OB - Chapter 22: Nursing Management of the Postpartum Woman at Risk

When monitoring a postpartum client 2 hours after delivery, the nurse notices heavy bleeding with large clots. Which response is most appropriate initially? a) Massaging the fundus firmly b) Administering ergonovine (Ergotrate) c) Performing bimanual compressions d) Notifying the primary health care provider

Massaging the fundus firmly

When planning care for a postpartum patient, the nurse is aware the most common site for postpartum infection is which of the following? a) Integumentary b) Reproductive c) Breast d) Urinary

Reproductive

Brenda develops mastitis 3 weeks after delivery. What part of self-care do you tell her is most important? a) To take her antibiotic medication for the full 10 days even if she begins to feel better sooner b) To breast-feed or otherwise empty her breasts every 1 to 2 hours c) To increase her fluid intake to ensure that she will continue to produce adequate milk d) To use NSAIDs, warm showers, and warm compresses to relieve her discomfort

To breast-feed or otherwise empty her breasts every 1 to 2 hours

When providing care for a postpartum patient at a 6 week check-up, which behavior would alert the nurse the patient may have postpartum psychosis? a) Tearful during appointment b) Talkative and asking questions c) Restless and agitated, concerned with self d) States being tired and happy at same time

Restless and agitated, concerned with self

A woman is two weeks postpartum when she calls the clinic and tells the nurse that she has a fever of 101°F. She complains of abdominal pain and a "bad smell" to her lochia. The nurse recognizes that these symptoms are associated with which condition? a) Episiotomy infection b) Endometritis c) Mastitis d) Subinvolution

Endometritis

The nurse is performing a postpartum check on a 40-year-old client. Which nursing measure is appropriate? a) Instruct the client to empty her bladder before the examination b) Wear sterile gloves when assessing the pad and perineum c) Perform the examination as quickly as possible d) Place the client in a supine position with her arms overhead for the examination of her breasts and fundus

Instruct the client to empty her bladder before the examination

When teaching a postpartum woman about possible complications during this time, the nurse would include information about which of the following as a possible effect? a) Delayed development of the newborn b) Ineffectiveness of breast-feeding c) Interference with the maternal-newborn attachment process d) Alteration in normal maternal hormonal function

Interference with the maternal-newborn attachment process

A nurse finds that a client is bleeding excessively after a vaginal delivery. Which assessment finding would indicate retained placental fragments as a cause of bleeding? a) Firm uterus with a steady stream of brightred blood b) Large uterus with painless dark-red blood mixed with clots c) Firm uterus with trickle of bright-red blood in perineum d) Soft and boggy uterus that deviates from the midline

Large uterus with painless dark-red blood mixed with clots

An Rh-positive client vaginally delivers a 6-lb, 10-oz neonate after 17 hours of labor. Which condition puts this client at risk for infection? a) Size of the neonate b) Length of labor c) Method of delivery d) Maternal Rh status

Length of labor

A client has had a forceps delivery which resulted in lacerations and bleeding. How can a nurse identify if the bleeding is due to laceration? a) Look for a contracted uterus with vaginal bleeding. b) Look for a boggy uterus with vaginal bleeding. c) Look for an inverted uterus with vaginal bleeding. d) Look for a subinvoluted uterus with vaginal bleeding.

Look for a contracted uterus with vaginal bleeding.

A nurse is assessing a client with postpartal hemorrhage; the client is presently on IV oxytocin. Which of the following interventions should the nurse perform to evaluate the efficacy of the drug treatment? Select all that apply. a) Monitor client's vital signs b) Get a pad count c) Assess client's skin turgor d) Assess client's uterine tone e) Assess deep tendon reflexes

• Monitor client's vital signs • Get a pad count • Assess client's uterine tone

A client who gave birth vaginally 16 hours ago states she doesn't need to void at this time. The nurse reviews the documentation and finds that the client hasn't voided for 7 hours. Which response by the nurse is indicated? a) "It's not uncommon after delivery for you to have a full bladder even though you can't sense the fullness." b) "I'll check on you in a few hours." c) "I'll contact your physician." d) "If you don't attempt to void, I'll need to catheterize you."

"It's not uncommon after delivery for you to have a full bladder even though you can't sense the fullness."

On the third day postpartum, which temperature is internationally defined as a postpartal infection? a) 102.4°F (39.1°C) b) 99.6°F (37.5°C) c) 104.2°F (40.1°C) d) 100.4°F (38°C)

100.4°F (38°C)

A client has had a cesarean birth. Which of the following amounts of blood loss would the nurse document as a postpartum hemorrhage in this client? a) 250 ml. b) 1000 ml. c) 500 ml. d) 750 ml.

1000 ml.

Mrs. M. and her infant are being discharged home after an unplanned cesarean delivery. You explain to her that she is at a higher risk for postpartum infection than most patients. What is the major risk factor for a post-partum infection? a) Labor more than 12 hours long. b) A planned cesarean birth. c) Labor less than 12 hours long. d) A nonelective cesarean birth.

A nonelective cesarean birth.

Which of the following behaviors exhibited by a 4-hour postpartum woman requires further interventions by the nurse? a) Returns her son to the nursery because of fatigue. b) Absent verbalization about the birthing process. c) Cuddles her son close to her while feeding. d) Tells visitors about her son and the labor.

Absent verbalization about the birthing process.

Which of the following would the nurse use to monitor the effectiveness of intravenous anticoagulant therapy for a postpartum woman with deep vein thrombosis? a) Platelet level b) Fibrinogen level c) Prothrombin time d) Activated partial thromboplastin time

Activated partial thromboplastin time

When diagnosed with a deep vein thrombosis, the nurse knows the patient will be treated with which medication? a) Non-steroidal inflammatory b) Anticoagulants c) Narcotic analgesics d) Beta blockers

Anticoagulants

Which intervention would be helpful to a bottle-feeding client who's experiencing hard or engorged breasts? a) Applying warm compresses b) Restricting fluids c) Administering bromocriptine (Parlodel) d) Applying ice

Applying ice

Which of the following assessments would lead you to believe a postpartal woman is developing a urinary complication? a) She has voided a total of 1000 mL in two voidings, each spaced 1 hour apart. b) At 8 hours postdelivery she has voided a total of 100 mL in four small voidings. c) Her perineum is obviously edematous on inspection. d) She tells you she is extremely thirsty.

At 8 hours postdelivery she has voided a total of 100 mL in four small voidings.

A 29-year-old postpartum client is receiving anticoagulant therapy for deep venous thrombophlebitis. The nurse should include which instructions in her discharge teaching? a) Avoid iron replacement therapy b) Shortness of breath is a common adverse effect of the medication c) Wear knee-high stockings when possible d) Avoid over-the-counter (OTC) salicylates

Avoid over-the-counter (OTC) salicylates

Which measurement best describes delayed postpartum hemorrhage? a) Blood loss in excess of 300 ml, occurring 24 hours to 6 weeks after delivery b) Blood loss in excess of 800 ml, occurring 24 hours to 6 weeks after delivery c) Blood loss in excess of 1,000 ml, occurring 24 hours to 6 weeks after delivery d) Blood loss in excess of 500 ml, occurring 24 hours to 6 weeks after delivery

Blood loss in excess of 500 ml, occurring 24 hours to 6 weeks after delivery

You are caring for a postpartum woman who exhibits a large amount of bleeding. Which areas would you need to assess before the woman ambulates? a) Degree of responsiveness, respiratory rate, fundus location b) Blood pressure, pulse, complaints of dizziness c) Attachment, lochia color, complete blood cell count d) Height, level of orientation, support systems

Blood pressure, pulse, complaints of dizziness

It is discovered that a new mother has developed a puerperal infection. Which of the following is the most likely expected outcome that the nurse will identify for this patient related to this condition? a) Lochia discharge amount is 6 inches or less on a perineal pad in 1 hour b) Client maintains a urinary output greater than 30 mL per hour c) Fundus remains firm and midline with progressive descent d) Client's temperature remains below 100.4° F or 38° C orally

Client's temperature remains below 100.4° F or 38° C orally

One of the primary assessments you, as a postpartum nurse, make every day is for postpartum hemorrhage. What do you assess the fundus for? a) Location, shape, and content b) Consistency, shape, and location c) Content, lochia, place d) Consistency, location, and place

Consistency, shape, and location

A postpartal woman is developing a thrombophlebitis in her right leg. Which of the following assessments would you make to detect this? a) Ask her to raise her foot and draw a circle. b) Bend her knee and palpate her calf for pain. c) Blanch a toe and count the seconds it takes to color again. d) Dorsiflex her right foot and ask if she has pain in her calf.

Dorsiflex her right foot and ask if she has pain in her calf.

The nurse is teaching a group of students about factors that place a pregnant woman at risk for infection in the postpartum period. Which of the following would the nurse be least likely to include? a) Retained placental fragments b) Prolonged labor with multiple vaginal examinations to evaluate progress c) Increased vaginal acidity leading to growth of bacteria d) Loss of protection with premature rupture of membranes

Increased vaginal acidity leading to growth of bacteria

A nurse is assessing vital signs for a postpartum patient 48 hours after delivery. The vital signs are: T 101.2°F; HR 82; RR 18; BP 125/78. How will the nurse interpret the vital signs? a) Dehydration b) Normal vital signs c) Infection d) Shock

Infection

While assessing a postpartum woman, the nurse palpates a contracted uterus. Perineal inspection reveals a steady stream of bright-red blood trickling out of the vagina. The woman reports mild perineal pain. She just voided 200 mL of clear yellow urine. Which of the following would the nurse suspect? a) Uterine atony b) Uterine inversion c) Laceration d) Hematoma

Laceration

The nurse assesses the patient who is one hour postpartum and observes a heavy steady gush of bright red blood from the vagina in the presence of a firm fundus. Select the most likely cause of the signs and symptoms. a) Infection of the uterus. b) Uterine atony. c) Perineal hematoma. d) Lacerations.

Lacerations

A woman recovering from cesarean birth in the hospital and who was catheterized complains of a feeling of burning on urination and a feeling of frequency. Which of the following should be the next nursing action? a) Suggest that she take an oral analgesic b) Encourage her to drink large amounts of fluid c) Administer amoxicillin, as prescribed d) Obtain a clean-catch urine specimen

Obtain a clean-catch urine specimen

The nurse has attempted to massage a boggy uterus to firm state without success. The next intervention the nurse should anticipate is the administration of what medication? a) Ibuprofen b) Oxytocin c) Digoxin d) Penicillin

Oxytocin

Manual manipulation was used to reposition the uterus of a client who experienced uterine inversion. Which of the following would the nurse administer as ordered after repositioning? a) Magnesium sulfate b) Terbutaline c) Low-dose nitroglycerin d) Oxytoxic agent

Oxytoxic agent

When assessing the patient for postpartum hemorrhage the nurse monitors which of the following every hour? a) Pad count b) Vital signs c) Complete blood count d) Urine volume excreted

Pad count

Samantha delivered her fourth child after protracted and difficult labor during which oxytocin was used to augment her contractions. The next day, her vaginal bleeding continues to be moderately heavy with numerous large clots. Palpating her fundus, you find that it is in the midline but boggy and above the level of the umbilicus. Fundal massage is indicated; what should you do first? a) Seek an order to obtain and administer an oxytocic. b) Ensure that her bladder is empty. c) Place one hand over the symphysis pubis. d) Insert uterine packing to control the hemorrhage.

Place one hand over the symphysis pubis.

A nurse is caring for a client in the postpartum period. When observing the client's condition, the nurse notices that the client tends to speak incoherently. The client's thought process is disoriented and she frequently indulges in obsessive concerns. The nurse notes that the client has difficulty in relaxing and sleeping. The nurse interprets these findings as suggesting which of the following conditions? a) Postpartum psychosis b) Postpartum panic disorder c) Postpartum blues d) Postpartum depression

Postpartum psychosis

Your patient is showing signs and symptoms of a pulmonary embolism. What should you do? a) Lay the patient flat and start oxygen. b) Sit the patient up 90 degrees and call the RN. c) Raise the head of the bed to at least 45 degrees. d) Start oxygen at 2 to 3 liters per minute via nasal cannula.

Raise the head of the bed to at least 45 degrees.

A woman arrives at the office for her 4-week postpartal visit. Her uterus is still enlarged and soft, and lochial discharge is still present. Which of the following is the most likely nursing diagnosis for this patient? a) Risk for infection related to microorganism invasion of episiotomy b) Risk for fatigue related to chronic bleeding due to subinvolution c) Ineffective peripheral tissue perfusion related to interference with circulation secondary to development of thrombophlebitis d) Risk for impaired breastfeeding related to development of mastitis

Risk for fatigue related to chronic bleeding due to subinvolution

Methylergonovine is ordered for a woman experiencing postpartum hemorrhage. The nurse monitors the woman closely for which of the following adverse effects? a) Uterine hyperstimulation b) Seizures c) Flushing d) Headache

Seizures

A postpartum woman is diagnosed as having endometritis. Which position would you expect to place her in based on this diagnosis? a) Semi-Fowler's. b) On her left side. c) Flat in bed. d) Trendelenburg.

Semi-Fowler's.

Which recommendation should be given to a client with mastitis who's concerned about breast-feeding her neonate? a) She should stop breast-feeding until completing the antibiotic b) She shouldn't use analgesics because they aren't compatible with breastfeeding c) She should supplement feeding with formula until the infection resolves d) She should continue to breast-feed; mastitis won't infect the neonate

She should continue to breast-feed; mastitis won't infect the neonate

The nurse is teaching a client with newly diagnosed mastitis about her condition. The nurse would inform the client that she most likely contracted the disorder from which organism? a) Escherichia coli b) Streptococcus pyogenes c) Group beta-hemolytic streptococci (GBS) d) Staphylococcus aureus

Staphylococcus aureus

Which situation should concern the nurse treating a postpartum client within a few days of delivery? a) The client is nervous about taking the baby home b) The client feels empty since she delivered the neonate c) The client would like to watch the nurse give the baby her first bath d) The client would like the nurse to take her baby to the nursery so she can sleep

The client feels empty since she delivered the neonate

A woman delivered a healthy baby girl two days ago. This is her third child and both of the other children are also girls. Which observation by the nurse indicates the need for additional assessment and follow-up? a) The woman comments that her baby has red hair like her grandmother. b) The woman reports that she will be happy to get home because she does not like hospital food. c) The woman actively participates in the care of her baby. d) The woman tells a friend, referring to her baby, "It just cries all the time."

The woman tells a friend, referring to her baby, "It just cries all the time."

A fundal massage is sometimes performed on a postpartum woman. Which of the following is a reason for performing a fundal massage? a) Uterine atony b) Uterine prolapse c) Uterine contraction d) Uterine subinvolution

Uterine atony

Which of the following is the most frequent reason for postpartum hemorrhage? a) Endometritis. b) Uterine atony. c) Perineal lacerations. d) Disseminated intravascular coagulation.

Uterine atony.

A nurse is assigned to care for a client with a uterine prolapse. Which of the following would be most important for the nurse to assess when determining the severity of the prolapse? a) Uterine bleeding present b) Pain in the lower abdomen c) Foul smelling lochia d) Uterine protrusion into the vagina

Uterine protrusion into the vagina

Which complication is most likely responsible for a late postpartum hemorrhage? a) Cervical laceration b) Uterine subinvolution c) Clotting deficiency d) Perineal laceration

Uterine subinvolution

When assessing a postpartum patient who was diagnosed with a cervical laceration which has been repaired, what sign should the nurse report as a possible development of hypovolemic shock? a) Elevated blood pressure b) Decreased respiratory rate c) Warm and flushed skin d) Weak and rapid pulse

Weak and rapid pulse

Jerry, who is hypertensive and who received corticosteroids during pregnancy, delivered by cesarean and subsequently developed endometritis. Her incision is red, warm, and very sensitive to touch, and she remains febrile despite antibiotic therapy. What is the most important aspect of post hospital care to teach her? a) Wound care and hand washing b) Strict adherence to antibiotic therapy c) Proper perineal care d) Use of warm compresses and sitz baths

Wound care and hand washing

A client in her 7th week of the postpartum period is experiencing bouts of sadness and insomnia. The nurse suspects that the client may have developed postpartum depression. What signs or symptoms are indicative of postpartum depression? Select all that apply. a) Bizarre behavior b) Inability to concentrate c) Manifestations of mania d) Loss of confidence e) Decreased interest in life

• Inability to concentrate • Loss of confidence • Decreased interest in life

A nurse is caring for a client who has just undergone delivery. What is the best method for the nurse to assess this client for postpartum hemorrhage? a) By frequently assessing uterine involution b) By assessing skin turgor c) By monitoring hCG titers d) By assessing blood pressure

By frequently assessing uterine involution

A nurse is assigned to care for a client with deep vein thrombosis who has to undergo anticoagulation therapy. Which of the following instructions should the nurse offer the client as a caution when the client receives anticoagulation therapy? a) Refrain from performing any leg exercises b) Avoid prolonged straining during defecation c) Avoid products containing aspirin d) Sit with legs crossed over each other

Avoid products containing aspirin

A nurse is caring for a client who has been treated for a deep vein thrombosis (DVT). Which teaching point should the nurse stress when discharging the client? a) Avoid use of oral contraceptives. b) Plan long rest periods throughout the day. c) Avoid using compression stockings. d) Avoid using products containing aspirin.

Avoid use of oral contraceptives.

You are conducting discharge teaching with a postpartum woman. What would be an important instruction for this patient? a) Call her caregiver if amount of lochia decreases. b) Call her caregiver if lochia moves from serosa to rubra. c) Call her caregiver if lochia moves from rubra to serosa. d) Call her caregiver if lochia moves from serosa to alba.

Call her caregiver if lochia moves from serosa to rubra.

The nurse notes that a client's uterus which was firm after the fundal massage has become "boggy." Which intervention would the nurse do next? a) Offer analgesics prescribed by primary care provider b) Use semi-Fowler's position to encourage uterine drainage c) Check for bladder distention, while encouraging the client to void d) Perform vigorous fundal massage for the client

Check for bladder distention, while encouraging the client to void

Initial measures to stop Jessica's bleeding have not proved successful and she is being transferred to the ICU. Her family is frightened by the IV lines and the nasal cannula; Jessica's brother suddenly says to her partner, "This is all your fault!" What is the best response by the nurse? a) Tell them that the RN will be notified, who will explain Jessica's treatment to them. b) Explain Jessica's care, focusing on any signs of improvement, while acknowledging that this is a difficult time for them. c) Leave the room quietly; this is a family matter. d) Draw the brother aside and tell him that if he can't control himself, he'll have to leave.

Explain Jessica's care, focusing on any signs of improvement, while acknowledging that this is a difficult time for them.

Over 75% of women who give birth experience postpartum depression. a) False b) True

False

Two weeks after a vaginal delivery, a client presents with low-grade fever. The client also complains of a loss of appetite and low energy levels. The physician suspects an infection of the episiotomy. What sign or symptom is most indicative of an episiotomy infection? a) Apprehension and diaphoresis b) Foul-smelling vaginal discharge c) Sudden onset of shortness of breath d) Pain in the lower leg

Foul-smelling vaginal discharge

Two weeks after their baby is born, Tom calls to report that his wife Sylvia is behaving strangely. She is extremely talkative and energetic and he has not observed her sleeping for more than an hour or two at a time. She is also forgetting to eat and neglecting her appearance, but worse, she seems to barely be aware of the baby's needs and appears surprised when Tom asks her about the child, "As if," Tom says, "she's forgotten that we even have a baby!" You tell him to bring her in right away, because you suspect Sylvia is suffering from what condition? a) Maladjustment b) Postpartum blues c) Postpartum psychosis d) Postpartum depression

Postpartum psychosis

You are caring for a woman who is receiving IV antibiotics and supportive care for endometritis. Which of the following findings should you report as soon as you notice it? a) Breast-feeding b) Gradually decreasing temperature and pulse rate c) Steadily decreasing volume of urine d) Excessive diaphoresis

Steadily decreasing volume of urine

The nurse is teaching a client about mastitis. Which statement should the nurse include in her teaching? a) Mastitis usually develops in both breasts of a breast-feeding client b) A breast abscess is a common complication of mastitis c) The most common pathogen is group A beta-hemolytic streptococci d) Symptoms include fever, chills, malaise, and localized breast tenderness

Symptoms include fever, chills, malaise, and localized breast tenderness

The nurse determines that a woman is experiencing postpartum hemorrhage after a vaginal birth when the blood loss is greater than which amount? a) 500 mL b) 100 mL c) 300 mL d) 250 mL

500 mL

Which woman should you suspect of having endometritis? a) A woman with diabetes who has delivered vaginally and develops tachycardia and a fever of 101.7 degrees on the third postpartum day. The next day, she appears ill; fever is 102.9 degrees; WBC is 31,500 cells/mm3; blood cultures are negative. b) A woman with a history of infection and smoking who develops a temperature of 101 degrees on the fourth postpartum day. She reports severe perineal pain. The edges of the episiotomy have separated. c) An obese woman who has a temperature of 100.4 degrees at 12 hours after delivery. Her lochia is moderate; vaginal cultures are negative. d) A woman with PROM before delivery complains of severe burning with urination, malaise and severe temperature spikes on the seventh postpartum day. WBC is 21,850cells/mm3; temperature is 101 degrees; and her skin is pale and clammy.

A woman with diabetes who has delivered vaginally and develops tachycardia and a fever of 101.7 degrees on the third postpartum day. The next day, she appears ill; fever is 102.9 degrees; WBC is 31,500 cells/mm3; blood cultures are negative.

A nurse is caring for a client with idiopathic thrombocytopenic purpura (ITP). The nurse is correct when performing which intervention? a) Avoiding administration of oxytocics b) Administration of prescribed nonsteroidal anti-inflammatory drugs (NSAIDs) c) Continual firm massage of the uterus d) Administration of platelet transfusions as ordered

Administration of platelet transfusions as ordered

The nurse is caring for a patient within the first four hours of her cesarean birth. Which of the following nursing interventions would be appropriate to prevent thrombophlebitis? a) Assist client in performing leg exercises every two hours b) Roll a bath blanket or towel and place it firmly behind the knees c) Limit oral intake of fluids for the first 24 hours to prevent nausea d) Ambulate the client as soon as her vital signs are stable

Ambulate the client as soon as her vital signs are stable

On examining a woman who gave birth 5 hours ago, the nurse finds that the woman has completely saturated a perineal pad within 15 minutes. Which action by the nurse should be implemented first? a) Assess the woman's fundus. b) Begin an IV infusion of Ringer's lactate solution. c) Assess the woman's vital signs. d) Call the woman's health care provider.

Assess the woman's fundus.

On examining a woman who gave birth 5 hours ago, the nurse finds that the woman has completely saturated a perineal pad within 15 minutes. Which action by the nurse should be implemented first? a) Call the woman's health care provider. b) Assess the woman's fundus. c) Assess the woman's vital signs. d) Begin an IV infusion of Ringer's lactate solution.

Assess the woman's fundus.

A nurse is assigned to care for a 38-year-old overweight client scheduled to undergo a cesarean birth. The client is at an increased risk of thromboembolic complications. During assessment, what factor will help the nurse in the diagnosis of deep vein thrombosis of the leg? a) Dyspnea b) Calf tenderness c) Tachypnea d) Sudden chest pain

Calf tenderness

The nurse collects a urine specimen for culture from a postpartum woman with a suspected urinary tract infection. Which organism would the nurse most likely expect the culture to reveal? a) Klebsiella pneumoniae b) Gardenerella vaginalis c) Staphylococcus aureus d) Escherichia coli

Escherichia coli

You administer methylergonovine (Methergine) 0.2 mg to a postpartal woman with uterine subinvolution. Which of the following assessments should you make prior to administering the medication? a) Her blood pressure is below 140/90. b) Her hematocrit level is over 45%. c) She can walk without experiencing dizziness. d) Her urine output is over 50 mL/h.

Her blood pressure is below 140/90.

Which assessment on the third postpartal day would make you evaluate a woman as having uterine subinvolution? a) Her uterus is at the level of the umbilicus. b) Her uterus is 2 cm above the symphysis pubis. c) Her uterus is three finger widths under the umbilicus. d) She experiences "pulling" pain while breastfeeding.

Her uterus is at the level of the umbilicus.

A postpartal woman calls you into her room because she is having a very heavy lochia flow containing large clots. Your first action would be to a) Assess her blood pressure. b) Palpate her fundus. c) Have her turn to her left side. d) Assess her perineum.

Palpate her fundus.

Which of the following instructions should the nurse offer a client as primary preventive measures to prevent mastitis? a) Apply cold compresses to the breast b) Perform handwashing before breastfeeding c) Avoid frequent breastfeeding d) Avoid massaging the breast area

Perform handwashing before breastfeeding

Two weeks after their baby is born, Tom calls to report that his wife Sylvia is behaving strangely. She is extremely talkative and energetic and he has not observed her sleeping for more than an hour or two at a time. She is also forgetting to eat and neglecting her appearance, but worse, she seems to barely be aware of the baby's needs and appears surprised when Tom asks her about the child, "As if," Tom says, "she's forgotten that we even have a baby!" You tell him to bring her in right away, because you suspect Sylvia is suffering from what condition? a) Postpartum depression b) Postpartum blues c) Maladjustment d) Postpartum psychosis

Postpartum psychosis

A nurse is caring for a postpartum client diagnosed with von Willebrand disease. What assessment finding will the nurse expect to find in the client? a) Prolonged bleeding time b) Postpartum fundal height that is higher than expected c) Foul-smelling vaginal discharge d) A fever of 100.4° F (38.0° C) after the first 24 hours following childbirth

Prolonged bleeding time

You are the nurse giving an educational presentation to the local Le Leche league chapter. One woman asks you about mastitis. What would be your best response? a) Risk factors include nipple piercing. b) Risk factors include breast pumps. c) Risk factors include complete emptying of the breast d) Risk factors include frequent feeding.

Risk factors include nipple piercing.