Quiz 4 OB Prep U

Which measurement best describes postpartum hemorrhage

blood loss of 1,000ml, occuring at least 24hrs after birth

A new mother has been reluctant to hold her newborn. Which action by the nurse would help promote this mothers attachment to her newborn

brining the newborn into the room

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

1000ml

A nurse is providing care to a postpartum woman who gave birth vaginally 6hrs ago. The client is reporting perineal pain secondary to an episiotomy. Which intervention would be most appropriate for the nurse to implement at this time

Apply an ice pack to the perineal area

Which intervention would be helpful to a client who is bottle feeding her infant and experiencing hard, engorged breasts?

Applying ice

The nurse observes a 2 inch lochia on the perineal pad of a 1 day postpartum client. Which action should the nurse do next ?

Document the lochia as scant

The nurse observes a 2in (5cm) lochia stain on the perineal pad of a 1day postpartum client. Which action should the nurse do next?

Document the lochia as scant

A nurse is developing a plan of care for a postpartum woman, newborn and partner to facilitate the attachment process. Which intervention would be appropriate for the nurse to include in the plan?

Ensure early and frequent parent-newborn interactions

When teaching the new mother about breastfeeding, the nurse is correct providing what instructions?

Help mother initiate breastfeeding within 30 min of birth Encourage breastfeeding of the newborn infant on demand Place baby in uninterrupted skin to skin contact with mother

A nurse is assessing a postpartum client. Which measure is appropriate?

Instruct the client to empty her bladder before examination

A nurse is assessing a postpartum client. Which measure is appropiate

Instruct the client to empty her bladder before the exam

Which instruction should the nurse offer a client as primary preventitive measures to prevent mastitis?

Perform handwashing before breastfeeding

The nurse is conducting a postpartum exam on a client who reports pain and is unable to sit comfortable. The perineal exam reveals an episiotomy without signs of a hematoma. Which action should the nurse prioritize?

Place an ice pack

The nurse is caring for a client who underwent a csection birth 24hr ago. What finding indicates the need for further action?

The fundus is located 2 fingerbreadths above the umbilicus

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

Thromboembolic disorder of lower extremities

The nurse inspects the clients perineum and finds it red, swollen and tender. The nurse explains to the client that hse needs to be monitored for blood loss, especially because of bleeding into the tissue of the perineum because the third degree laceration sustained while giving birth. what parameters will the nurse assess to detect signs of additional blood loss? Select all that apply

Urine output Blood pressure Pulse rate

A postpartum client who had a csection birth reports right calf pain to the nurse. The nurse observes that the client has nonpitting edema from her right knee to her foot. The nurse knows to prepare the client for which test first?

Venous duplex ultrasound of the right leg

A woman states that she feels exhausted on her second postpartum day. The nurses best advice for her would be to do which action

Walk with the nurse the length of her room

A woman comes to the clinic for her postpartum visit. She gave birth to a healthy term neonate 2wks ago. As part of this visit, the woman has a complete blood count drawn. Which result would the nurse identify as a potential problem?

White blood cell count 14,000 Normal level 6,000-10,000. Indication of infection

A woman comes to the clinic. She gave birth about 2 months ago to a health term male newborn. During the visit, the woman tells the nurse, "I've noticed that I am a bit uncomfortable now when we have sexual intercourse. Is there anything that I can do?" The woman's menstrual period has not yet resumed. Which suggestion by the nurse would be most appropriate?

You might try using a water-soluble lubricant to ease discomfort

A nurse is caring for a client with idiopathic thrombocytyopenic pupura (ITP). Which intervention should the nurse perform first?

administration of platelet transfusions as prescribed

Which finding would lead the nurse to suspect that a woman is developing a postpartum complication

an abscence of lochia

Which intervention would be helpful to a bottle feeding client who is experiencing hard or engorged breasts

applying ice

Seven hours ago, a multigravida woman gave birth to male infant weighing 4,133g. She has voided once and calls for a nurse to check because she states that she feels "really wet"now. Upon examination, her perineal pad is saturated. The immediate nursing action is to

assess and massage the fundus

A nurse is instructing a client who is breastfeeding for the first time that before her milk comes in she should expect to see colostrum, which is described as which color?

creamy yellow

During a routine assessment the nurse notes the postpartum client is tachycardic. What isa possible cause of tachycardia

delayed hemorrhage

A new mother is in the second developmental stage of becoming a mother and is becoming independent in her actions. Which action by the nurse would best foster this stage?

demonstrating how to do cord care on the newborn

A client is Rh-negative and has given birth to her newborn. What should the nurse do next?

determine the newborns blood type and rhesus

A nurse is conducting a class for a group of pregnant women who are near term. As part of the class the nurse is describing the process of attachment and bonding with their soon to be newborn. The nurse determines that the teaching was successful when the group states that bonding typically develops during which time frame after birth

first 30-60min

A nurse caring for a client who has received an episiotomy. The nurse observes that the laceration extends through the perineal area and continues through the anterior rectal wall. How does the nurse classify the laceration

fourth degree

When teaching the new mother about breastfeeding, the nurse is correct when providing what instructions? select all that apply

help the mother initiate breastfeeding within 30 minutes of birth Encourage breastfeeding of the newborn infant on demand Place baby in uninterupted skin-to-skin contact (kangaroo care with mom

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

hypovolemia

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.

inability to concentrate Loss of confidence decreased interest in life

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

A nurse is inspecting the perineal pad of a client who gave birth vaginally to a healthy newborn 6 hours ago. The nurse observes a 5 inch stain of lochia on the pad. The nurse would document this as

moderate

Manual manipulation is used to reposition the uterus of a client experiencing uterine inversion. After repositioning, which type of medication would the nurse administer as prescribed to the client

oxytocin agent

A nurse is caring for a client in the postpartum period. when observing the clients condition the nurse notices that the client tends to speak incoherently. The clients thought process is disoriented and they frequently indulge in obsessive concerns. The nurse notes that the client has difficulty in relaxing and sleeping. The nurse interprets these findings as suggesting which condition

postpartum psychosis

The nurse is assessing the client at the postpartum visit . Which hemodynamic change will the nurse expect the client to exhibit

rise in hematocrit

The nurse is teaching a client about mastitis. Which statement should the nurse include in her teaching

symptoms include fever, chills, malaise and localized breast tenderness

The nurse palpates a postpartum woman's fundus 2hrs after birth and finds it located to the right of midline and somewhat soft. What is the correct interpretation of this finding?

the bladder is distended

The nurse who is working with parents and their newborn encourage which action to encourage bonding attachment between them

touching

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

uterine atony

The nurse who works on postpartum floor is mentoring a new graduate. She informs the new nurse that a postpartum assessment of the mother includes which assessments?

vital signs of mother pain level head to toe assessment

A nurse is caring for a non breastfeeding client in postpartum period. The client reports engorgement. What suggestion should the nurse provide to alleviate breast discomfort?

wear a well-fitting bra

The father of a 2wk 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 2hrs 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 client presents to the clinic with 3wk old infant reporting a general flu like symptoms and a painful right breast. Assessment reveals temp 101.8 and the right breast nipple with a movable mass that is red and warm. The client is diagnosed with the mastitis.which instruction should the nurse prioritize for this client

Complete the full course of antibiotic prescribed, even if you begin to feel better

The nurse reviews the history of a postpartum woman G3P3 and notes it is positive for obesity and smoking. The nurse would be especially alert for the devel. of signs and symptoms of which complication in this client

DVT

A nurse is caring for a breastfeeding client who reports engorgement. The nurse identifies that the client's condition is due to not fully emptying her breasts at each feeding. Which suggestion should the nurse make to help her prevent engorgement?

Feed the baby at least every 2-3 hours

When monitoring a postpartum client 2hours after birth, the nurse notices heavy bleeding with large clots. Which response is most appropriate initially

massaging the fundus firmly

During the second day postpartum, a nurse notices that a client is initiating breastfeeding with her infant and changing her infant's diapers with some assistance from her partner. Which phase does the nurse recognize that the woman is experiencing?

taking hold phase

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 notes that. clients uterus which was firm after the fundal massage, has become boggy again. Which intervention would the nurse do next

Check for bladder distention, while encouraging the client to void

A nurse is performing a routine assessment of the client after birth. Inspection of a womans perineal pad reveals a 3in (7.5cm) lochia stain. This amount should be documented as what type

light

A woman who is breastfeeding her newborn reports that her breasts seem quite full. Assessment reveals that her breasts are engorged. Which factor would the nurse identify as the most likely cause for this development?

Inability of infant to empty breasts

The nurse is assessing a postpartum woman and is concerned the client may be hemorrhaging. Which assessment finding is the nurse finding most concerning?

Increased heart rate

One hour after birth the nurse is assessing a neonate in the nursery. The nurse begins by assessing which parameters?

Inspecting posture, color, and respiratory effort

A 2day old newborn is crying after being circumcised and the mother is attempting to comfort the infant but he continues to be fussy. Which statement by the nurse would best support the mothers actions?

Many mothers find that offering a nipple dipped in sugar water helps soothe a baby after a painful procedure

A nurse is caring for a non-breastfeeding client in the postpartum period. The client reports engorgement. What suggestion should the nurse provide to alleviate breast discomfort?

Wear well fitting bra Not application of warm compresses and expressing milk- that is only for breastfeeding clients

The nurse is planning care for a client at risk for postpartum depression. Which statement regarding postpartum depression does the nurse need to be aware of when attempting to formulate a plan of care?

Symptoms of postpartum depression can easily go undetected

A client who has given birth is being discharged from the health care facility. She wants to know how safe it would be for her to have intercourse. Which instructions should the nurse provide client regarding intercourse after birth ?

Resume intercourse if bright red bleeding stops

The nurse is teaching a client about mastitis. Which statement should the nurse include in her teaching

Symptoms include fever chills malaise and localized breast tenderness

A woman who delivered her infant 2 days ago asks the nurse why she wakes up at night drenched in sweat. She is concerned that this is a problem. The nurses best reply would be

Sweating is very normal for the first few days after childbirth because your body needs to get rid of all the excess water from pregnancy

Elevation of client temperature is crucial first sign of infection. However, when is elevated temperature not a warning sign of impending infection

during the first 24hrs after birth owing to dehydration from exertion

A postpartum client is having difficulty stopping her urine stream. Which should the nurse do next

educate the client on how to perform kegel exercises

The nurse is preparing a new mother to be discharged home after an uncomplicated delivery. During discharge education, which type of lochia pattern should the nurse tell the woman is abnormal and needs to be reported to her health care provider immediately

moderate lochia serosa on day 4 postpartum, increasing in volume and changing to rubra on day 5

A nurse is reviewing a postpartum womans history and labor and birth record. The nurse determines the need to closely monitor this client for infection based on which factor?

placenta removed via manual extraction

When completing the morning postpartum data collection, the nurse notices the clients perineal pad is completely saturated. Which action should the be the nurse first response

Ask the client when she last changed her perineal pad

Which assessment would lead the nurse to believe a postpartum woman is developing a urinary complication

at 8hr postdelivery she has voided a total of 100ml in four small voidings

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

drop in estrogen and progesterone levels after birth

The nurse is used to working on the postpartum floor taking care of women who have had normal vaginal births. Today, the nurse has been assigned to help care for women who are less than 24hrs post-csection birth. The nurse realizes that some areas will not be assessed . What would the nurse leave out of client assessments?

perineum

A nurse is conducting a class on various issues that might develop after going home with a new infant. After discussing how to care for hemorrhoids, the nurse understands that which statement by the class would indicate the need for more information?

I only eat a low fiber diet

In talking to a mother who is 6hrs post-delivery, the mother reports that she has changer her perineal pad twice in the last hour. What question by the nurse would best elicit information needed to determine the mothers status

How much blood was on the two pads

A nurse on the postpartum floor is conducting a class on danger signs for postpartum women after discharge. The nurse recognizes that further teaching is needed when a new mother makes which statement?

I am breastfeeding so

A nurse is conducting a class on various issues that might develop after going home with a new infant. After discussing how to care for hemorrhoids, the nurse understands that which statement by the class would indicate the need for more information

I only eat a low fiber diet

A mother just gave birth 3hrs ago. The nurse enters the room to continue hourly assessments and fins the client on the phone telling the listener about her fear while driving to the hospital and not making it in time. The mother finished the call and the nurse begins her assessment with which phrase?

It sounded like you had quite a time getting here. Would you like to continue your story?

A client who is given birth is being discharged from the healthcare facility. Shew wants to know how safe it would be for her to have intercourse. Which instructions should the nurse provide to the client regarding intercourse after birth?

Resume intercourse if bright red bleeding stops

During the discharge planning for new parents, what would the case manager do to help provide positive reinforcement and ensure multiple assessments are conducted?

Schedule home visits or high risk families

A new mother tells the postpartum nurse that she thinks her baby does not like her since it cries often when she holds it. How should the nurse respond to this statement?

Tell the mother that it is natural to have feelings of uncertainty when adjusting to a new baby

Which situation should concern the nurse treating a postpartum client within a few days of birth

The clients feels empty since she gave birth to the neonate

A client who gave birth to a baby 36hrs ago informs the nurse that she has been passing unusually large volumes of urine very often. How should the nurse explain this to the client?

Your body usually retains extra fluids during pregnancy, so this is one way it rids itself of the excess fluid

A client has come to the office her first postpartum visit. On evaluating her blood work, the nurse would be concerned if the hematocrit is noted to have:

acutely decreased

A nurse finds the uterus of a postpartum woman to be boggy and somewhat relaxed . This is a sign of which condition

atony

The nurse is screening a woman during a home visit following birth. The nurse identifies which risk factors for developing postpartum depression? select all that apply

low self-esteem feeling overwhelmed and out of control low socioeconomic status lack of social support

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 cant sense the fullness

When giving a postpartum client self-care instructions in preparation for discharge, the nurse instructs the client to report heavy or excessive bleeding. How should the nurse describe "heavy bleeding"

saturating 1 pad in 1 hr

Parents tell the nurse that their 3yr old son has begun to have accidents at home following the arrival of his baby sister and wants to sit in his mothers lap all the time now . What advice would the nurse offer these parents? Select all that apply

set aside time every day for the parents to focus on the big brother exclusively Buy the older sibling a doll for him ti care for, as the mother is caring for the new baby Be aware of potential aggressive behaviors from the older sibling

A client gave birth 1 day ago and the nurse is monitoring the clients bp. In which position will the nurse place the client to get the most accurate reading?

sitting on the side of the bed for 2 minutes

While caring for a client following a lengthy labor and birth, the nurse notes that the client repeatedly reviews her labor and birth and is very dependent on her family for care. The nurse is correct in identifying the client to be in which phase of maternal role adjustment?

taking-in

A nurse helps a postpartum woman out of bed for the first time postpartally and notices that she has a very heavy lochia flow. Which assessment finding would best help the nurse decide that the flow is within normal limits?

the color of the flow is red