Chapter 24 Maternal and Child Health Nursing 7th Edition

Chapter 24  Maternal and Child Health Nursing 7th Edition

Complete Chapter Questions And Answers
 

Sample Questions

1.
The nurse is caring for a patient recovering from a cesarean birth. Which assessment should the nurse make a priority for this patient?
A)
Breast filling
B)
Plan to breastfeed
C)
Abdominal texture
D)
Perineum for edema
Ans:
C

Feedback:

After a cesarean birth, the nurse should assess the abdomen for softness. A hard, “guarded” abdomen is one of the first signs of peritonitis, a complication that may occur with any abdominal surgical procedure. Although important, breast filling does not lead to a life-threatening complication. Plans to breastfeed could have been determined prior to the cesarean birth. Because the baby was delivered through the abdomen, the perineum should not be edematous.

2.
A patient who had a previous cesarean birth asks the nurse if all future births must occur the same way. Which response should the nurse make to support the 2020 National Health Goals regarding cesarean births?
A)
“All future births must be done through cesarean.”
B)
“Not if you fulfill the criteria for vaginal birth after cesarean.”
C)
“Your health care provider will let you know what kind of birth you can have.”
D)
“Most women prefer cesarean births because they are quicker and cause less pain.”
Ans:
B

Feedback:

To fulfill the 2020 National Health Goals regarding cesarean births and answer the patient’s question, the nurse should respond that patients who fulfill the criteria for vaginal birth after cesarean should attempt a vaginal birth with subsequent children. All future births do not need to be done through cesarean. The patient has a voice with deciding the type of birth that she would prefer with each pregnancy. Most women do not prefer cesarean births. This type of birth might not take as long; however, it is a painful surgical procedure.

3.
A patient whose fetus is presenting breech is scheduled to have a cesarean birth. What should the nurse anticipate this patient will need to ensure maximum postoperative care?
A)
Bed rest for the first 4 days
B)
Insertion of a nasogastric tube
C)
Maintenance of an indwelling catheter
D)
Separation from the infant for 72 hours
Ans:
C

Feedback:

To reduce bladder size and keep the bladder away from the surgical field, an indwelling urinary catheter may be prescribed before transport for surgery or after arrival in the surgical suite. Because the bladder was handled and displaced during surgery, its tone or ability to sense filling may be inadequate to initiate voiding for the first postoperative day. For this reason, the indwelling catheter placed before surgery is usually left in place for 4 to 24 hours to ensure good urine drainage. The patient will not be on bed rest for 4 days after a cesarean birth. A nasogastric tube is not indicated for a cesarean birth. The infant will not be separated from the mother for 72 hours after a cesarean birth.

4.
A woman is scheduled to have epidural anesthesia for a cesarean birth. What should the nurse anticipate to include in the preoperative plan of care while the patient waits for the anesthetic?
A)
Encouraging her to ambulate
B)
Administering an oral antacid
C)
Administering morphine sulfate
D)
Keeping in a side-lying position
Ans:
D

Feedback:

The side-lying position helps prevent supine hypotension syndrome, and epidural anesthesia is usually administered with the patient lying on the side. Ambulation prior to anesthesia may or may not be indicated for the patient. Oral antacids and morphine sulfate are not a part of preparation for epidural anesthesia.

5.
A patient scheduled for a cesarean birth asks if there are any difficulties with breastfeeding after this type of delivery. What should the nurse include when responding to this patient?
A)
Breastfeeding is not recommended after a cesarean birth.
B)
It is hard to find a comfortable position to hold a newborn to breastfeed.
C)
A comfortable position can be found to support breastfeeding the infant.
D)
The patient will have too much analgesia postoperatively to make breastfeeding safe.
Ans:
C

Feedback:

The nurse can help the patient with breastfeeding by placing a pillow over the lap while the infant nurses. This position can deflect the weight of the infant from the suture line and lessen pain. The use of the football hold for breastfeeding is another way to keep the infant’s weight off the incision. Breastfeeding is recommended after a cesarean birth. It is not difficult to find a comfortable position to hold a newborn to breastfeed. The patient will not have too much analgesia postoperatively for safe breastfeeding.