Deck 10: Nursing Care of Women With Complications Following Birth

Question 1

One day after discharge the postpartum patient calls the clinic complaining of a reddened area on her lower leg, a temperature elevation of 99.8°F, a rust-colored lochia, and sore breasts. From these symptoms, the nurse suspects:

A) Phlebitis
B) Puerperal infection
C) Late postpartum hemorrhage
D) Mastitis

Answer 1

Phlebitis

Question 2

When the 4-week postpartum patient with mastitis asks the nurse if she can continue to breastfeed, the nurse's most helpful response is:

A) Stop breastfeeding until the infection clears.
B) Pump the breasts to continue milk production, but do not give breast milk to the infant.
C) Begin all feedings with the affected breast until the mastitis is resolved.
D) Breastfeeding can continue unless there is any abscess formation.

Answer 2

Breastfeeding can continue unless there is any abscess formation.

Question 3

The best response to a postpartum woman who tells the nurse that she feels "tired and sick all of the time since I had the baby 3 months ago" is:

A) "This is a normal response for the body after pregnancy. Try to get more rest."
B) "I'll bet you will snap out of this funk real soon."
C) "Why don't you arrange for a babysitter so you and your husband can have a night out?"
D) "Let's talk about this further. I am concerned about how you are feeling."

Answer 3

"Let's talk about this further. I am concerned about how you are feeling."

Question 4

At her 6-week postpartum checkup, a woman mentions to the nurse that she can't sleep and she is not eating. She feels guilty because sometimes she wishes her baby would die. The nurse recognizes this woman's symptoms as:

A) Bipolar disorder
B) Major depression
C) Postpartum blues
D) Postpartum depression

Question 5

The nurse assesses a boggy uterus with the fundus above the umbilicus and deviated to the side. The nurse should next assess:

A) Fullness of the bladder
B) Amount of lochia
C) Blood pressure
D) Level of pain

Question 6

The statement that would indicate to the nurse on a postpartum home visit that the patient understands the signs of late postpartum hemorrhage is:

A) "My discharge would change to red after it has been pink or white."
B) "If I have a postpartum hemorrhage, I will have severe abdominal pain."
C) "I should be alert for an increase in my lochia alba."
D) "I would pass a large clot that was retained from the placenta."

Question 7

During a postpartum assessment, a woman reports that her right calf is painful. The nurse observes edema and redness along the saphenous vein in the right lower leg. Based on this finding, the nurse explains that the probable treatment will involve:

A) Anticoagulants for 6 weeks
B) Application of ice to the affected leg
C) Gentle massage of the affected leg
D) Passive leg exercises twice a day

Question 8

Five days after a spontaneous vaginal delivery, a woman comes to the emergency room because she has a fever and persistent cramping. The nurse recognizes that the cause of these signs and symptoms may be:

A) Dehydration
B) Hypovolemic shock
C) Endometritis
D) Cystitis

Question 9

The first sign of hypovolemic shock from postpartum hemorrhage is likely to be:

A) Cold, clammy skin
B) Tachycardia
C) Hypotension
D) Decreased urinary output

Question 10

The nurse conducting a childbirth preparation class warns the patients that shock is a real threat after delivery due to: Select all that apply.

A) Pulmonary embolism
B) Blood clotting disorders
C) Anemia
D) Infection
E) Postpartum hemorrhage
F) None of the above

Question 11

Although the nurse has massaged the uterus every 15 minutes, the uterus remains flaccid and the patient continues to pass large clots. The nurse recognizes these signs as indicating:

A) Uterine atony
B) Uterine dystocia
C) Uterine hypoplasia
D) Uterine dysfunction

Question 12

If massage and putting the baby to breast is not effective in controlling a boggy uterus, the nurse explains that the physician may order:

A) Ritodrine
B) Magnesium sulfate
C) Pitocin
D) Parlodel

Question 13

The nurse is caring for a woman who had a cesarean birth yesterday. Varicose veins are visible on both legs. To prevent thrombus formation the nurse would:

A) Have the woman sit in a chair for meals.
B) Monitor vital signs every 4 hours and report any changes.
C) Tell the woman to remain in bed with her legs elevated.
D) Assist the woman with ambulation for short periods of time.

Question 14

Three weeks after delivering her first child, a woman tells the nurse, "I waited so long for this baby and now that she is here, I can't believe how different my life is from what I expected." The best nursing response to the woman's statement is:

A) "How is your partner adjusting to the change?"
B) "I hear this from a lot of first-time mothers."
C) "Have you told anyone else about your feelings?"
D) "Tell me how things are different."

Question 15

The nurse's first action when postpartum hemorrhage from uterine atony is suspected is to:

A) Teach the patient how to massage the abdomen and then get help
B) Start IV fluids to prevent hypovolemia, then notify the registered nurse
C) Begin massaging the fundus while another person notifies the physician
D) Ask the patient to void and reassess fundal tone and location

Question 16

The 1-day postpartum patient shows a temperature elevation, cough, and slight shortness of breath on exertion. Based on these symptoms the nurse should:

A) Notify the charge nurse of a possible upper respiratory infection
B) Notify the physician of a possible pulmonary embolism
C) Document expected postpartum mucous membrane congestion
D) Medicate with antipyretic remedy for elevated temperature

Question 17

A woman had a vaginal delivery two days ago and is preparing for discharge. To help prevent postpartum complications, the nurse plans to teach the woman to report any:

A) Fever
B) Change in lochia from red to white
C) Contractions
D) Fatigue and irritability

Question 18

A woman has had persistent lochia rubra for two weeks since her delivery and is experiencing pelvic discomfort. When subinvolution is diagnosed, the nurse explains that the usual treatment for this disorder is:

A) Uterine massage
B) Pitocin infusion
C) Dilation and curettage
D) Hysterectomy

Question 19

After a prolonged labor, a woman vaginally delivered a 10 pound, 3 ounce baby boy. In the immediate postpartum period, the nurse would be alert for the development of:

A) Cervical laceration
B) Hematoma
C) Endometritis
D) Retained placental fragments

Question 20

The nurse determines that a woman with mastitis understands treatment instructions when she says:

A) "Apply cold compresses to the painful areas."
B) "Take a warm shower before nursing the baby."
C) "Nurse first on the affected side."
D) "Empty the affected breast every 8 hours."

Question 21

In order to reduce the risk of mastitis, the nurse will teach a nursing mother to: Select all that apply.

A) Limit fluid intake to 1 liter per day
B) Empty both breasts with each feeding
C) Take warm showers
D) Wear a supportive bra
E) Pump breasts to ensure emptying

Question 22

When the nurse flexes the patient's leg and dorsiflexes the foot, the nurse is: Select all that apply.

A) Assessing for edema in the lower limb
B) Performing range of motion exercises
C) Stimulating circulation to limbs
D) Assessing for deep vein thrombus
E) Comparing color and temperature of the limbs

Question 23

The nurse instructs the postpartum patient that her nutritional intake should include foods which are particularly supportive to healing, such as: Select all that apply.

A) Legumes
B) Potatoes and pasta
C) Citrus fruits
D) Rice
E) Cantaloupe

Question 24

When the nurse assesses the perineal pad placed on a 3-hour postdelivery patient and finds that there is no lochia on it, the nurse would expect to find on further assessment: Select all that apply.

A) A firm fundus the size of a grapefruit
B) A full and turgid bladder
C) Retained placental fragments
D) Vital signs indicative of shock
E) A soft boggy fundus