Chapter 23: conditions occurring after delivery

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

d. the client feels empty since she gave birth to the neonate.

Manual manipulation is used to reposition the uterus of a client experiencing uterine inversion. After the repositioning, which type of medication would the nurse administer as prescribed to the client? magnesium sulfate oxytocin agent indomethacin nifedipine

oxytocin agent

A client has had a cesarean birth. Which amount of blood loss would the nurse document as a postpartum hemorrhage in this client?

1000mL

The nurse is interacting with a young mother and her 2-week-old infant. Which behavior by the mother should the nurse prioritize and report to the RN or health care provider?

Not responding to the infant crying

A postpartum woman is prescribed oxytocin to stimulate the uterus to contract. Which action would be most important for the nurse to do?

Piggyback the IV infusion into a primary line.

A postpartum woman is prescribed oxytocin to stimulate the uterus to contract. Which action would be most important for the nurse to do? Piggyback the IV infusion into a primary line. Administer the drug as an IV bolus injection. Give as a vaginal or rectal suppository. Withhold the drug if the woman is hypertensive.

Piggyback the IV infusion into a primary line.

The nurse instructs a client on actions to prevent postpartum depression. During a home visit, which observation indicates that instruction has been effective?

The client is chatting on the telephone with a friend.

Which woman is at highest risk for postpartum hemorrhage?

a 40-year-old primigravida at 37 weeks with twins when twin A has mild polyhydramnios

What postpartum client should the nurse monitor most closely for signs of a postpartum infection?

a client who had a non-elective cesarean birth

A nurse is making an initial call on a new mother who gave birth to her third baby 5 days ago. The woman says, "I just feel so down this time. Not at all like when I had my other babies. And this one just doesn't sleep. I feel so inadequate." What is the best response to this new mother? a. "It sounds like you have the 'baby blues.' They are common after having a baby when you are not getting enough sleep, are busy with your other children, and are still a bit uncomfortable from the birth. They will most likely go away in a day or two." b. "Tell me, are you seeing things that aren't there, or hearing voices?" c. "It sounds like you need to make an appointment with a counselor. You may have postpartum depression." d. "Every baby is different with their own temperament. Maybe this one just isn't ready to sleep when you want him to."

a. "it sounds like you have the 'baby blues.' they are common after having a baby when you are not getting enough sleep, are busy with your other children, and are still a bit uncomfortable from the birth. they will most likely go away in a day or two."

A nurse is developing a plan of care for a woman who is at risk for thromboembolism. Which measure would the nurse include as the most cost-effective method for prevention? a. early ambulation. b. warm compresses c. prophylactic heparin administration. d. compression stockings

a. early ambulation

A fundal massage is sometimes performed on a postpartum woman. The nurse would perform this procedure to address which condition? a. uterine atony b. uterine contraction c. uterine prolapse d. uterine subinvolution

a. uterine atony

Which factor puts a multiparous client on her first postpartum day at risk for developing hemorrhage? a. uterine atony b. moderate amount of lochia rubra c. thrombophlebitis d. hemoglobin level of 12 g/dl (120 g/L)

a. uterine atony

The nurse is assessing the breast of a woman who is 1 month postpartum. The woman reports a painful area on one breast with a red area. The nurse notes a local area on one breast to be red and warm to touch. What should the nurse consider as the potential diagnosis? a. breast yeast b. mastitis c. engorgement d. plugged milk duct

b. mastitis

The nurse is assessing a client at a postpartum visit and notes the client is emotionally sensitive, complains about being a failure, and appears extremely sad. The nurse concludes the client is presenting with which potential condition? a. anxiety disorders b. postpartum depression c. postpartum blues d. postpartum psychosis

b. postpartum depression

The nurse determines that a woman is experiencing postpartum hemorrhage after a vaginal birth when the blood loss is greater than which amount? a. 750mL b. 300mL c. 500mL d. 1000mL

c. 500mL

A nurse is caring for a postpartum client diagnosed with von Willebrand disease. What should be the nurse's priority for this client? a. Monitor the pain level. b. Assess the fundal height. c. Check the lochia. d. Assess the temperature.

c. Check the lochia.

The nursing instructor is leading a discussion exploring the various conditions that can result in postpartum hemorrhage. The instructor determines the session is successful when the students correctly choose which condition is most frequently the cause of postpartum hemorrhage? a. Disseminated intravascular coagulation b. Hematoma c. Uterine atony d. Perineal lacerations

c. 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. pain in the lower abdomen b. uterine bleeding present c. uterine protrusion into the vagina d. foul-smelling lochia

c. uterine protrusion into the vagina

A postpartum client is recovering from the birth and emergent repair of a cervical laceration. Which sign on assessment should the nurse prioritize and report to the health care provider? a. decreased respiratory rate b. elevated blood pressure c. weak and rapid pulse d. warm and flushed skin

c. weak and rapid pulse

A client in her seventh 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. manifestations of mania decreased interest in life inability to concentrate loss of confidence bizarre behavior

decreased interest in life inability to concentrate loss of confidence

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? a. "It's strange, one minute I'm happy, the next I'm sad." b. "I just feel so overwhelmed and tired." c. "I keep hearing voices telling me to take my baby to the river." d. "I'm feeling so guilty and worthless lately."

d. "i'm feeling so guilty and worthless lately"

The nurse observes an ambulating postpartum woman limping and avoiding putting pressure on her right leg. Which assessments should the nurse prioritize in this client? a. Blanch a toe, and count the seconds it takes to color again. b. Ask the client to raise the foot and draw a circle. c. Bend the knee and palpate the calf for pain. d. Assess for warmth, erythema, and pedal edema.

d. Assess for warmth, erythema, and pedal edema.

A nurse is developing a program to help reduce the risk of late postpartum hemorrhage in clients in the labor and birth unit. Which measure would the nurse emphasize as part of this program? a. manually removing the placenta at birth b. applying pressure to the umbilical cord to remove the placenta c. administering broad-spectrum antibiotics d. inspecting the placenta after delivery for intactness.

d. inspecting the placenta after delivery for intactness.

Which finding(s) leads the nurse to suspect that a postpartum woman has developed endometritis? Select all that apply. foul-smelling lochia flank pain leukocytosis pain on both sides of the abdomen hematuria

foul-smelling lochia pain on both sides of the abdomen

A client in her sixth week postpartum reports general weakness. The client has stopped taking iron supplements that were prescribed to her during pregnancy. The nurse would assess the client for which condition?

hypovolemia

The nurse is administering methylergonovine 0.2 mg to a postpartum client with uterine subinvolution. Which assessment will the nurse need to make prior to administering the medication?

if blood pressure is lower than 140/90 mm Hg

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 condition would the nurse suspect? uterine atony laceration hematoma uterine inversion

laceration

The client, who has just been walking around her room, sits down and reports leg tightness and achiness. After resting, she states she is feeling much better. The nurse recognizes that this discomfort could be due to which cause?

thromboembolic disorder of the lower extremities

The nurse is giving an educational presentation to the local Le Leche league chapter. One woman asks about risk factors for mastitis. Which condition would the nurse most likely include in the response? a. pierced nipple b. complete emptying of the breast c. frequent feeding d. use of breast pumps

a. pierced nipple

When assessing the postpartum woman, the nurse uses indicators other than pulse rate and blood pressure for postpartum hemorrhage because: a. the body's compensatory mechanisms activate and prevent any changes. b. these measurements may not change until after the blood loss is large. c. maternal anxiety adversely affects these vital signs. d. they relate to change in condition than to the amount of blood lost.

b. these measures may not change until after the blood loss is large.

The nurse is concerned that a postpartum client with a cervical laceration is developing hypovolemic shock. What did the nurse assess in this client? a. warm and flushed skin b. weak and rapid pulse. c. decreased respiratory rate. d. elevated blood pressure

b. weak and rapid pulse.

A pregnant woman comes to the clinic and reports redness and swelling in her right calf as well as pain, even when resting. The nurse suspects a deep vein thrombosis (DVT). Which nursing concern related to the new diagnosis is of highest priority? a. pain related to oxygen deficiency to the tissue b. pulmonary embolism development related to thrombus movement. c. physical injury related to mobility issues and the potential for falls. d. increased circulatory volume related to anxiety

b. pulmonary embolism development related to thrombus movement.