Chapter 22
23. A nurse is massaging a postpartum client's fundus and places the non-dominant hand on the area above the symphysis pubis based on the understanding that this action:
Helps support the lower uterine segment
25. A postpartum woman who developed deep vein thrombosis is being discharged on anticoagulant therapy. After teaching the woman about this treatment, the nurse determines that additional teaching is needed when the woman states which of the following?
"I can take ibuprofen if I have any pain."
27. A nurse is assessing a postpartum client who is at home. Which statement by the client would lead the nurse to suspect that the client may be developing postpartum depression?
"I'm feeling so guilty and worthless lately."
13. After teaching a woman with a postpartum infection about care after discharge, which client statement indicates the need for additional teaching?
"When I put on a new pad, I'll start at the back and go forward."
8. When assessing the postpartum woman, the nurse uses indicators other than pulse rate and blood pressure for postpartum hemorrhage based on the knowledge that:
These measurements may not change until after the blood loss is large
21. Assessment of a postpartum woman experiencing postpartum hemorrhage reveals mild shock. Which of the following would the nurse expect to assess? (Select all that apply.)
A) Diaphoresis D) Cool extremities
15. A postpartum woman is diagnosed with metritis. The nurse interprets this as an infection involving which of the following? Select all that apply
A) Endometrium B) Decidua C) Myometrium
17. A home health care nurse is assessing a postpartum woman who was discharged 2 days ago. The woman tells the nurse that she has a low-grade fever and feels "lousy." Which of the following findings would lead the nurse to suspect metritis? (Select all that apply.)
A) Lower abdominal tenderness E) Anorexia
22. A group of students are reviewing risk factors associated with postpartum hemorrhage. The students demonstrate understanding of the information when they identify which of the following as associated with uterine tone? (Select all that apply.)
A) Rapid labor C) Hydramnios
26. The nurse is developing a discharge teaching plan for a postpartum woman who has developed a postpartum infection. Which of the following would the nurse most likely include in this teaching plan? (Select all that apply.)
A) Taking the prescribed antibiotic until it is finished C) Washing hands before and after perineal care D) Handling perineal pads by the edges
9. The nurse is assessing a woman with abruption placentae who has just given birth. The nurse would be alert for which of the following?
Appearance of petechiae
2. As part of an in-service program, a nurse is describing a transient, self-limiting mood disorder that affects mothers after childbirth. The nurse correctly identifies this as postpartum
Blues
19. Assessment of a postpartum client reveals a firm uterus with bright-red bleeding and a localized bluish bulging area just under the skin at the perineum. The woman also is complaining of significant pelvic pain and is experiencing problems with voiding. The nurse suspects which of the following?
Hematoma
1. Review of a primiparous woman's labor and birth record reveals a prolonged second stage of labor and extended time in the stirrups of these findings, the nurse would be especially alert for which of the following?
Thrombophlebitis
14. A nurse suspects that a postpartum client is experiencing postpartum psychosis. Which of the following would most likely lead the nurse to suspect this condition?
Delirium
6. A multipara client develops thrombophlebitis after delivery. Which of the following would alert the nurse to the need for immediate intervention?
Dyspnea, diaphoresis, hypotension, and chest pain
24. A nurse is developing a plan of care for a woman who is at risk for thromboembolism. Which of the following would the nurse include as the most cost-effective method for prevention?
Early ambulation
3. A woman who is 2 weeks postpartum calls the clinic and says, "My left breast hurts." After further assessment on the phone, the nurse suspects the woman has mastitis. In addition to pain, the nurse would assess for which of the following?
Hardening of an area in the affected breast
A client experienced prolonged labor with prolonged premature rupture of membranes. The nurse would be alert for which of the following in the mother and the newborn?
Infection
5. After presenting a class on measures to prevent postpartum hemorrhage, the presenter determines that the teaching was successful when the class states which of the following as an important measure to prevent postpartum hemorrhage due to retained placental fragments?
Inspecting the placenta after delivery for intactness
4. A group of students are reviewing the causes of postpartum hemorrhage. The students demonstrate understanding of the information when they identify which of the following as the most common cause?
Uterine atony
18. A postpartum client comes to the clinic for her routine 6-week visit. The nurse assesses the client and suspects that she is experiencing subinvolution based on which of the following?
Moderate lochia serosa
20. A postpartum woman is ordered to receive oxytocin to stimulate the uterus to contract. Which of the following would be most important for the nurse to do?
Piggyback the IV infusion into a primary line.
16. A group of nursing students are reviewing information about mastitis and its causes. The students demonstrate understanding of the information when they identify which of the following as the most common cause?
S. aureus
10. A nurse is assessing a postpartum woman. Which finding would cause the nurse to be most concerned?
Sharp stabbing chest pain with shortness of breath
11. A woman experiencing postpartum hemorrhage is ordered to receive a uterotonic agent. Which of the following would the nurse least expect to administer?
Terbutaline
12. Which of the following would be most appropriate when massaging a woman's fundus?
Wait until the uterus is firm to express clots