Postpartum

A client gave birth vaginally 2 hours ago and has a third-degree laceration. There is ice in place on her perineum. However, her perineum is slightly edematous, and the client is reporting pain rated 6 on a scale of 1 to 10. Which nursing intervention would be the most appropriate at this time?

Administer pain medication per prescription.

When instilling erythromycin ointment into the eyes of a neonate 1 hour old, the nurse would explain to the parents that the medication is used to prevent which problem?

blindness secondary to gonorrhea

Normal lochial findings in the first 24 hours after birth include:

bright red blood

A client has admitted use of cocaine prior to beginning labor. After the infant is born, the nurse should anticipate the need to include which action in the infant's plan of care?

urine toxicology screening

A diabetic postpartum client plans to breastfeed. The nurse determines that the client's understanding of breastfeeding instructions is sufficient when she states:

"Breastfeeding will assist in lowering maternal blood glucose."

Which information should the nurse include in the teaching plan for a primiparous client who asks about weaning her neonate?

"Gradually eliminate one feeding at a time."

Which client statement indicates effective teaching about burping a breastfed neonate?

"When I switch to the other breast, I'll burp the baby."

After receiving methylergonovine I.M. for postpartum hemorrhage, a client is prescribed methylergonovine 0.4 mg by mouth every 6 hours. The pharmacy sends 0.2 mg tablets. How many tablets must the nurse administer with each dose? Record your answer using a whole number.

2

A primiparous client who is bottle-feeding her neonate asks, "When should I start giving the baby solid foods?" The nurse instructs the client to introduce solid foods no sooner than at which age?

6 months

A nurse visits a client at home on the 10th postpartum day. When assessing the client's uterus, which finding requires further evaluation?

A fundus palpable at the umbilicus

A nurse is orienting a new nurse to the labor and delivery unit. Which action by the new nurse regarding a neonate's security requires intervention by the preceptor?

Allowing volunteers to return neonates to the nursery

The nurse is assessing a client who is 4 hours postpartum. Based on the findings documented by the nurse, which action is most appropriate at this time?

Ask the client to empty her bladder.

Before a postpartum client is discharged, a nurse checks her hormone levels. Which laboratory finding should the nurse expect to see?

Circulating hCG disappears within 24 hours.

Staff nurses on the postpartum floor are concerned that discharge teaching is consuming a large portion of their time. How can the nurses teach their clients in a more efficient manner?

Conduct a class for clients who require the same discharge teaching.

Which practice should a nurse recommend to a client who has had a cesarean birth?

Coughing and deep-breathing exercises

A 15-year-old client gives birth to a healthy neonate. The neonate's adolescent father arrives on the unit demanding to see his baby. Both sets of grandparents are also present and asking to see their grandchild. The newly hired nurse assigned to the nursery should take which action?

Discuss the unit's policy with the charge nurse.

While assisting a multiparous client to the bathroom for the first time 1 hour after a vaginal birth of a viable neonate, the nurse notes that the client's urine has two small blood clots in the measuring container. What should the nurse do next?

Document this observation as a normal finding.

During an annual checkup, a client tells the nurse that she and her partner have decided to start a family. Ideally, when should the nurse plan for childbirth education to begin and end?

It should begin before conception and end 3 months after childbirth.

A nurse is providing care for a postpartum client. Which condition increases this client's risk for a postpartum hemorrhage?

Placenta previa

A nurse is instructing the client to do Kegel exercises. What should the nurse tell the client to do to perform these pelvic floor exercises?

Stop the flow of urine while urinating.

A home care lactation nurse has asked a client to keep a record of her intake, including calories, and output for 1 day. After reviewing the flow sheet that the client used to document the results, the nurse would make which assessments?

The client consumed an inadequate amount of fluids and calories for breast-feeding.

While assessing a primiparous client 8 hours after childbirth, the nurse inspects the episiotomy site, finding it edematous and slightly reddened. Which interpretation by the nurse is most appropriate?

The client needs application of an ice pack.

A nurse is performing a psychosocial assessment on a first-time mother and her neonate. Which behavior indicates a need for further evaluation?

The mother makes little eye contact with the neonate.

As part of the postpartum follow-up, a nurse calls a new mother at home a few days after discharge. The client answers the telephone, begins to cry, and tells the nurse that she has feelings of inadequacy and isn't coping with the demands of motherhood. Based on this information, which assessment would the nurse make?

This is expected behavior for a client 3 to 7 days postpartum

While caring for a multiparous client 4 hours after vaginal birth of a term neonate, the nurse notes that the mother's temperature is 99.8°F (37.2°C), the pulse is 66 bpm, and the respirations are 18 breaths/min. Her fundus is firm, midline, and at the level of the umbilicus. The nurse should:

continue to monitor the client's vital signs.

While making a home visit to a multigravida 2 weeks after the birth of viable twins at 38 weeks' gestation, the nurse observes that the client looks pale, has dark circles around her eyes, and is breastfeeding one of the twins. The client's apartment is clean, and nothing appears out of place. The client tells the nurse that she completed three loads of laundry this morning. A priority need for this client is:

fatigue related to home maintenance and caring for twins.

A multiparous client at 24 hours postpartum is found to have a swelling and pain in her right leg. She demonstrates a positive Homan sign with discomfort. The nurse should:

notify the client's health care provider (HCP) immediately

A primiparous client, 48 hours after a vaginal birth, is to be discharged with a prescription for vitamins with iron because she is anemic. To maximize absorption of the iron, the nurse instructs the client to take the medication with which liquid?

orange juice

The nurse evaluates the mothering skills of an adolescent primigravida changing her baby's diaper for the first time. When caring for this client, the nurse should focus on the client's need for which support?

praise and encouragement

While assessing a primipara during the immediate postpartum period, the nurse plans to use both hands to assess the client's fundus to:

prevent uterine inversion.

A primigravid client at 41 weeks' gestation is admitted to the hospital's labor and birth unit in active labor. After 25 hours of labor with membranes ruptured for 24 hours, the client gives birth to a healthy neonate vaginally with a midline episiotomy. Which problem should the nurse identify as the priority for the client?

risk for infection

A woman who is breastfeeding tells the nurse that she plans to return to work in 6 months and will probably wean her baby then. The client asks the nurse, "How will I stop producing milk when I want to wean the baby?" What information should the nurse give the client?

gradual decrease in milk supply as the baby nurses less

A woman who gave birth to a healthy baby 6 hours is having cramps in her legs. Upon further assessment, the nurse identifies leg pain on dorsiflexion. The nurse should:

notify the health care provider (HCP).

A primiparous client 3 days postpartum is to be discharged on heparin therapy. After teaching her about possible adverse effects of heparin therapy, the nurse determines that the client needs further instruction when she states that the adverse effects include which symptom?

slow pulse

When assessing an 18-year-old primipara who gave birth to a viable neonate under epidural anesthesia 24 hours ago, the nurse determines that the fundus is firm but to the right of midline. Based on this finding, the nurse should further assesses for:

urinary retention.

The nurse makes a home visit to a primigravida on the fourth postpartum day after birth of a viable neonate. When the nurse enters the house, the nurse finds the client sitting in a chair, crying inconsolably, while the neonate is crying in another room. The client tells the nurse that she has not been sleeping well and has been hearing voices. The nurse determines that the client is most likely experiencing:

postpartum psychosis.

When preparing a teaching plan for a client who is to receive a rubella vaccine during the postpartum period, the nurse should include which information?

Pregnancy should be avoided for 4 weeks after the immunization.