O'Mara Ch 17 PrepU

A nurse is working with a group of new parents, assisting them in transitioning to parenthood. The nurse explains that this transition may take 4 to 6 months and involves four stages. Place the stages below in the order in which the nurse would explain them to the group. All options must be used. Click an option, hold and drag it to the desired position, or click an option to highlight it and move it up or down in the order using the arrows to the left. 1 commitment, attachment, and preparation for an infant 2 achievement of the parental role 3 moving toward a new normal routine 4 acquaintance with and increasing attachment to the infant

1, 4, 3, 2

A nurse is reviewing the history of a postpartum woman. The nurse determines that the woman is at low risk for uterine subinvolution based on which findings? Select all that apply. a. early ambulation b. hydramnios c. uterine infection d. breastfeeding e. prolonged labor

A, D

A nurse is assessing uterine involution of a postpartum woman. When reviewing the woman's labor and birth record, which factor would the nurse identify as potentially delaying involution? Select all that apply. a. labor of 4 hours b. limited use of analgesia c. grand multiparity d. birth of triplets e. hydramnios

E, D, C

A primipara client gave birth vaginally to a healthy newborn girl 12 hours ago. The nurse palpates the client's fundus. Which finding would the nurse identify as expected? a. at the level of the umbilicus b. two fingerbreadths above the umbilicus c. two fingerbreadths below the umbilicus d. four fingerbreadths below the umbilicus

a. at the level of the umbilicus

While caring for a new mother on her second day postpartum, the nurse notes the new mother handles her newborn tentatively, not kissing her child but appears afraid to interact with her baby. Which situation would the nurse suspect as the probable reason for this? a. normal reaction to accepting a new child b. responding with cultural customs of avoiding interaction c. waiting for instruction from the nurse d. disappointment in the child's sex

a. normal reaction to accepting a new child

During a home visit, the client mentions she is still having significant of joint pain. The nurse explains that the changes that softened the pelvic joints to allow for the birth were due to the hormone relaxin. The nurse informs the client that it takes approximately how long for the joints to return to prepregnancy status? a. 4 to 6 weeks after pregnancy b. 6 to 8 weeks after pregnancy c. 8 to 10 weeks after pregnancy d. 2 to 4 weeks after pregnancy

b. 6 to 8 weeks after pregnancy

A client is 22 hours postpartum. Her lochia is soaking a pad after 1 hour. Which of the following is the priority nursing action? a. Do a pad count and weigh all pads. b. Do nothing; this finding is normal. c. Notify the physician immediately. d. Massage the client's uterus.

b. Do nothing; this finding is normal.

What two elements play the biggest role in becoming a mother after delivery of her newborn? a. Planned and desired pregnancy and previous experience with infants b. Love and attachment to the child and engagement with the child c. Confidence and happiness with the pregnancy d. Interactions with the child and support systems

b. Love and attachment to the child and engagement with the child

When assessing a woman with pelvic organ prolapse, which of the following would the nurse be least likely to find? a. stress incontinence b. diarrhea c. dyspareunia d. feeling of dragging in the vagina

b. diarrhea

Which assessment on the third postpartum day would indicate to the nurse that a woman is experiencing uterine subinvolution? a. Her uterus is 2 cm above the symphysis pubis. b. Her uterus is three finger widths under the umbilicus. c. Her uterus is at the level of the umbilicus. d. She experiences "pulling" pain while breastfeeding.

c. Her uterus is at the level of the umbilicus.

The nurse is preparing a nursing care plan for an immediate postpartum client. Which nursing diagnosis should the nurse prioritize? a. Acute pain related to afterpains or episiotomy discomfort b. Risk for infection related to multiple portals of entry for pathogens c. Risk for injury: postpartum hemorrhage related to uterine atony d. Risk for injury: falls related to postural hypotension and fainting

c. Risk for injury: postpartum hemorrhage related to uterine atony

The nurse is appraising the post-birth laboratory results of a client and discovers the WBC is 22,000 cells/μL (22 x 109/L). Which action should be prioritized in response? a. none, a normal variation due to labor b. occurs in clients after a cesarean birth c. further testing is required to determine source. d. an abnormal finding, needs antibiotics

c. further testing is required to determine source.

A client who gave birth 5 days ago reports profuse sweating during the night. What should the nurse recommend to the client in this regard? a. "I'm not sure why this is occurring since this usually doesn't occur until much later in the postpartum period." b. "Drink plenty of cold fluids before you go to bed." c. "I would suggest that you speak with your primary care provider about this." d. "Be sure to change your pajamas to prevent you from chilling."

d. "Be sure to change your pajamas to prevent you from chilling."

A health care provider is discussing the results of a recent sonogram with the client. A new diagnosis of uterine displacement is made. Which statement indicates a need for further teaching? a. "To eliminate the source of the problem, my uterus will have to be removed." b. "You thought that I had a problem when doing my pelvic examination." c. "My bladder can enter into my vagina if the muscles of the vagina are weak." d. "Kegel exercises may help strengthen my perineal muscles and decrease stress incontinence."

a. "To eliminate the source of the problem, my uterus will have to be removed."

A nurse is providing care to a postpartum woman. The nurse determines that the client is in the taking-in phase based on which finding? a. The client performs self-care independently. b. The client shows interest in caring for the newborn. c. The client confidently cares for the newborn. d. The client states, "He has my eyes and nose."

a. The client states, "He has my eyes and nose."

A client gave birth 90 minutes ago and has just arrived on the postpartum unit. The initial set of vital signs reveals a blood pressure of 138/86 mm Hg. The blood pressure during labor never rose above 128/74 mm Hg. Which best describes the rise in blood pressure? a. The client's stroke volume has increased after birth of the placenta, causing a physiologic response in blood pressure. b. The client's stroke volume should decrease after birth; this reflects a pathologic adjustment of blood pressure. c. The client is having a side effect to the opioid pain medication given while in labor. d. The client is experiencing pain after the childbirth, causing the rise in blood pressure.

a. The client's stroke volume has increased after birth of the placenta, causing a physiologic response in blood pressure.

A nurse is assessing a postpartum woman's adjustment to her maternal role. Which event would the nurse expect to occur first? a. assuming a passive role in meeting her own needs b. reestablishing relationships with others c. becoming preoccupied with the present d. demonstrating increasing confidence in care of the newborn

a. assuming a passive role in meeting her own needs

When an infant smiles at the mother and the mother in turn smiles and kisses her baby, this would be which phase of attachment? a. proximity b. reciprocity c. commitment d. all of the above

b. reciprocity

When assessing a new father's adaptation to his new role, which statement would indicate that he is in the reality stage? a. "I may not be a pro at helping out with the baby, but I enjoy being involved." b. "It'll be fun to have a baby in the house, but things shouldn't change too much." c. "I've learned how to diaper and bathe the baby so I can be a really involved dad." d. "I didn't realize all that went into being a dad. I wasn't prepared for this."

d. "I didn't realize all that went into being a dad. I wasn't prepared for this."