The nurse palpates a postpartum client's fundus two hours after birth and finds it located to the right of midline and somewhat soft. What does the nurse understand about this information?

The nurse notices a decreased fetal heart rate (FHR) on the fetal monitor tracing and contacts the charge nurse. The charge nurse completes a vaginal exam and can feel a portion of the umbilical cord in the vagina.

Which emergency interventions will the charge nurse implement? Select all that apply.

IV calculations: (rate-mL/h and gtt/min)

IV rate calculations will be rounded to nearest whole number.

.Adult calculations: the calculation will be rounded to the nearest tenth.

.Drug Calculation safety considerations:

• Examples:
  • 5 must be answered as 0.5
  • 5.0 must be answered as 5

To promote safety, a zero must be placed to the left of the decimal point in answers that are less than one. No zero is allowed to the right of the decimal point in answers that are whole numbers. Labeling is not necessary.

Question

The nurse is caring for a client in preterm labor. The physician orders magnesium sulfate to stop her contractions. The order reads 30 grams magnesium sulfate in 1000 mL of mL/hr DSW to infuse at 2 grams/hr. What will be the flow rate in mL/hr?

The nurse is completing a fundal assessment for her postpartum clients today. What will the nurse determine when assessing the fundus?

IV calculations: (rate-mL/h and gtt/min)

.IV rate calculations will be rounded to nearest whole number.

• Adult calculations: the calculation will be rounded to the nearest tenth Drug Calculation safety considerations:
• Examples:
  • 5 must be answered as 0.5
  • 5.0 must be answered as 5
• To promote safety, a zero must be placed to the left of the decimal point in answers that are less than one. No zero is allowed to the right of the decimal point in answers that are whole numbers. Labeling is not necessary

Question

The physician ordered oxytocin 20 units in 1000 mL. LR to begin at 2 mU/min. What is the flow rate in mL/hr?

The nurse is caring for a client in labor. Assessment reveals that the fetus is in a vertex presentation and at -4 station. What does the nurse determine as the position of the fetal head?

The nurse is caring for a laboring client with early decelerations and a fetal heart rate baseline of 130 with moderate variability. What will the nurse do for this client?

The nurse is caring for a client with contractions every 2-3 minutes, moderate to palpation, with a duration of 45-60 seconds. The client is having a difficult time breathing through contractions and is requesting something for pain. The client is 5 cm dilated, 80% effaced, and at a -1 station.

Which pain relief measure would be most effective for this client?

The nurse is assisting a pregnant patient into bed after the patient reports a gush of fluid from the vagina. Which action will the nurse take first?

IV calculations: (rate-mL/h and gtt/min)

IV rate calculations will be rounded to nearest whole number.

Adult calculations: the calculation will be rounded to the nearest tenth. Drug Calculation safety considerations:

Examples:

5 must be answered as 0.5

5.0 must be answered as 5

To promote safety, a zero must be placed to the left of the decimal point in answers that are less than one. No zero is allowed to the right of the decimal point in answers that are whole numbers.

Labeling is not necessary

Question

The nurse received report for the client at 1400. The client was given medication through her NG tube at 1800: Ampicillin 20 mL, Pepcid 10 mL, and Reglan 15 mL. After each medication was given, there was a 30 mL flush with water. Her Hemovac drained 320 mL. Her chest tube drained 210 mL. At 2000, she drank 240 mL of water. Her IV was infusing @ 150mL/hour when report was received. She has voided 275 mL. 325 mL and 310 mL.

What is her I&O from 1400- 2200?

(Separate the answers with a comma)

The nurse is admitting a pregnant client into the labor and delivery unit. Which findings indicate the client is in the latent phase of the first stage of labor? Select all that apply.