Week 4 OB prep u
Which finding would lead the nurse to suspect that a postpartum client is developing thrombophlebitis?
redness in lower legs
Which action would most make the nurse believe that a postpartum woman is accepting a child well?
she turns her face to meet the infant's eyes when she holds her
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 nurse's 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"
Which instruction would the nurse include in the teaching plan for a postpartum woman with mastitis?
"try applying warm compresses to your breasts to encourage the milk to be released"
A client who gave birth to a baby 36 hours 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"
When assessing the episiotomy site of a postpartum client that delivered 3-hours ago, the nurse would document which findings as expected? Select all that apply.
-edema -slight bruising
A nurse is assessing a woman during the first 24 hours after birth. Which assessment finding would the nurse determine as acceptable during this time? Select all that apply.
-fundus one fingerbreath below the umbilicus -moderate saturation of peripad every 3 hours
After teaching a group of pregnant women about the skin changes that will occur after the birth of their newborn, the nurse understands there is a need for additional teaching when one of the women makes which statement?
"I can't wait for these stretch marks to disappear after I give birth"
A woman who gave birth to her infant 1 week ago calls the clinic to report pain with urination and increased frequency. What response should the nurse prioritize?
"after birth it is easier to develop an infection in the urinary system; we need to see you today."
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?
"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 birth. They will most likely go away in a day or two."
A new mother is concerned because it is 24 hours after birth and her breasts have still not become engorged with breast milk. How should the nurse respond to this concern?
"it takes about 3 days after birth for milk to begin forming."
A postpartum client who is bottle feeding her newborn asks, "When should my period return?" Which response by the nurse would be most appropriate?
"it varies, but you can estimate it returning in about 7 to 9 weeks"
On the third day postpartum, which temperature is internationally defined as a postpartal infection?
100.4
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
The nurse is questioning the effective bonding of a client and her 2-day-old infant after noting signs of impaired bonding and attachment. Which actions does the nurse find concerning?
Calling the baby "it" or "they"
During pregnancy a woman's cardiovascular system expands to care for the growing fetus. After birth, during the early postpartum period, the woman eliminates the additional fluid volume she has been carrying. What is one way she does this?
Urinary elimination
Based on the nurse's knowledge about the postpartum period and an increase in blood coagulability during the first 48 hours, the nurse closely assesses the client for which condition?
Thromboembolism
A nurse is developing a plan of care for a woman who has had a spontaneouls vaginal delivery of a healthy newborn. The nurse determines the need for close monitoring for postpartum hemorrhage based on which information?
all but forceps birth *not sure if this is right*
The nurse is conducting discharge teaching with a postpartum woman. What would be an important instruction for this client?
call her caregiver if lochia moves from serosa to rubra
One of the primary assessments a nurse makes every day is for postpartum hemorrhage. What does the nurse assess the fundus for?
consistency, shape, and location
The father of a stillborn infant tells the nurse he wants to hold the child. What is the nurse's best response?
dress the infant in a t-shirt and diaper and let him hold the infant
A breastfeeding client informs the nurse that she is unable to maintain her milk supply. What instruction should the nurse give to the client to improve milk supply?
empty the breasts frequently
A woman is 2 weeks postpartum when she calls the clinic and tells the nurse that she has a fever of 101°F (38.3°C). She reports abdominal pain and a "bad smell" to her lochia. The nurse recognizes that these symptoms are associated with which condition?
endometritis
A nurse is making a home visit to a postpartum woman who gave birth to a healthy newborn 4 days ago. The woman's breasts are swollen, hard, and tender to the touch. The nurse documents this finding as:
engorgement
A young mother is at the office for her 6-week visit. She is still experiencing mild loch alba and is concerned that she has an infection. Which finding would the nurse interpret as supporting this suspicion?
foul odor
The nurse is caring for a client is who 24-hours post delivery of an infant. Which assessment does the nurse predict the health care provider will prioritize for the mother at this time?
hemoglobin and hematocrit
The nurse administers methylergonovine 0.2 mg to a postpartal woman with uterine subinvolution. Which assessment should the nurse make prior to administering the medication?
her blood pressure is below 140/90 mmHg
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?
laceration
The nurse assesses a postpartum woman's perineum and notices that her lochial discharge is moderate in amount and red. The nurse would record this as what type of lochia?
lochia rubra
A postpartum client reports stress incontinence. What information should the nurse suggest to the client to overcome stress incontinence?
perform Kegel exercises
During the birth, the primary care provider performed an episiotomy. The client is now reporting discomfort. To reduce this discomfort and increase hygiene to the perineum, the nurse would encourage the client to use which intervention?
peribottle and warm water
The nurse is concerned that the parents are having difficulties relating to their newborn. In an effort to assist with and encourage attachment, which activity should the nurse suggest?
promoting skin-to-skin contact on the chest
A woman gave birth yesterday to a child with a cleft palate. The newborn is in the special care nursery, and the mother has seen the newborn only at birth. Which intervention would be the priority?
provide time for the mother to grieve for the loss of the perfect baby
It has been 2 hours since a woman gave birth vaginally to a healthy newborn. When assessing the woman's uterine fundus, the nurse would expect to find it at:
the level of the umbilicus
What is the primary rationale for monitoring a new mother every 15 minutes for the first hour after delivery?
to check for postpartum hemorrhage
When planning care for a postpartum client, the nurse is aware that which site is the mostcommon for postpartum infection?
up the reproductive tract
A postpartum client reports urinary frequency and burning. What cause would the nurse suspect?
urinary tract infection
A postpartum woman who has experienced diastasis recti asks the nurse about what to expect related to this condition. Which response by the nurse would be most appropriate?
"Exercise will help improve the muscles"
The nurse is providing discharge education for a new mother regarding constipation. Which statement by the mother indicates that she understands what the nurse explained to her?
"I will increase my intake of fruits and and vegetables in my diet. I love to eat them anyhow."
After a class for expectant parents on the various forms of birth control after the birth of their infant, the nurse realizes more training is needed when a participant makes which comment?
"I'm going to be breastfeeding occasionally, so we won't need to use any other birth control for at least six months"
A nurse is reviewing the medical record of a postpartum client. The nurse identifies that the woman is at risk for a postpartum infection based on which information? Select all that apply.
-history of diabetes -hemoglobin level 10 mg/dl -placenta requiring manual extraction
After teaching a group of nurses during an 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.
-placenta previa -hydramnios -labor augmentation
When teaching an unlicensed assistant personnel (UAP) how to provide perineal care on a postpartum woman, the nurse would include which steps? Select all that apply.
-remove perineal pad in the direction of front to back -place a protective pad under the client's buttocks
A breastfeeding client presents with a temperature of 102.4°F (39°C) and a pulse of 110 bpm. She reports general fatigue and achy joints, and her left breast is engorged, red, and tender. Which instructions would the nurse anticipate being given to this client? Select all that apply.
-take prescribed antibiotics until all prescribed doses are completed -continue breastfeeding on the left side, if the infant is willing to latch on -if infant refuses to feed, bump the breast to maintain flow
A nurse is assisting a postpartum client out of bed to the bathroom for the first time. Which interventions would be most appropriate? Select all that apply.
-walk alongside the client to the bathroom -elevate the head of the bed for several minutes before getting her up -frequently ask the client how her head feels
The nurse develops a teaching plan for a postpartum client and includes teaching about how to perform pelvic floor muscle training or Kegel exercises. The nurse includes this information for which reason?
improve pelvic floor tone
A nurse is teaching a postpartum client how to do muscle-clenching exercises for the perineum. The client asks the nurse, "Why do I need to do these exercises?" Which reason would the nurse most likely incorporate into the response?
improves pelvic floor tone
The postpartum client is reporting her left calf hurts and it is making it difficult for her to walk. The nurse predicts which factor is contributing to this situation after finding an area of warmth and redness?
increased coagulation factors
A fundal massage is sometimes performed on a postpartum woman. The nurse would perform this procedure to address which condition?
uterine atony
A nurse is caring for a client with postpartum hemorrhage. What should the nurse identify as the significant cause of postpartum hemorrhage?
uterine atony
