Breastfeeding
A nurse is teaching a postpartum client about breast-feeding. Which of the following instructions should the nurse include?
A. The diet should include additional fluids.
B. Prenatal vitamins should be discontinued.
C. Soap should be used to cleanse the breasts.
D. Birth control measures are unnecessary while breast-feeding.
A. The diet should include additional fluids.
A nurse is prepared to perform a fundal assessment on a postpartum client. The initial nursing action in performing this assessment is which of the following?
A. Ask the client to turn on her side.
B. Ask the client to urinate and empty her bladder.
C. Massage the fundus gently before determining the level of the fundus.
D. Ask the client to lie flat on her back with the knees and legs flat and straight.
B. Ask the client to urinate and empty her bladder.
The nurse is planning care for a postpartum client who had a vaginal delivery 2 hours ago. The client had a midline episiotomy and has several hemorrhoids. What is the priority nursing consideration for this client?
A. Client pain level
B. Inadequate urinary output
C. Client perception of body changes
D. Potential for imbalanced body fluid volume
A. Client pain level
The nurse has provided discharge instructions to a client who delivered a healthy newborn by cesarean delivery. Which statement made by the client indicates a need for further instruction?
A. "I will begin abdominal exercises immediately."
B. "I will notify the health care provider if I develop a fever."
C. "I will turn on my side and push up with my arms to get out of bed."
D. "I will lift nothing heavier than my newborn baby for at least two weeks."
A. "I will begin abdominal exercises immediately."
Which of the following side effects can occur following the insertion of an epidural catheter?
A. Tachycardia
B. Hypertension
C. Hypotension
D. Drowsiness
C. Hypotension
What information should the nurse provide the client about breastfeeding?
A. breastfed babies are more likely to experience constipation
B. breast milk can cause allergies in newborns
C. suckling a baby promotes expansion of the uterus after delivery of the placenta
D. breastfeeding provides natural immunity for the newborn because of passed antibodies
D. breastfeeding provides natural immunity for the newborn because of passed antibodies
The nurse in the postpartum unit is caring for a client who has just delivered a newborn infant following a pregnancy with a placenta previa. The nurse reviews the plan of care and prepares to monitor the client for which risk associated with placenta previa?
A. Infection
B. Hemorrhage
C. Chronic hypertension
D. Disseminated intravascular coagulation
B. Hemorrhage
he nurse is assessing a client in the fourth stage of labor and notes that the fundus is firm, but that bleeding is excessive. Which should be the initial nursing action?
A. Record the findings
B. Massage the fundus
C. Notify the health care provider
D. Place the client in the trendelenburg position
C. Notify the health care provider
The nurse is performing discharge teaching to a client who had a vaginal delivery 48 hours ago. Which statement, if made by the client, indicates a clear understanding of the material taught?
A. "I can have intercourse one week after I am discharged from the hospital."
B. "I cannot wait to get home and sit in the hot tub."
C. "I will need to change my peripad once a day, regardless of the number of times I use the bathroom."
D. "I will not use a tampon until my obstetrician tells me it is OK."
D. "I will not use a tampon until my obstetrician tells me it is OK."
The nurse is caring for a postpartum woman who has chosen not to breastfeed her infant. She asks why she cannot use drugs to suppress lactation. Which response by the nurse is correct?
A. "Hormonal drugs are not as effective as complementary therapies."
B. "Hormonal drugs cause increased constipation."
C. "Hormonal drugs increase the risk of blood clots."
D. "Hormonal drugs promote uterine atony."
C
Estrogenic drug therapy is less common than in the past because of the increased risk of thrombophlebitis. They are more effective than complementary drugs. They do not increase constipation or promote uterine atony.
The nurse is preparing a list of self care instructions for a postpartum client who was diagnosed with mastitis. Which instructions should be included in the list? Select all that apply.
A. Wear a supportive bra
B. Rest during the acute phase
C. Maintain a fluid intake of at least 3000 mL
D. Continue to breast feed if the breasts are not too sore
E. Take the prescribed antibiotics until the soreness subsides
F. Avoid decompression of the breast by breast feeding or breast pumping
A. Wear a supportive bra
B. Rest during the acute phase
C. Maintain a fluid intake of at least 3000 mL
D. Continue to breast feed if the breasts are not too sore
The postpartum nurse is taking the vital signs of a client who delivered a healthy newborn 4 hours ago. The nurse notes that the client's temperature is 100.2. What is the priority nursing action?
A. Document the finding
B. Retake the temperature in 15 minutes
C. Notify the health care provider
D. Increase hydration by encouraging oral fluids
D. Increase hydration by encouraging oral fluids
The clients temperature should be taken every 4 hours while she is awake. Temperatures up to 100.4 in the first 24 hours after birth often are related to the dehydration effects of labor.
The nurse is caring for a client who is 4 days postpartum. The client states that her discharge has returned to a bright red color. What is the nurse's first action?
A. Take the client's temperature.
B. Notify the RN, obstetrician, or midwife.
C. Do nothing; this is a normal finding.
D. Prepare the sitz bath.
B. Notify the RN, obstetrician, or midwife.
This condition presents itself after childbirth. It is attributed to the increased number of white blood cells being expelled from the uterus, and is white to yellowish in color.
A. lochia
B. lochia rubra
C. lochia alba
D. lochia serosa
C. lochia alba
The nurse is caring for a postpartal patient who has just delivered her first baby by caesarean section. The mother's blood type is Rh-negative, and the infant's blood type is Rh-positive. The provider has ordered human D immune globulin (RhoGAM). The nurse understands that this patient will need
A. less than the usual RhoGAM dose.
B. more than the usual RhoGAM dose.
C. no RhoGAM.
D. the usual RhoGAM dose.
B
For women with abruption, previa, caesarean births, or manual placental removal, more than 15 mL of fetal-maternal hemorrhage of Rh-positive red blood cells may have occurred, necessitating an increased dose of D immune globulin.
The nurse has just finished educating a first time postpartum mom that is breastfeeding. Which of the following indicates understanding of the information by the patient? Select all that apply.
A. Wear a bra that provides support.
B. If mastitis is suspected stop breastfeeding immediately and call the provider.
C. Caffeine can affect milk supply.
D. Breastfeeding is a sufficient method of birth control as long as my period has not returned.
E. I plan on having water at my bedside and in the fridge for easy access to ensure I stay hydrated.
A, C, E
The nurse is assessing a client who is 6 hours postpartum after delivering a full-term healthy newborn. The client complains to the nurse of feelings of faintness and dizziness. Which nursing action would be most appropriate?
A. Raise the head of the clients bed
B. Obtain hemoglobin and hematocrit levels
C. Instruct the client to request help when getting out of bed
D. Inform the nursery room nurse to avoid bringing the newborn to the client until the mother's symptoms have subsided
C. Instruct the client to request help when getting out of bed
Which of the following lab values, if obtained 2 days postpartum, would require the nurse to call the obstetrician or midwife?
A. White blood cell (WBC) of 18,000/mm3
B. Hemoglobin (Hgb) 13
C. White blood cell (WBC) of 8,000/mm3
D. Hematocrit (Hct) 9.0%
D. Hematocrit (Hct) 9.0%
The nurse is providing dishcarge teaching for the postpartum client and includes which of the following?
A. drink at least 1000mL of fluid per day
B. the breastfeeding mother should consume an additional 700cal per day
C. the diet should be low in fiber and high in fluids
D. the new mother should consume 125g of protein per day
A. drink at least 1000mL of fluid per day
RhoGam is prescribed for a client after delivery and the nurse provides information to the client about the purpose of the medication. The nurse determines that the woman understands the purpose of the medication if the woman states that is will protect her next baby from which of the following?
A. Having Rh-positive blood
B. Developing a rubella infection
C. Developing physiological jaundice
D. Being affected by Rh incompatibility
D. Being affected by Rh incompatibility
The nurse is providing postpartum teaching to the breastfeeding client in order to reduce the risk of mastitis. Which of the following are important strategies to teach the mother? Select all that apply.
A. good hygiene practices
B. antibiotic ointment applied to cracked or fissured nipples
C. adequate emptying of the breast
D. hand washing prior to touching the nipples
E. wearing a supportive bra at all times
A, C, D, E
A nurse is preparing to assess the uterine fundus of a client in the immediate postpartum period. After locating the fundus, the nurse notes that the uterus feels soft and boggy. Which nursing intervention would be most appropriate?
A. Elevate the client's legs
B. Massage the fundus until it is firm
C. Ask the client to turn on her left side
D. Push on the uterus to assist in expanding clots
B. Massage the fundus until it is firm
The nurse is caring for a postpartum client who delivered vaginally 36 hours ago. The client suddenly complains of severe perineal pain. Which of the following postpartum complications is most likely occurring?
A. Subinvolution of the uterus
B. Thrombophlebitis
C. Disseminated intravascular coagulation (DIC)
D. Labial or vaginal hematoma
D. Labial or vaginal hematoma
What score on the Edinburg Postnatal Depression Scale would be considered the threshold for concern that the client is suffering from postpartum depression?
A. 12-13
B. 6-7
C. 15-16
D. 10-11
A. 12-13
A nurse is providing care for a postpartum client who is experiencing a postpartum hemorrhage. Which of the following medications may be prescribed by the provider? (Select all that apply.)
A. Methylergonovine (Methergine)
B. Misoprostol (Cytotec)
C. Carboprost (Hemabate)
D. Hydralazine
E. Oxytocin (Pitocin)
A B C E