Which of the following would be essential to implement to prevent late postpartum hemorrhage? Select one:

Inspecting the placenta after delivery for intactness.

Manually removing the placenta at delivery.

Administering broad-spectrum antibiotics prophylactically.

Applying traction on the umbilical cord to speed up separation of the placenta.

Answer and Explanation

The Correct Answer is A

Choice A Reason: Inspecting the placenta after delivery for intactness. This is because inspecting the placenta after delivery for intactness is a nursing intervention that can prevent late postpartum hemorrhage, which is excessive bleeding from the uterus or genital tract that occurs more than 24 hours but less than 12 weeks after delivery. Late postpartum hemorrhage can be caused by retained placental fragments, subinvolution of the uterus, infection, or coagulation disorders. Inspecting the placenta after delivery for intactness can help identify and remove any retained placental fragments that may interfere with uterine contraction and involution, which are essential for hemostasis.

Choice B Reason: Manually removing the placenta at delivery. This is an incorrect answer that indicates an inappropriate and risky intervention that can cause late postpartum hemorrhage. Manually removing the placenta at delivery is a procedure that involves inserting a hand into the uterus and detaching the placenta from the uterine wall. Manually removing the placenta at delivery is indicated only for a retained or adherent placenta that does not separate spontaneously or with gentle traction within 30 minutes after delivery. Manually removing the placenta at delivery can cause trauma, infection, or incomplete removal of the placenta, which can increase the risk of late postpartum hemorrhage.

Choice C Reason: Administering broad-spectrum antibiotics prophylactically. This is an incorrect answer that suggests an unnecessary and ineﬀective intervention that can prevent late postpartum hemorrhage. Administering broad- spectrum antibiotics prophylactically is a pharmacological intervention that involves giving antibiotics to prevent or treat infection. Administering broad-spectrum antibiotics prophylactically is indicated for women with risk factors or signs of infection during or after delivery, such as prolonged rupture of membranes, chorioamnionitis, fever, or foul- smelling lochia. Administering broad-spectrum antibiotics prophylactically may reduce the risk of infection-related late postpartum hemorrhage, but it does not address other causes of late postpartum hemorrhage such as retained placental fragments or subinvolution of the uterus.

Choice D Reason: Applying traction on the umbilical cord to speed up separation of the placenta. This is an incorrect answer that refers to a diﬀerent intervention that can prevent early postpartum hemorrhage, not late postpartum hemorrhage. Applying traction on the umbilical cord to speed up separation of the placenta is a technique that involves pulling on the umbilical cord while applying counter pressure on the uterus to facilitate placental expulsion. Applying traction on the umbilical cord to speed up separation of the placenta is indicated for active management of the third stage of labor, which can prevent early postpartum hemorrhage, which is excessive bleeding from the uterus or genital tract that occurs within 24 hours after delivery. Early postpartum hemorrhage can be caused by uterine atony, retained placenta, lacerations, or coagulation disorders.

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Correct Answer is D

Explanation

Choice A Reason: Respiratory rate of 16. This is an incorrect answer that indicates a normal finding that does not suggest magnesium sulfate toxicity. Respiratory rate is a measure of the number of breaths per minute, which reﬂects the respiratory function and oxygenation status. Respiratory rate of 16 is within the normal range for adults, which is 12 to 20 breaths per minute. Respiratory rate of 16 does not indicate magnesium sulfate toxicity, which can cause respiratory rate below 12 breaths per minute.

Choice B Reason: Complaints by the client of feeling ﬂushed and warm. This is an incorrect answer that indicates a common side eﬀect that does not indicate magnesium sulfate toxicity. Feeling ﬂushed and warm are sensations that are caused by vasodilation (widening of blood vessels), which can occur as a result of magnesium sulfate administration. Feeling ﬂushed and warm are not signs of magnesium sulfate toxicity, but rather expected and mild reactions that usually subside within a few hours.

Choice C Reason: Fetal heart rate of 120. This is an incorrect answer that indicates a normal finding that does not suggest magnesium sulfate toxicity. Fetal heart rate is a measure of the number of beats per minute of the fetal heart, which reﬂects the fetal well-being and oxygenation status. Fetal heart rate of 120 is within the normal range for fetuses, which is 110 to 160 beats per minute. Fetal heart rate of 120 does not indicate magnesium sulfate toxicity, which can cause fetal heart rate below 110 beats per minute or above 160 beats per minute.

Choice D Reason: Patellar reﬂexes are absent. This is because absent patellar reﬂexes are a sign of magnesium sulfate toxicity, which is a condition where the level of magnesium in the blood is too high, which can cause adverse eﬀects on the neuromuscular and cardiovascular systems. Magnesium sulfate is a medication that is used to prevent or treat preterm labor, which is labor that occurs before 37 weeks of gestation. Magnesium sulfate works by relaxing the uterine muscles and inhibiting uterine contractions. However, magnesium sulfate can also aﬀect other muscles and nerves in the body, and cause symptoms such as muscle weakness, respiratory depression, hypotension, or cardiac arrest.

A. Rule out a suspected hydatidiform mole. B. Assess for congenital anomalies. C. Determine fetal presentation. D. Monitor fetal growth.

Correct Answer is D

Explanation

Choice A Reason: Rule out a suspected hydatidiform mole. This is an incorrect answer that describes an unlikely condition for this client. A hydatidiform mole is a type of gestational trophoblastic disease where abnormal placental tissue develops instead of a normal fetus. A hydatidiform mole can cause vaginal bleeding, hyperemesis gravidarum (severe nausea and vomiting), preeclampsia, and hyperthyroidism. A hydatidiform mole usually causes a fundal height measurement that is larger than expected for gestational age, not smaller.

Choice B Reason: Assess for congenital anomalies. This is an incorrect answer that implies that the client has not had a previous ultrasound to screen for fetal anomalies. Congenital anomalies are structural or functional defects that are present at birth, such as cleft lip, spina bifida, or Down syndrome. Ultrasound can detect some congenital anomalies by visualizing the fetal anatomy and morphology. However, ultrasound screening for fetal anomalies is usually done between 18 and 22 weeks of gestation, not at 32 weeks.

Choice C Reason: Determine fetal presentation. This is an incorrect answer that suggests that the client has an uncertain fetal presentation. Fetal presentation is the part of the fetus that is closest to the cervix, such as vertex (head), breech (butocks or feet), or transverse (shoulder). Fetal presentation can aﬀect the mode and outcome of delivery. Ultrasound can determine fetal presentation by locating the fetal head and spine. However, fetal presentation can also be assessed by abdominal palpation or vaginal examination, which are simpler and less invasive methods.

Choice D Reason: Monitor fetal growth. This is because fundal height measurement is a method of estimating fetal size and gestational age by measuring the distance from the pubic symphysis to the top of the uterus (fundus) in centimeters. A fundal height measurement that is significantly smaller or larger than expected for gestational age may indicate intrauterine growth restriction (IUGR) or macrosomia, respectively. IUGR means that the fetal growth is slower than expected for gestational age, which can increase the risk of fetal distress, hypoxia, acidosis, and stillbirth. Macrosomia means that the fetal weight is higher than expected for gestational age, which can increase the risk of birth injuries, shoulder dystocia, cesarean delivery, and hypoglycemia. Ultrasound is a more accurate way of assessing fetal size and growth by measuring various parameters such as biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), and femur length (FL). Ultrasound can also detect other factors that may aﬀect fetal growth such as placental function, amniotic ﬂuid volume, umbilical cord blood ﬂow, and fetal anomalies.

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Which of the following would be essential to implement to prevent late postpartum hemorrhage? Select one:

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Naxlex Comprehensive Predictor Exams

A woman is being treated for preterm labor with magnesium sulfate. Which finding by the nurse indicates magnesium sulfate toxicity? Select one:

Correct Answer is D

Explanation

Correct Answer is D

Explanation

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