postpartum quiz

Upon entering the room of a client who has had a spontaneous abortion, the nurse observes the client crying. Which response by the nurse would be most appropriate?

"I'm sorry you lost your baby."

A client who is breast-feeding her newborn tells the nurse, "I notice that when I feed him, I feel fairly strong contractions-like pain. Labor is over. Why am i having contractions now?" Which response by the nurse would be MOST appropriate?

"The baby's sucking releases a hormone that causes the uterus to contract."

A client on the postpartum unit has been diagnosed with a deep vein thrombosis. The following titration schedule is included in the client's orders: If INR is less than 1: administer 7,500 units of heparin subcu If INR is 1.1 to 2.0: administer 5,000 units of heparin subcu If INR is 2.1 to 3.0: administer 2,500 units of heparin subcu if INR is greater than 3: administer 0 units of heparin subcu The client's INR is 2.6 how many mL of heparin will the nurse administer if the available concentration of heparin is 5,000 units per 0.2 mL? Calculate to the nearest tenth.

0.1 mL

A client informs the nurse that she intends to bottle feed her baby. Which of the following actions should the nurse encourage the client to perform? Select all that apply.

Wear a supportive bra 24 hours a day. Stand with your back towards the shower water.

After a client's placenta is birthed, the obstetrician states, "Please add 20 units of oxytocin to the intravenous and increase the drip rate to 250 mL/hr." The client has 750 mL in her IV and the IV tubing delivers fluid at the rate of 10 gtt/mL. To what drip rate should the nurse set the intravenous? gtt/min

42 gtt/min

A deviated fundus to the right side of the abdomen would indicate a _________.

full bladder

A client is 36 hours post cesarean section. Which of the following assessments would indicate that the client has a paralytic ileus?

Absent bowel sounds.

A client who has just given birth to a healthy newborn required an episiotomy. Which action would the nurse implement immediately after birth to decrease the client's pain from the procedure?

Apply an ice pack to the site.

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?

At the level of the umbilicus

A nurse is performing a postpartum assessment on a client who delivered by cesarean section. Which of the following actions will the nurse perform? Select all that apply

Auscultate the lung fields. Auscultate the abdomen. Palpate the fundus. Assess nipple integrity.

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?

Client states, "He has my eyes and nose."

After teaching parents about their newborn, the nurse determines that the teaching was successful when they identify which concept as reflecting the enduring nature of their relationship involving placing the infant at the center of their lives and finding their own way to assume the parental identity

Commitment

The nurse administers Rho(D) immune globulin to an Rh-negative client after delivery of an Rh-positive newborn based on the understanding that this drug will prevent her from:

Developing Rh sensitivity.

A G2 P2002 who is postpartum 6 hours from a spontaneous vaginal delivery is assessed. The nurse notes that the fundus is firm at the umbilicus, mid-line, there is heavy lochia rubra, and the perineal sutures are intact. Which of the following actions should the nurse take at this time?

Notify the woman's primary healthcare provider.

Immediately after childbirth in the recovery area, the nurse observes the mother's partner's fascination and interest in their new son. This behavior is often termed?

Engrossment

The nurse is evaluating the involution of a woman who is three days postpartum. Which of the following findings would the nurse evaluate as normal?

Fundus 3 cm below the umbilicus, lochia serosa

On admission to the labor and delivery unit, a client's hemoglobin (Hgb) was assessed at 11 g/dL and her hematocrit (Hct) at 33%. Which of the following values would the nurse expect to see 2 days after a normal spontaneous vaginal delivery?

Hbg 10.5 g/dL; Hct 31%

When assessing a postpartum woman, which of the following would lead you to suspect postpartum blues?

Periodic crying and insomnia

After teaching a group of nurses during in-service program about risk factors associated with postpartum hemorrhage, the nurse determines that the teaching was successful when the group identifies which risk factors? SELECT ALL THAT APPLY

Prolonged labor Placenta previa Hydramnios Labor augmentation

A nurse is assessing a postpartum woman. Which finding would lead the nurse to suspect that a postpartum woman is having a problem?

Pulse rate 110 bpm

During a postpartum assessment, the nurse assesses the calves of a client's legs. The nurse is checking for which of the following sings/symptoms? Select all that apply.

Redness Pain Warmth

The nurse would expect the postpartum woman to demonstrate lochia in which sequence?

Rubra, serosa, alba

A client is suspected of having a ruptured ectopic pregnancy. Which assessment would the nurse identify as the priority?

Uterine atony