The nurse is preparing to administer oxytocin to a laboring client.

The nurse notes the patient's oxytocin infusion is set at 10 mL/hr. The IV bag contains 20 units of oxytocin mixed in 500 mL Lactated Ringer's. How many mU/min of oxytocin is the patient receiving? Round to the nearest tenths place. Record numerical answers only.

Choice A rationale

While certain maternal health conditions, such as severe heart disease, can affect the timing of the return to ovulation, conception is still possible and occurs frequently in the postpartum period. Ovulation typically returns about 4 to 6 weeks after birth in non-lactating women, necessitating the use of effective contraception for all sexually active women who wish to avoid pregnancy, especially those with high-risk conditions.

Choice B rationale

Barrier methods like foam with a condom are less effective than many other forms of contraception, with a typical use failure rate of about 13-21.

Choice C rationale

Combined oral hormonal contraceptives (COCs), which contain both estrogen and progestin, are generally contraindicated in women with certain types of heart disease (e.g., ischemic heart disease, heart failure) and diabetes with vascular complications, due to the increased risk of thromboembolism and cardiovascular events associated with estrogen exposure.

Choice D rationale

The intrauterine device (IUD) is an excellent choice for a postpartum client with heart disease and type 2 diabetes because it is a long-acting reversible contraceptive (LARC), which is one of the most effective methods (typical failure rate <1%) and its effects are local or progestin-only (if hormonal), which avoids the systemic risks associated with estrogen-containing contraceptives.

Choice A rationale

Half sit-ups involve contracting the abdominal muscles, which is generally discouraged, especially later in pregnancy, due to the risk of exacerbating diastasis recti, which is the separation of the rectus abdominis muscles. Exercises that strain the core are contraindicated as they place excessive stress on the already stretched abdominal wall and ligaments.

Choice B rationale

The pelvic tilt (or pelvic rocking) is a recommended exercise often performed on the hands and knees or on the back. This movement helps to strengthen the abdominal and lower back muscles, improve posture, reduce backache by promoting lumbar flexion, and can encourage the baby to move into an optimal position for delivery.

Choice C rationale

Pelvic rocking (or pelvic tilt) is a recommended exercise that involves alternating between arching and flattening the back. This exercise helps to relieve lower back pain by strengthening the abdominal and back muscles, promotes flexibility, and encourages better alignment of the pelvis, which can also prepare the pelvis for labor.

Choice D rationale

Kegel exercises involve the rhythmic contraction and relaxation of the pelvic floor muscles (pubococcygeus muscle). These exercises are highly recommended as they strengthen the muscles supporting the uterus, bladder, and bowel, which helps prevent urinary incontinence during and after pregnancy, and may aid in pushing during labor.