O'Meara Prep U: Ch 23

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

Obtain a clean-catch urine specimen

The nurse is administering a postpartum woman an antibiotic for mastitis. Which statement by the mother indicates that she understood the nurse's explanation of care

"I can continue breastfeeding my infant, but it may be somewhat uncomfortable."

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 makes which statement

"I can take ibuprofen if I have any pain."

A client who gave birth vaginally 16 hours ago states she does not need to void at this time. The nurse reviews the documentation and finds that the client has not voided for 7 hours. Which response by the nurse is indicated

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

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."

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

1000 mL

The nurse determines that a woman is experiencing postpartum hemorrhage after a vaginal birth when the blood loss is greater than which amount

500 mL

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

A client who had a nonelective cesarean birth

The nurse recognizes that the postpartum period is a time of rapid changes for each client. What is believed to be the cause of postpartum affective disorders

drop in estrogen and progesterone levels after birth

The nurse is reviewing orders written for a postpartum patient with a fourth-degree perineal laceration. Which order should the nurse question before implementing

Administering an enema

A postpartum woman is developing a thrombophlebitis in her right leg. Which assessments would the nurse make to detect this

Assess for pedal edema.

A 29-year-old postpartum client is receiving anticoagulant therapy for deep venous thrombophlebitis. The nurse should include which instruction in her discharge teaching

Avoid over-the-counter (OTC) salicylates.

A nurse is caring for a postpartum client diagnosed with von Willebrand disease. What should be the nurse's priority for this client

Check the lochia.

It is discovered that a new mother has developed a postpartum infection. What is the mostlikely expected outcome that the nurse will identify for this client related to this condition

Client's temperature remains below 100.4°F (38.8°C) orally.

What medication would the nurse administer to a client experiencing uterine atony and bleeding leading to postpartum hemorrhage

Oxytocin

The nurse administers methylergonovine 0.2 mg to a postpartum woman with uterine subinvolution. Which assessment should the nurse make prior to administering the medication

Her blood pressure is below 140/90 mm Hg.

The nurse is performing a postpartum check on a 40-year-old client. Which nursing measure is appropriate

Instruct the client to empty her bladder before the examination.

The father of a 2-week-old infant presents to the clinic with his disheveled wife for a postpartum visit. He reports his wife is acting differently, is extremely talkative and energetic, sleeping only 1 or 2 hours at a time (if at all), not eating, and appears to be totally neglecting the infant. The nurse should suspect the client is exhibiting signs and symptoms of which disorder

Postpartum psychosis

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 client calls the nurse to her room and states that she knows something awful is going to happen to her. What should the nurse do

Report this immediately to the health care provider.

The nurse is giving an educational presentation to the local Le Leche league chapter. One woman asks about risk factors for mastitis. How should the nurse respond

Risk factors include nipple piercing.

Which recommendation should be given to a client with mastitis who is concerned about breastfeeding her neonate

She should continue to breast-feed; mastitis will not 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

Staphylococcus aureus

The nurse is explaining the discharge instructions to a client who has developed postpartum cystitis. The client indicates she is not drinking a glass of fluid every hour because it hurts too much when she urinates. What is the best response from the nurse

Teach that adequate hydration helps clear the infection quicker.

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

Weak and rapid pulse

The nurse is monitoring the woman who is 1 hour postpartum and notes on assessment the uterine fundus is boggy, to the right, and approximately 2 cm above the umbilicus. The nurse would conclude this is most likely related to which potential complication

bladder distention

A nurse is making a home visit to a postpartum client. Which finding would lead the nurse to suspect that a woman is experiencing postpartum psychosis

delirium

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

early ambulation

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 question the woman about which symptom

hardening of an area in the affected breast

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

inspecting the placenta after delivery for intactness

An Rh positive client vaginally gives birth to a 6 lb, 10 oz (3,005 g) neonate after 17 hours of labor. Which condition puts this client at risk for infection

length of labor

A woman presents to the clinic at 1-month postpartum and reports her left breast has a painful, reddened area. On assessment, the nurse discovers a localized red and warm area. The nurse predicts the client has developed which disorder

mastitis

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

mastitis

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

oxytocin agent

Which findings would lead the nurse to suspect that a postpartum woman has developed endometritis? Select all that apply

pain on both sides of the abdomen foul-smelling lochia leukocytosis

The nurse is developing a discharge teaching plan for a postpartum woman who has developed a postpartum infection. Which measures would the nurse most likely include in this teaching plan? Select all that apply

taking the prescribed antibiotic until it is finished handling perineal pads by the edges washing hands before and after perineal care

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

A postpartum patient is prescribed methylergonovine 0.2 mg for uterine subinvolution. Which action should the nurse take before administering the medication to the patient

Measure blood pressure.

The nurse is caring for several women in the postpartum clinic setting. Which statement(s), when made by one of the clients, would alert the nurse to further assess that client for postpartum psychosis? Select all that apply

"The newborn is not really mine emotionally, since I was never pregnant and do not have children." "When the newborn is sleeping, I can see his thoughts projected on my phone and I do not like the thoughts." "I believe my newborn is losing weight because I will not feed him because my milk was poisoned by the health care provider."

The nurse is concerned that a postpartum patient with a cervical laceration is developing hypovolemic shock. What did the nurse assess in this patient

Weak and rapid pulse

Which measurement best describes delayed postpartum hemorrhage

blood loss in excess of 500 ml, occurring 24 hours to 6 weeks after birth

Various medications are available to help control hemorrhage in the postpartum client. When reviewing the client's history, the nurse notes the client's history of asthma. Which medication if prescribed would the nurse question

carboprost

The nurse reviews the history of a postpartum woman, G3, P3 and notes it is positive for obesity and smoking. The nurse would be especially alert for the development of signs and symptoms of which complication in this client

deep venous thrombosis

On a follow-up visit to the clinic, a nurse suspects that a postpartum client is experiencing postpartum psychosis. Which finding would most likely lead the nurse to suspect this condition

delusional beliefs

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 reviewing the medical record of a postpartum client. The nurse determines that the client is at risk for thromboembolism based on which factors from her history? Select all that apply

previous oral contraceptive use severe varicose veins preeclampsia

Review of a primiparous woman's labor and birth record reveals a prolonged second stage of labor and extended time in the stirrups. Based on an interpretation of these findings, the nurse would be especially alert for which condition

thrombophlebitis

A fundal massage is sometimes performed on a postpartum woman. The nurse would perform this procedure to address which condition

uterine atony

Which factor puts a multiparous client on her first postpartum day at risk for developing hemorrhage

uterine atony