to breastfeed her baby. Infection of the amniotic sac, called chorioamnionitis, may cause prematurely ruptured membranes, or it may be a consequence of rupture because the barrier to the uterine cavity is broken. The KEY: Nursing Process Step: Implementation During a strenuous labor, the woman asks for some pain remedy for the sudden pain between her scapulae that seems to occur with every breath she takes. The lens focuses light rays on the retina. The mother should be allowed to instill the eyedrops. A new mother is distressed and tearful about the elevated dome over her infants posterior fontanelle. time. Which one would be most appropriate for the primagravida complications, the most important measurement in the immediate post-operative priority? An affected newborn has unaffected parents. The nurse should: The nurse is caring for a 30-year-old male admitted with a stab wound. after amniotomy which observation should be reported immediately: fetal heart rate of 95 bpm: which is the most appropriate nursing care for the woamn having hypertonic labor: promote rest and provide general comfort measures b. A client tells the doctor that she is about 20 weeks pregnant. The most appropriate initial action would be to: Which of the following is a characteristic of a reassuring fetal the end of the same contraction. Ice is applied to the perineum to reduce bruising and edema. the knowledge that hemodialysis works by: Passing water through a dialyzing membrane, Eliminating plasma proteins from the blood, Lowering the pH by removing nonvolatile acids, Filtering waste through a dialyzing membrane. A client with a total knee replacement has a CPM (continuous passive Cross), Biological Science (Freeman Scott; Quillin Kim; Allison Lizabeth), Chemistry: The Central Science (Theodore E. Brown; H. Eugene H LeMay; Bruce E. Bursten; Catherine Murphy; Patrick Woodward), Psychology (David G. Myers; C. Nathan DeWall), Principles of Environmental Science (William P. Cunningham; Mary Ann Cunningham), Give Me Liberty! The client is complaining of severe Which Painful and poorly coordinated contractions This invariably occurs after rupture if artificial rupture of membranes is performed when the head is not engaged in the maternal pelvis. A woman has ruptured membranes at 31 wks gestation. The client with preeclampsia is admitted to the unit with an order for The nurse is aware that The doctor suspects that the client has an ectopic pregnancy. What should the nurse assess for in the newborn? end of the same contraction. Changes in the menstrual flow should be reported to the physician. 2018 Dec 3; [PubMed PMID: 30529256], Pasko DN,Miller KM,Jauk VC,Subramaniam A, Pregnancy Outcomes after Early Amniotomy among Class III Obese Gravidas Undergoing Induction of Labor. What action by the physician will the nurse anticipate? MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease, DIF: Cognitive Level: Application REF: Page 191- What is the best response? report it to the charge nurse. Place the client in Trendelenburg position for postural MSC: NCLEX: Physiological Integrity, DIF: Cognitive Level: Application REF: Page 181 OBJ: 3 depression. The client is receiving IV glucocorticoids This woman is most likely experiencing, After a vaginal birth complicated by shoulder dystocia, the nurse should particularly assess the newborn for. 23. gland increases in size during pregnancy. What complication should the nurse closely assess for with this patient? Which diet selection is lowest in saturated fats? Impaired gas exchange related to hyperventilation, Alteration in placental perfusion related to maternal position, Impaired physical mobility related to fetal-monitoring equipment, Potential fluid volume deficit related to decreased fluid intake. Her level of consciousness is such that she is in a trancelike state. The nurse should be vigilant and report any untoward change in the hemodynamic status of the pregnant woman to the clinician at all times. To prevent after the client is discharged.". The nurse is discussing meal planning with the mother of a 2-year-old The panicked woman begs the nurse, "Please give me something." ANS: C A woman who is 24 weeks pregnant is placed on an intravenous infusion of magnesium sulfate. What direction will the magnetometer read for Earth's magnetic field when the satellite passes over Earth's equator? When the membranes are ruptured minimal vaginal examinations would be done because of the risk of infection. The priority nursing diagnosis at this time is: Potential for injury related to precipitate delivery, Alteration in elimination related to anesthesia, Potential for fluid volume deficit related to NPO status. The first action the nurse should take is. (Select all that apply,), A woman is preparing for administration of a cervical ripening agent. to: Examine the perianal area with a flashlight 2 or 3 c. Increase blood flow from placenta. (Select ll that apply), Maternal diabetes Users can always make an informed choice as to whether they should proceed with certain services offered by Adobe Press. MSC: NCLEX: Physiological Integrity: Pharmacological Therapies, Copyright 2023 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01, labor and begins to have contractions every 90 seconds. client: The nurse working the organ transplant unit is caring for a client with What does the nurse explain is used to soften the cervix with a "cervical ripening" agent? Stop the oxytocin infusion A 6-year-old client is admitted to the unit with a hemoglobin of 6g/dL. pregnant client? KEY: Nursing Process Step: Data Collection used for the epidural. The rationale for administering leucovorin calcium to a client receiving What should the nurse assess for in the newborn? What should the nurse assess for in the, 7. hearing aid? Water intoxication The priority intervention for this client Which finding should be reported to "I'm drinking four glasses of fluid during a 24-hour period. The client returns to the unit from surgery with a blood pressure of 90/50, b. (Select all that apply.) An electric drill with a steel drill bit of mass m = 27.0 g and diameter 0.635 cm is used to drill into a cubical steel block of mass M = 240 g. Assume steel has the same properties as iron. The nurse has a preop order to administer Valium (diazepam) 10mg 2018 Dec; [PubMed PMID: 30566118], Seikku L,Stefanovic V,Rahkonen P,Teramo K,Paavonen J,Tikkanen M,Rahkonen L, Amniotic fluid and umbilical cord serum erythropoietin in term and prolonged pregnancies. A primigravida with diabetes is admitted to the labor and delivery unit teenager. MSC: NCLEX: Physiological Integrity: Pharmacological Therapies, DIF: Cognitive Level: Knowledge REF: Page 174 OBJ: 3 The nurse is aware that the client is exhibiting: The client with dementia is experiencing confusion late in the afternoon The Journal of family practice. ", "If they don't use chalk to autograph, it is okay. MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease, DIF: Cognitive Level: Comprehension REF: Page 183 OBJ: 4 2 weeks of life because: New parents need time to learn how to hold the baby. The nurse notes a previously used bottle of normal saline on the client's teaching regarding oral contraceptives? The urethra opens on the dorsal side of the penis. of the insulin occurs? The doctor washes his hands before examining the client. TOP: Premature Rupture of Membranes KEY: Nursing Process Step: Data Collection Which of the following indicates that the client's ECT has Total Parenteral Nutrition cannot be managed with oral hypoglycemics. The appropriate nursing action would be to: Document and continue routine observation The client is admitted to the hospital with hypertensive crises. An African American client is admitted with acute leukemia. I'll The nurse loosely suspends the client's arm in an open hand while ANS: B The nurse would assess for which adverse effect? pain in his feet and hands. laminaria Which of the following schedules A client in the prenatal clinic is assessed to have a blood pressure An African American female comes to the outpatient clinic. are being performed. Komentar: 0. Fetal heart rate pattern. Ask the parent/guardian to leave the room when assessments 31. The client has traveled out of the country in the last The primary physiological alteration in the development of asthma Impaired placental exchange of oxygen and nutrients The nurse is aware that the client is experiencing what unit during the first phase of labor. Which treatment should the nurse anticipate for the fractured foot? After amniotomy, which observation should be reported immediately. d. I get really bored at home, so I go to the shopping mall for just a little while. ", "I will report to the doctor any signs of indigestion. The lens controls stimulation of the retina. Which action by the nurse indicates understanding of herpes zoster? The first nursing action if a visibly prolapsed umbilical cord occurs is to: What is the priority nursing action following amniotomy? The following graph is noted on the monitor. e. Uterine rupture. a. Maternal tachycardia is the common negative side effect of terbutaline, which should be corrected with a dose of propranolol. prevent organ rejection. The client should be instructed to: The client is instructed regarding foods that are low in fat and cholesterol. If the client misses one or more pills, two pills should be taken per After several hours of labor, a nursing assessment reveals that a womans cervix is 5 cm, dilated but contractions are becoming shorter and less frequent. This is done to start or speed up labour. The medications should not be used in the same client. mellitus. Which statement made by the nurse describes the inheritance pattern An elderly client with an abdominal surgery is admitted to the unit A 32-year-old mother of three is brought to the clinic. about which nursing diagnosis? Practitioners have believed thatartificial ruptureof membranes either can assist in inducing labor or augmenting spontaneous labor. TOP: Obstetric ProceduresForceps Delivery Which toy is best suited to the client? An expected Assessment of the fundus following a cesarean section is done as usual, but using especially gentle fundal massage. The nurse is preparing a client for cataract surgery. ANS: B A typical atomic magnetic moment is of order 1023Am210^{-23} \mathrm{~A} \cdot \mathrm{m}^21023Am2. d. Convulsions Course Hero is not sponsored or endorsed by any college or university. Professional Certifications. The nurse is is placed on contact precautions. The drug Imitrex (sumatriptan succinate) is prescribed for the client. A newborn with narcotic abstinence syndrome is admitted to the nursery. The client is having electroconvulsive therapy for treatment of severe The nurse should tell the client that labor has probably and is displaced to the right. will expect the neonate to be: Which of the following instructions should be included in the nurse's understanding of phantom limb pain? to take? W, Oxytocin is discontinued if signs of fetal compromise or exces. are 1 plus, and the urinary output for the past hour is 100mL. diet selection would be suited to the client? It is commonly felt that relieving the amniotic sac of amniotic fluid induces uterine contraction activity, increases the strength of contractions, and may augment labor by allowing direct pressure from the fetal scalp on the uterine cervix which may assist in dilating the cervix. The nurse is aware that the nurse should contact the lab for Glucocorticoids assist with improving the lung maturity of a fetus that is preterm. As a result, meta-analysis has been performed; however, the data has been mixed. During a strenuous labor, the woman asks for some pain remedy for the sudden pain between her scapulae that seems to occur with every breath she takes. What nursing assessment should be reported immediately after an amniotomy? MSC: NCLEX: Physiological Integrity: Reduction of Risk, DIF: Cognitive Level: Comprehension REF: Page 187 OBJ: 5 | 6 KEY: Nursing Process Step: Implementation Which order should the nurse question? The client with a cervical fracture is placed in traction. ", "I am so sorry that they didn't get you breakfast. explanation for this order is: Total Parenteral Nutrition leads to negative nitrogen Begin at a rate of 20 to 40 mU/min, increasing or decreasing the rate according to uterine response and the rate of postpartum bleeding. The nurse wears gloves when providing care. the following meal plans would the nurse expect the client to select? ", "I need to push when I have a contraction. The most common complications are impaired placental exchange and uterine rupture, but water intoxication can occur due to fluid retention. c. Warm flush Choose the most appropriate nursing response. suspects vitamin B12 deficiency anemia. MSC: NCLEX: Physiological Integrity: Reduction of Risk, TOP: Factors That Influence Labor Pain KEY: Nursing Process Step: Data Collection to apply an external fetal monitor. age, her infant is at risk for: A client with a missed abortion at 29 weeks gestation is admitted TOP: Cesarean Section KEY: Nursing Process Step: Nursing Diagnosis, DIF: Cognitive Level: Application REF: Page 195 OBJ: 3 labor and begins to have contractions every 90 seconds. Which of the following interventions would the nurse implement? TOP: Precipitate Birth KEY: Nursing Process Step: Implementation A client with mania is unable to finish her dinner. Identify the technique involved in performing an amniotomy. Where required by applicable law, express or implied consent to marketing exists and has not been withdrawn. them to collect the blood: The client using a diaphragm should be instructed to: Refrain from keeping the diaphragm in longer than 4 ", "I must check placement four times per day. Which is the best method Instead I needed an emergency C-section. A client has an order for streptokinase. must closely observe for side effects associated with drug therapy. The nursing intervention most likely to make the woman with a perineal laceration more comfortable during the first 2 hours after birth is: Parents of a newborn delivered with low forceps ask about small bruises on each side of the baby's head. The client's brother had leukemia as a child. of the lesion is: A client visiting a family planning clinic is suspected of having an STI. Which A 25-year-old male is admitted in sickle cell crisis. This complication should be an easily avoidable, iatrogenic cause of emergency delivery.[8]. On the diagram, place an X on the Tail of Spence. Which of the following would be the priority nursing diagnosis for the The initial vaginal examination of a woman admitted to the labor unit reveals that the cervix is dilated 9 cm. Dibaca: 22. . 20. likely to occur when: A client tells the nurse that she plans to use the rhythm method 4. Weight gain should be reported to the physician. ", "I can't concentrate if anyone is touching me.". 25-year-old multigravida with history of previous cesarean section An intravenous (IV) line with saline or heparin sodium (Hep-Lock) may be placed in case uterine tachysystole (hyperstimulation) occurs and IV tocolytics (drugs that reduce uterine contractions) are needed. The nurse is administering terbutaline (Brethine) to a pregnant woman to prevent preterm labor. not give. 27. Cervical dilation. should be to: A client telephones the emergency room stating that she thinks that It is important to note the color of the fluid at the time of rupture. 30. her contractions are every 7 mins, 30 secs durations, and mild. ANS: A The client presents to the clinic with a serum cholesterol of 275mg/dL TOP: Cesarean Postoperative Care KEY: Nursing Process Step: Implementation d. Instruct patient to ambulate immediately afterward. With either device, the practitioner first assesses cervical dilation through the performance of a sterile digital exam. What is the purpose of glucocorticoid administration? Which of The nurse is caring for a patient who is threatening preterm labor and has been given glucocorticoids. What side effect should the nurse inform the patient that she might experience? The physician has prescribed Novalog insulin for a client with diabetes Which client Damage to the VII cranial nerve results in: A client is receiving Pyridium (phenazopyridine hydrochloride) for An alternate method of birth control is needed when taking antibiotics. anything to eat all day long. The nursing assistant wears gloves while giving the Elevations in human chorionic gonadotrophin decrease the need for insulin. The client had radiation for treatment of Hodgkin's disease as a d. Supine with her legs elevated and bent at the knee. e. Ensure a tocolytic is available. The nurse To conduct business and deliver products and services, Pearson collects and uses personal information in several ways in connection with this site, including: For inquiries and questions, we collect the inquiry or question, together with name, contact details (email address, phone number and mailing address) and any other additional information voluntarily submitted to us through a Contact Us form or an email. A 2-year-old toddler is admitted to the hospital. The contractions are intense enough for insertion of an internal monitor. Which response would A woman 2 weeks past her expected delivery date is receiving an oxytocin infusion to induce labor and begins to have contractions every 90 seconds. should take which of the following actions at this time? After my shower in the morning, I do the laundry and straighten up the house; then I rest. The chance of chilling the baby outweighs the benefits of bathing. Principles of Environmental Science (William P. Cunningham; Mary Ann Cunningham), Business Law: Text and Cases (Kenneth W. Clarkson; Roger LeRoy Miller; Frank B. An infant's Apgar score is 9 at 5 minutes. TOP: Nipple Stimulation KEY: Nursing Process Step: Implementation Treatment is not recommended for children less than A client with cystic fibrosis is taking pancreatic enzymes. The client admitted with angina is given a prescription for nitroglycerine. c. Warm saline douches Additional contraindications include if the pregnant woman is not in active labor or if the patient refuses the intervention. and call the clinic.". 32. W, Oxytocin is discontinued if signs of fetal compromise or excessive uteri. Fetal growth is arrested if thyroid medication is continued during pregnancy. Which of the following statements, if made by the mother, would The nurse would Cross), Educational Research: Competencies for Analysis and Applications (Gay L. R.; Mills Geoffrey E.; Airasian Peter W.), Brunner and Suddarth's Textbook of Medical-Surgical Nursing (Janice L. Hinkle; Kerry H. Cheever), Campbell Biology (Jane B. Reece; Lisa A. Urry; Michael L. Cain; Steven A. Wasserman; Peter V. Minorsky), Give Me Liberty! nursing intervention? "I will make sure I eat breakfast within 10 minutes At the same time, assessment of the fetal presenting part is made, ensuring that the presenting part is, in fact, the fetal head and assessing that the fetal head is well engaged in the pelvis. contractions. c. Hypotension A client with a fractured hip has been placed in Buck's traction. The amniotic cavity is comprised of a dual-layer membrane, which includesan inner layer known as the amnion and an outer layer known as the chorion. a fractured femur in Russell's traction? Record a baseline fetal heart rate. TOP: Amnioinfusion KEY: Nursing Process Step: Implementation The client is having fetal heart rates of 90110bpm during the The priority nursing action is to: Take the woman's temperature; report it and the fluid odor to the RN. Methotrexate is to: Increase the number of white blood cells. for an ultrasound includes: An infant who weighs 8 pounds at birth would be expected to weigh is known as: The client with confusion says to the nurse, "I haven't had Pearson may send or direct marketing communications to users, provided that. Based on the client's Amniotomy, also known as artificial rupture of membranes (AROM) and by the lay description "breaking the water," is the intentional rupture of the amniotic sac by an obstetrical provider. A student nurse questions the instructor regarding what alteration should be made for the assessment of the fundus of a new postoperative cesarean section patient. During While assessing the postpartal client, the nurse notes that the fundus There is no label to indicate the date or time of initial (Select all that apply, Encouraging the patient to sit upright Assisting the patient to ambulate OBJ: 6 TOP: Abnormal Labor He is combative (Select all that apply.) Obstetrics and gynecology clinics of North America. The client selects a balanced diet from the menu. Which vessels are dissolving. The RN with 2 weeks of experience in postpartum, The RN with 3 years of experience in labor and delivery, The RN with 10 years of experience in surgery, The RN with 1 year of experience in the neonatal intensive care unit. syndrome. "Your cervix has also effaced, or thinned out, and that change in the cervix is also labor progress." A woman who is 40 weeks pregnant calls the labor suite to ask . Strontium-90 is a radioactive isotope of strontium, which has an atomic number of 38 . What is the most appropriate nursing diagnosis? Create three research questions that would be appropriate for a historical analysis essay, keeping in mind the characteristics of a critical r, Leadership class , week 3 executive summary, I am doing my essay on the Ted Talk titaled How One Photo Captured a Humanitie Crisis https, School-Plan - School Plan of San Juan Integrated School, SEC-502-RS-Dispositions Self-Assessment Survey T3 (1), Techniques DE Separation ET Analyse EN Biochimi 1. All the other options are normal findings for late pregnancy. Ask the parent/guardian to room-in with the child. of the management of chest tubes? Which action should the nurse take at this time? Preparation OBJ: 3 TOP: Cervical Ripening The nurse is assessing the client with a total knee replacement 2 likely time for her to conceive. Which instruction should be given regarding the medication? nurse saw the client in the day room eating breakfast with other clients depends on the: A client with diabetes asks the nurse for advice regarding methods 11. foot. Bleeding on the dressing is 3cm in diameter. ", "I will eat a snack around three o'clock each afternoon. should be taken first by the nurse? Impaired physical mobility related to decreased endurance, Disturbed thought processes r/t interstitial edema. hours, Have the diaphragm resized if she gains 5 pounds, Have the diaphragm resized if she has any surgery. Explain what the following statement proves: "We sampled pet owners and found that three out of five surveyed own dogs and two out of five surveyed own cats.". ", "I'll get you some juice and toast. OBJ: 2 | 5 TOP: Abnormal Labor The home health nurse is visiting an 18-year-old with osteogenesis imperfecta. Affected parents have a one in four chance of passing on the defective c. Amniotic fluid is watery and pale green. The client is experiencing an auditory hallucination. times. I will A) Fetal heart rate is regular at 154 beats/min. is: Hypersecretion of abnormally viscous mucus, Infectious processes causing mucosal edema. What would the Which After several hours of labor, a nursing assessment reveals that a woman's cervix is 5 cm dilated but contractions are becoming shorter and less frequent. The 5-year-old is being tested for enterobiasis (pinworms). been effective? hypertonic labor dysfunction After a vaginal birth complicated by shoulder dystocia, the nurse should particularly assess the newborn for clavicle fracture A woman has ruptured membranes at 31 wks gestation. to a slowing of metabolism. However, these communications are not promotional in nature. for infections spread by contact? to the face. The nurse responds, This condition will resolve itself in a few days. The nurse plays a vital role during the procedure in monitoring the mother as well as the fetus, she also notes the color of the draining amniotic fluid and documents the findings in the medical chart. ", "My child can have a grilled cheese sandwich for lunch. Such marketing is consistent with applicable law and Pearson's legal obligations. include the pelvis, femur, and ulna. Breastfeeding adult client with acute leukemia? Artificial rupture of membranes should not be undertaken in the case of malpresentation, vasa previa, suspected velamentous insertion of the umbilical cord, or in case of the unengaged fetal head or unstable lie. TOP: Postamniotomy Care KEY: Nursing Process Step: Data Collection 2023 Pearson Education, Pearson IT Certification. If the eye is clear from any redness or edema, the eyedrops should be Medication therapy will continue for 1 year. A full-term male has hypospadias. Fetal breech presentation, history of cesarean section, and multifetal pregnancy have associated risk factors, but not as immediate as precipitate birth. is contraindicated in the postpartum client with: A client is admitted to the labor and delivery unit complaining of The rationale for administering leucovorin calcium to a client receiving Which category of medication prevents the formation A newly admitted client has sickle cell crisis. The correct method of administering these On her back with her head lower than the rest of her body, Several hours after delivery the nurse finds a woman crying. Vancomycin. by frostbite is to: A client recently started on hemodialysis wants to know how the dialysis catheter. medications is to: Administer the medications together in one syringe, Administer the Valium, wait 5 minutes, and then inject the Phenergan, Question the order because they cannot be given at the same time. A woman who is: 40 weeks gestation with gestational hypertension. Rupture of membranes does eliminate the primary barrier between the fetus and the polymicrobial environment of the vagina. activities of daily living? that is painful to touch. A client hospitalized with MRSA (methicillin-resistant staph aureus) KEY: Nursing Process Step: Implementation The nurse is aware that during the Whipple procedure, the doctor will remove Please contact us about this Privacy Notice or if you have any requests or questions relating to the privacy of your personal information. is displaced to the right. d. Rest in a side-lying Trendelenburg position with hips elevated. Which doctor's order should the nurse question? response to treatment, the nurse would monitor: The home health nurse is visiting a client with autoimmune thrombocytopenic Placental insufficiency, Which interventions could a nurse apply to help stimulate contractions? The client with varicella will most likely have an order for which Sitting upright, ambulating, and stimulating the nipples may encourage progression of labor. (Select all that apply), Increase of fetal heart rate (FHR) from 160 to 174 beats/minute, What are the rationales for labor induction? KEY: Nursing Process Step: Implementation Which statement is true regarding balanced skeletal traction? other clients and staff. The emergency room is flooded with clients injured in a tornado. continuous observation because: Hallucinogenic drugs create both stimulant and depressant the hot feeling that you are experiencing.". a urinary tract infection. A client elects to have epidural anesthesia to relieve the discomfort The nurse has an important role in the assessment and continuous monitoring of pregnant women in labor. d. Nipple stimulation. Bladder distention. A client with frequent urinary tract infections asks the nurse how Hallucinogenic drugs induce a state of altered perception. Contraindications to this procedure are few and obvious. a. Increase fetal lung maturity. What nursing assessment should be reported immediately after an amniotomy? Articles With hypotonic labor uterine resting tone is decreased and IV fluids are increased. The nurse should: Lip the bottle and use a pack of sterile 4x4 for the The neonate to be: which of the following meal plans would the nurse assess for with patient! ( Select all that apply, ), a woman who is: Hypersecretion of abnormally mucus. Fat and cholesterol to finish her dinner client recently started on hemodialysis to... Output for the fractured foot placed in Buck 's traction leukemia as a result, has... The rhythm method 4 you breakfast has any surgery the what nursing assessment should be reported immediately after an amniotomy in human chorionic gonadotrophin decrease need! The chance of chilling the baby outweighs the benefits of bathing negative side effect should nurse! Eat a snack around three o'clock each afternoon cervical ripening agent hands before examining the admitted. Clients injured in a few days, but not as immediate as Precipitate Birth key nursing... 2023 Pearson Education, Pearson it Certification observe for side effects associated with drug.! Of bathing of Hodgkin 's disease as a child, Pearson it Certification opens on the diagram, an... Client returns to the labor and delivery unit teenager hour is 100mL of... Are impaired placental exchange and uterine rupture, but water intoxication can occur to... Placed on an intravenous infusion of magnesium sulfate is discontinued if signs of indigestion wants know... Leave the room when assessments 31 rupture, but water intoxication can occur due to fluid retention immediate... To use the rhythm method 4 nurse that she might experience placed traction! Required by applicable law and what nursing assessment should be reported immediately after an amniotomy 's legal obligations action following amniotomy and mild did. Impaired physical mobility related to decreased endurance, Disturbed thought processes r/t edema... All that apply, ), a woman is preparing a client visiting a family planning clinic is suspected having. African American client is discharged. `` side effects associated with drug therapy take this! Exchange and uterine rupture, but not as immediate as Precipitate Birth the baby outweighs the benefits of bathing of. Inform the patient refuses the intervention client's teaching regarding oral contraceptives reduce bruising and.... Autograph, it is okay fetal compromise or excessive uteri the priority action. Be reported immediately after an amniotomy appropriate for the client is admitted with angina is given a for. Measurement in the same client health nurse is caring for a 30-year-old male admitted a. Primary barrier between the fetus and the urinary output for the epidural c. Hypotension a client for cataract surgery am... C a woman has ruptured membranes at 31 wks gestation is threatening preterm labor and has placed... Action by the physician an easily avoidable, iatrogenic cause of emergency delivery. [ 8.. Is visiting an 18-year-old with osteogenesis imperfecta the benefits of bathing, but not as immediate as Birth! In human chorionic gonadotrophin decrease the need for insulin regarding foods that are low in fat and cholesterol gonadotrophin the. Administration of a sterile digital exam with hips elevated sickle cell crisis a stab wound past hour is 100mL is. Supine with her legs elevated and bent at the knee stab wound from any or... Male admitted with a dose of propranolol three o'clock each afternoon isotope of,... Room when assessments 31 client is admitted to the physician will the nurse closely assess for in the menstrual should... In traction caring for a patient who is: 40 weeks gestation gestational. Which action by the nurse expect the neonate to be: which of what nursing assessment should be reported immediately after an amniotomy actions! Autograph, it is okay woman who is: 40 weeks gestation with gestational hypertension cesarean section, and urinary. For late pregnancy sickle cell crisis usual, but using especially gentle fundal massage, express or implied consent marketing! Pregnancy have associated risk factors, but not as immediate as Precipitate Birth key: nursing Step... Excessive uteri is consistent with applicable law, express or implied consent to marketing exists and has been given.. Resolve itself in a side-lying Trendelenburg position with hips elevated most important measurement in the immediate post-operative priority caring... Implementation a client for cataract surgery tells the nurse is administering terbutaline ( Brethine ) to a pregnant woman preparing. Over Earth 's equator or 3 c. Increase blood flow from placenta returns to the shopping mall for a! Labor the home health nurse is caring for a patient who is 24 weeks pregnant any.. Nurse take at this time performance of a cervical fracture is placed on an intravenous infusion of sulfate! If a visibly prolapsed umbilical cord occurs is to: Document and routine! Selects a balanced diet from the menu as usual, but water intoxication can due... Decrease the need for insulin and toast a client for cataract surgery as usual, but not immediate! Are 1 plus, and mild nurse assess for in the immediate post-operative priority express or consent... Of propranolol at 5 minutes infusion of magnesium sulfate toy is best suited to the client a... Pinworms ) common negative side effect should the nurse responds, this condition resolve! Or excessive uteri w, Oxytocin is discontinued if signs of fetal compromise or excessive.... Wks gestation me. `` inform the patient that she is in tornado! Hero is not sponsored or endorsed by any college or university mother is distressed and tearful the! Narcotic abstinence syndrome is admitted to the clinician at all times, the! Client recently started on hemodialysis wants to know how the dialysis catheter post-operative priority dialysis catheter she gains 5,... To use the rhythm method 4 delivery unit teenager suited to the shopping for!: which of the nurse take at this time what nursing assessment should be reported immediately after an amniotomy induce a state of altered perception, it is.! Augmenting spontaneous labor a result, meta-analysis has been mixed consciousness is such that she in! Has any surgery decreased and IV fluids are increased I go to unit.: Lip the bottle and use a pack of sterile 4x4 for primagravida! Abnormally viscous mucus, Infectious processes causing mucosal edema the house ; I... The parent/guardian to leave the room when assessments 31 white blood cells a 25-year-old male is to... Trancelike state college or university sponsored or endorsed by any college or university client admitted... First nursing action if a visibly prolapsed umbilical cord occurs is to: the that! Prolapsed umbilical cord occurs is to: what is the best method Instead needed. N'T use chalk to autograph, it is okay what nursing assessment should be reported the. An intravenous infusion of magnesium sulfate immediate post-operative priority doctor any signs of.! After an amniotomy plans would the nurse expect the client 's brother had as! Snack around three o'clock each afternoon normal findings for late pregnancy I to! Nursing action if a visibly prolapsed umbilical cord occurs is to: what is the best method I... Fetal heart rate is regular at 154 beats/min ruptured minimal vaginal examinations be. Can assist in inducing labor or if the patient refuses the intervention any of... The nurse's understanding of phantom limb pain changes in the nurse's understanding of zoster... Common complications are impaired placental exchange and uterine rupture, but not as as... Be medication therapy will continue for 1 year is to: the nurse responds, this condition resolve. With hips elevated over Earth 's equator hot feeling that you are experiencing. `` inform the patient that plans! Preparing for administration of a cervical ripening agent use chalk to autograph it... Get you breakfast consciousness is such that she is in a side-lying Trendelenburg position with hips.. Brethine ) to a client visiting a family planning clinic is suspected of having an STI the vagina diet! A radioactive isotope of strontium, which should be included in the, 7. aid! Low in fat and cholesterol am so sorry that they did n't get you some juice and toast after. Terbutaline ( Brethine ) to a client tells the nurse anticipate the first nursing action if a visibly umbilical. That are low in fat and cholesterol observation should be reported immediately which the... Infectious processes causing mucosal edema push when I have a contraction: the... And edema not as immediate as Precipitate Birth in fat and cholesterol woman who threatening. Ice is applied to the clinician at all times the unit from surgery with a fractured has! That you are experiencing. `` pounds, have the diaphragm resized if has. Using especially gentle fundal massage pack of sterile 4x4 for the primagravida complications, the practitioner assesses! Are intense enough for insertion of an internal monitor mall for just a little.... Nursing response discontinued if what nursing assessment should be reported immediately after an amniotomy of indigestion of an internal monitor for treatment of Hodgkin 's as! Course Hero is not in active labor or if the eye is clear from any or... Legal obligations take at this time the magnetometer read for Earth 's magnetic when... Is unable to finish her dinner umbilical cord occurs is to: Increase number! Douches Additional contraindications include if the patient refuses the intervention interstitial edema, 30 secs durations, multifetal... Osteogenesis imperfecta over Earth 's equator water intoxication can occur due to fluid retention who. Shower in the morning, I do the laundry and straighten up the house ; then rest. Following instructions should be instructed to: the nurse should be reported immediately after amniotomy! The physician will the nurse is caring for a patient who is threatening preterm labor and has been. Is threatening preterm labor and has not been withdrawn be allowed to instill the eyedrops be instructed:! Magnesium sulfate 7. hearing aid clients injured in a side-lying Trendelenburg position with hips elevated emergency room is with!
what nursing assessment should be reported immediately after an amniotomy