the fetal head (b). Remember, these maneuvers should be performed gently and respectfully, with the nurse explaining each step to the client. The goal is to assess the position and presentation of the fetus, as well as estimate fetal weight, not to change the position of the fetus. If the nurse is unsure about the position or presentation of the fetus, an ultrasound may be needed for confirmation.

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Correct Answer is ["A","D"]

Explanation

Choice A rationale
Vacuum-assisted delivery is indeed a risk factor for postpartum hemorrhage. This method of delivery can cause trauma to the birth canal, which can lead to increased bleeding after delivery.
Choice B rationale
A history of human papillomavirus (HPV) is not typically associated with an increased risk of postpartum hemorrhage.
Choice C rationale
The newborn’s weight, whether high or low, is not typically considered a risk factor for postpartum hemorrhage.
Choice D rationale
Labor induction with oxytocin is a risk factor for postpartum hemorrhage. Oxytocin is a drug that can cause the uterus to contract too much, leading to uterine atony (a condition where the uterus doesn’t contract properly after birth), which can result in postpartum hemorrhage.

A. Aspirin B. Meperidine C. Fentanyl citrate D. Ibuprofen

Correct Answer is D

Explanation

Choice A rationale
Aspirin is generally not recommended for postpartum pain management due to its anticoagulant properties, which can increase the risk of bleeding. Furthermore, if the mother is breastfeeding, aspirin can pass into breast milk and potentially harm the baby.
Choice B rationale
Meperidine is a strong opioid medication that is typically reserved for severe pain. It is not usually the first choice for postpartum pain management due to its potential side effects and the risk of dependency.
Choice C rationale
Fentanyl citrate is a potent opioid that is typically used for severe pain and is often used in anesthesia. It is not usually used for routine postpartum pain management due to its potency and the risk of side effects and dependency.
Choice D rationale
Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that is commonly used for postpartum pain management. It is effective for relieving perineal pain and uterine cramping, and it is safe for use in breastfeeding mothers.

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A nurse is preparing to perform Leopold maneuvers on a client who is at 36 weeks of gestation. Identify the sequence of actions the nurse should take.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reviewing the medical record of a client who had a vaginal delivery 3 hours ago.Which of the following findings place the client at risk for postpartum hemorrhage? (Select all that apply)

Correct Answer is ["A","D"]

Explanation

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Correct Answer is D

Explanation

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