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d. Have epinephrine ready for administration. ANS: a In the event of severe matemal hypotension, the nurse should place the patient in a lateral position oruse a wedge under the hip to displace the uterus, elevate the legs, maintain or increase the IV infusion rate, and administer oxygen by face mask at 10 to 12 L/min, or according to institution protocol. KEY: Integrated Process: Clinical Problem Solving | Cognitive Level: Application | Content Area:Maternity | Client Need: Physiological Integrity | Difficulty Level: Difficult 12. The perinatal nurse listens as Chantal describes her labor and emergency cesarean birth. Providingan opportunity to review this experience may assist Chantal in: Her role development in the letting go stage a b. Decreasing her ambivalence about her labor and birth ] Understanding her guilt involved in her labor and birth d. Developing more positive feelings about her labor and birthANS: d After a cesarean birth, especially when unplanned, nurses must be aware of the myriad of potential psychological issues that may arise. Research suggests that women may perceive cesarean birth to bea less positive experience than a vaginal birth. Unplanned or emergent cesarean deliveries and the experience of cesarean birth may be associated with more negative perceptions of the birthing experience. Allowing Chantal to talk about the experience can help her develop a more positive attitude about her own experience. KEY: Integrated Process: Clinical Problem Solving | Cognitive Level: Knowledge | Content Area:Maternity | Client Need: Safe and Effective Care Environment | Difficulty Level: Easy Maternal-Newbom Nursing: The Critical Components Of Nursing Care, 3rd Edition, Roberta Durham, Linda Chapman 13. The best time to give prophylactic antibiotics to the women undergoing cesarean section is: a. One hour before the surgery b. Two hours before the surgery c. Not indicated unless she has an active infection d. At the time the cord is clampedANS: a Administration of narrow-spectrum prophylactic antibiotics should occur within 60 minutes prior to theskin incision. KEY: Integrated Process: Communication and Documentation | Cognitive Level: Comprehension | Content Area: Matemity | Client Need: Safe and Effective Care Environment | Difficulty Level: Easy 14. During a cesarean section, which action by the nurse is done to prevent compression of thedescending aorta and vena cava? a. Right lateral tilt b. Left lateral tilt c. Elevate head of gurney at 30 degrees d. Administration of IV fluid preload of 500 to 1000 mLANS: b Positioning of the patient with a left tilt maintains a left uterine displacement to decrease the risk ofaortocaval compression related to compression on the aorta and inferior vena cava due to weight ofthe gravid uterus. KEY: Integrated Process: Nursing Process: Intervention | Cognitive Level: Application and Comprehension | Content Area: Reduction of Risk Potential: Potential for Alterations in Body Systems | Client Need: Safe and Effective Care Environment | Difficulty: HardFill-in-the-Blank