prep u chapter 15

The woman asks the nurse about the average weight loss for 5 days postpartum. Which information would the nurse incorporate into the response?

19lb

Which suggestion should the nurse make to help her prevent engorgement?

Feed the baby at least every two or three hours.

What information would the nurse need to gather prior to administering Rho (D) immune globulin injection

Has the mother ever been sensitized to Rh-positive blood? Has the mother had any previous pregnancies? Has the mother experienced any miscarriages or abortions?

The nurse is inspecting a new mother's perineum. What actions would the nurse take for this client?

Inspect the episiotomy for sutures and to ensure that the edges are approximated. Note any hemorrhoids. Gently palpate for any hematomas.

After the abdominal dressing is removed 24 hours following a cesarean delivery, the nurse inspects the incision and observes drainage from the incision, redness along the suture line and moderate edema. Staples are intact. What action would the nurse take?

Let the health care provder know the condition of the incision.

The perineal exam reveals an episiotomy without signs of a hematoma. Which action should the nurse prioritize?

Place an ice pack.

Which intervention would be helpful to a bottle-feeding client who's experiencing hard or engorged breasts?

applying ice

involution

contraction of muscle fibers; catabolism; regeneration of uterine epithelium

taking in phase

immediately after birth client needs sleep, depends on others to meet her needs, and relives the events surrounding the birth process

The postpartum client is reporting her left calf hurts and it is making it difficult for her to walk. The nurse predicts which factor is contributing to this situation after finding an area of warmth and redness?

increased coagulation factors

If the breasts are engorged and the woman is bottle-feeding her newborn, instruct her to

instruct her to keep a support bra on 24 hours per day. Cool compresses or an ice pack wrapped in a towel will usually be soothing and help to suppress milk production.

baby blues

mild depressive, anxiety irraitability, mood swings, tearfulness, increased sensitivity, fatigue usually peak at days 4 and 5 resolve by day 10 can take a nap and feel better

which type of lochia pattern should the nurse tell the woman is abnormal and needs to be reported to her health care provider immediately

moderate lochia serosa on day 4 postpartum, increasing in volume and changing to rubra on day 5

Diaphoresis

often occurs in postpartum women as a way to get rid of both excess water and waste through the skin.

Secretion of which substance would the nurse identify as the cause of afterpains?

oxytocin

serosa

pinkish brown 4-10 days

engorgment

process of swelling of the breast tissue due to an increase in blood and lymph supply as a precursor to lactation

the nurse would identify which hormone that is responsible for milk production?

prolactin

Breast engorgement may be uncomfortable but there should never be

reddened, painful areas on either breast and, if this occurs, the health care provider needs to be called

despite the decreased in blood volume the hemtatocrit level remains what?

relatively stable and may even increase

Which factor might result in a decreased supply of breast milk in a postpartum client?

supplemental feedings with formula

lochia

vaginal discharge after childbirth

Which time frame for using a birth control method should the nurse point out will best help the client achieve her goals?

when she resumes sexual activity

alba

whitish yellow 10-28 days

A new mother comes in for her first visit and reports pain and tenderness in her breast just before feeding. Based on her description, the nurse determines she is experiencing breast engorgement. Which instruction should the nurse provide to her?

"Take a warm shower just before feeding your infant."

The acceptable amount of blood loss during a normal vaginal delivery is

300 ml to 500 m

The nurse is performing an assessment on a 2-day postpartum client and discovers a boggy fundus at the umbilicus and slightly to the right. The nurse determines that this is most likely related to which situation?

Bladder distention

A concerned client tells the nurse that her husband, who was very excited about the baby before its birth, is apparently happy but seems to be afraid of caring for the baby. What suggestion should the nurse give to the client's husband to resolve the issue?

Hold the baby frequently.

Engrossment

describes the action of new fathers when they stare at their newborn for long intervals

postpartum depression

symptoms last longer and are more severe and require treatment

letting go phase

third phase in which woman establishes relationships with others

Nurses must be sensitive to how people respond when being

touched and should refrain from it if the client's response indicates that it is unwelcomed.

talking hold phase

second phase characterized by dependnet and independent maternal behavior

A woman who gave birth to her infant 1 week ago calls the clinic to report pain with urination and increased frequency. What response should the nurse prioritize?

"After birth it is easier to develop an infection in the urinary system; we need to see you today."

A client who recently gave birth to her third child expresses a desire to have her older two children come to the hospital for a visit. What should the nurse say in response to this request?

"As long as they are well, absolutely. Why don't we give you a dose of pain medication beforehand so that you will enjoy the visit?"

A client who had a vaginal birth 2 days ago asks the nurse when she will be able to breathe normally again. Which response by the nurse is accurate?

"Within 1 to 3 weeks, your diaphragm should return to normal, and your breathing will feel like it did before your pregnancy."

for a cesarean delivery approximately

500 mL to 1000 ml

The nurse is caring for several postpartum clients on the unit. Which client's reaction should the nurse prioritize for possible intervention?

Neglects to engage or provide care or show interest in infant.

A postpartum client delivered her infant 1 day ago and the nurse is monitoring her blood pressure. What position would the nurse place the client in to get the most accurate reading?

Sitting on the side of the bed for 2 to 3 minutes

the significant cause of postpartum hemorrhage

Uterine atony

The nurse is preparing discharge for a client who plans to bottle-feed her infant. Which instruction should the nurse prioritize for this client in the discharge teaching?

Wear a tight, supportive bra.

rubra

dark red 3-4 days

The nurse is assessing a postpartum woman and is concerned the client may be hemorrhaging. Which assessment finding is the nurse finding most concerning?

increased heart rate

Which factor should the nurse identify as a potential cause for urinary frequency?

postpartum diuresis