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A nurse is caring for a client who had a vaginal delivery 2 hr ago and is reporting increasing perineal pain and pressure. The nurse examines the client's perineum and sees a 4 cm (1.6 in) area of purplish discoloration with swelling. The nurse should interpret these findings as which of the following?

 

A nurse is caring for a postpartum client who is breastfeeding their newborn and reports that their nipples have become sore and cracked.
Which of the following statements should the nurse make?

A nurse is assessing a newborn.
Which of the following findings indicates a need to check the newborn's blood glucose level for hypoglycemia?

A nurse is reviewing the laboratory results for a client who is at 29 weeks of gestation and has a history of anemia.
Which of the following results should the nurse identify and report as an indication of a prenatal complication?

A nurse is caring for a 28-year-old female client who is gravida 1 para 0 at 32 weeks of gestation in the prenatal unit.
Exhibit 1: History and PhysicalThe client is a 28-year-old female, gravida 1 para 0 at 32 weeks of gestation. She reports cramping and low back pain that started about 3 hours ago, with pain rated 2 on a scale of 0 to 10. She believes the contractions feel stronger than Braxton Hicks and expresses concern that it's too early for labor pains. The client mentions a small amount of urinary leakage earlier in the day, but no vaginal bleeding. She decided to come in for evaluation upon her doctor's advice.Exhibit 2: Nurses' NotesAt 0900, the client stated that she began experiencing cramping and low back pain approximately 3 hours ago, rating the pain as 2 out of 10. She described the contractions as stronger than Braxton Hicks but believed they were not labor pains. She also mentioned experiencing a small amount of urinary leakage earlier in the day, with no vaginal bleeding reported. The external fetal monitor indicated contractions every 5 minutes, lasting 30 seconds each, with moderate intensity upon palpation. Fetal heart rate was recorded at 140 beats per minute. A vaginal exam revealed a closed cervix that was 80% effaced, with clear mucus discharge observed on the exam glove.Exhibit 3: Vital SignsBlood Pressure: 120/80 mmHgHeart Rate: 80 bpmRespiratory Rate: 18 breaths/minTemperature: 98.6°F (37°C)Oxygen Saturation: 98%Exhibit 4: Physical Examination ResultsUpon physical examination, the client appeared anxious but was otherwise in stable condition. Her abdomen was soft and non-tender, with no signs of rigidity. Fetal movements were noted to be active. The client had no edema in her extremities, and her reflexes were normal. Auscultation of the lungs revealed clear breath sounds bilaterally. Cardiovascular examination showed a regular heart rhythm without any murmurs. The nurse is providing teaching about tocolytic medication. Which of the following statements should the nurse include? Select all that apply.

A nurse is caring for a client who is 3 days postpartum in the postpartum unit.

History and Physical: A 30-year-old female client had a vaginal birth 3 days ago with prolonged rupture of membranes. Internal fetal monitoring was used during labor. The client has been experiencing fever, chills, and abdominal pain. She has a history of gestational diabetes and hypertension.

Nurses Notes: The client reports feeling weak and fatigued. She has been having difficulty breastfeeding and feels engorged. The lochia is malodorous and heavy. She complains of a headache and dizziness. The client has been crying frequently and expresses feeling overwhelmed. She also mentions that she has not been able to sleep well since delivery.

Vital Signs:

Temperature: 38.5°C (101.3°F)

Pulse: 110 bpm
Respiratory rate: 24 breaths per minute

Blood pressure: 140/90 mmHg

Oxygen saturation: 98% on room air

Physical Examination Results:

The client appears pale and diaphoretic. Her breasts are tender and engorged with signs of erythema. The abdomen is soft but tender to palpation, especially in the lower quadrants. The fundus is boggy and located above the umbilicus. Lochia is heavy and malodorous. There is mild pedal edema noted in both lower extremities.

Querry:A nurse is caring for a client who is 3 days postpartum. Which of the following actions should the nurse take? (Click on the "Exhibit" button for additional information about the client.)

A nurse is caring for a client who is at 28 weeks of gestation and has received two doses of terbutaline subcutaneously.
Which of the following adverse effects is the priority for the nurse to report to the provider?

A nurse on an antepartum unit is caring for a 28-year-old gravida 1 para 0 female client at 32 weeks of gestation.

Exhibit 1: History and Physical The client is 32 weeks pregnant and has been experiencing cramping and low back pain for the past 3 hours. She rates her pain as 2 on a scale of 0 to 10. She describes the pain as stronger than usual Braxton Hicks contractions and mentions having a little urinary leakage earlier in the day. She denies vaginal bleeding. The client decided to come in for evaluation at her doctor's advice.
 

Exhibit 2: Nurse's Notes 0900: The client reports cramping and low back pain started 3 hours ago. She rates the pain as 2 on a scale of 0 to 10. She feels the contractions are stronger than usual Braxton Hicks contractions. She mentions urinary leakage earlier today but denies any vaginal bleeding. The external fetal monitor shows contractions occurring every 5 minutes, lasting 30 seconds, and of moderate intensity. Fetal heart rate is 140/min. A vaginal exam reveals the cervix is closed and 80% effaced. No bleeding is noted, but there is clear mucus discharge on the exam glove.

Exhibit 3:

Vital Signs Heart rate: 80/min

Blood pressure: 120/80 mmHg

Respiratory rate: 18/min

Temperature: 36.8°C (98.2°F)

Oxygen saturation: 98%Exhibit 4:

Physical Examination Results

The client's abdomen is soft, non-tender, and the fundal height corresponds to the gestational age. No signs of vaginal bleeding are observed. Clear mucus discharge is noted on the exam glove. The cervix is closed and 80% effaced. The fetal heart rate is regular at 140/min. The client appears anxious but is in no acute distress. The fetal movements are felt and reported to be normal.

Complete the following sentence by using the list of options. The nurse should identify that _______ are findings that require follow-up.

A nurse is completing a health history and assessment for a client who reports they are pregnant.
Which of the following findings is a presumptive sign of pregnancy?

A nurse is teaching a prenatal class to a group of parents and is discussing facilitation of sibling acceptance of the newborn.
Which of the following instructions should the nurse include in the teaching?

A nurse is caring for a 2-day-old newborn who has a bilirubin level of 14 mg/dL (1 to 12 mg/dL) and is to begin phototherapy.
Which of the following actions should the nurse take?