Deck 29: The Postpartum Family: Early Care Needs and Home Care

Question 1

The nurse is caring for a client who plans to relinquish her baby for adoption. Which nursing actions are appropriate based on this information? Select all that apply.
1) Encourage the client to see and hold her infant.
2) Encourage the client to express her emotions.
3) Respect any special requests for the birth.
4) Acknowledge the grieving process in the client.
5) Allow for access to the infant if the client requests it.

Answer 1

2, 3, 4, 5

Question 2

The nurse is caring for a postpartum client who is 4 hours postoperative following a cesarean birth. Which nursing interventions are appropriate based on these data? Select all that apply.
1) Administering the prescribed analgesics, as needed
2) Encouraging ambulation to the bathroom to void
3) Encouraging leg exercises every 2 hours
4) Encouraging coughing and deep breathing every 2 to 4 hours
5) Encouraging the use of breathing, relaxation, and distraction

Answer 2

1, 3, 4, 5

Question 3

The nurse is caring for a client who delivered by cesarean birth and during which she received a general anesthetic. Which will the nurse encourage to prevent or minimize abdominal distention? Select all that apply.
1) Increasing intake of cold beverages
2) Participating in leg exercises every 2 hours
3) Tightening the abdominal muscles
4) Ambulating as often as possible
5) Eating a high-protein general diet

Answer 3

2, 3, 4

Question 4

On the second day postpartum, the client who is bottlefeeding experiences engorgement. Which should the nurse encourage to enhance the client's comfort?
1) Removing her bra
2) Applying heat to her breasts
3) Applying ice packs to her breasts
4) Limiting breastfeeding to twice daily

Question 5

The nurse is caring for an adolescent client who gave birth to her first child yesterday. Which nursing action indicates accurate understanding of adolescent parenting concepts?
1) The client's mother is included in all discussions and demonstrations.
2) The father of the baby is encouraged to change a diaper and give a bottle.
3) The nurse explains the characteristics and cues of the baby during the assessment.
4) A discussion on contraceptive methods is the first topic of teaching.

Question 6

The nurse completes a postpartum assessment on a client who gave birth to her first child 12 hours ago. Assessment findings include: the client nauseated, but has not vomited in the last 2 hours; fundus was boggy but firmed with massage to 1 FB ↓ the uterus; client is experiencing moderately heavy lochia rubra and the perineum ecchymotic and edematous. The client's pain rating is 6 on scale of 1 to
10) Her partner is present and supportive. Breastfeeding has been successful 3 times. Which nursing diagnosis has the highest priority for this client?
1) Acute Pain related to perineal trauma
2) Risk for Deficient Fluid Volume related to uterine bleeding and nausea
3) Readiness for Enhanced Family Coping related to vaginal childbirth experience
4) Knowledge Deficit related to newborn care

Question 7

A new mother is concerned about spoiling her newborn. Which statement should the home care nurse include in this teaching session with the new mother?
1) "Spoiling occurs when an infant is rocked to sleep every night."
2) "Newborns can be manipulative, so caution is advised."
3) "Crying is good for an infant, and letting them cry it out is advised."
4) "It is important to meet your infant's needs to develop a trusting relationship."

Question 8

The hospital is developing a new maternity unit. What aspects should be included in the planning of this new unit to best promote family wellness?
1) Normal newborn nursery centrally located to all client rooms
2) A kitchen with refrigerator stocked with juice and sandwiches
3) Small, cozy rooms with a client bed and rocking chair
4) A nursing model based on providing couplet care

Question 9

During a home care visit, the new breastfeeding mother reports breast engorgement. Which statement by the home care nurse is most appropriate based on this information?
1) "Apply an ice compress to your breast before nursing."
2) "Encourage your baby to suckle for an average of 5 minutes per feeding."
3) "Apply warm compresses to your breast after you finish feeding your baby."
4) "When you are not nursing, wear a well-fitted nursing bra at all times, even when you sleep."

Question 10

The postpartum client, who delivered 4 hours ago, has a mediolateral episiotomy and large hemorrhoids. The client currently rates her pain at 7 on a scale of 1 to
10) She has a history of anaphylactic reaction to acetaminophen (Tylenol). Which nursing action is most appropriate?
1) Offering 800 mg ibuprofen (Advil) orally with food
2) Providing two oxycodone with acetaminophen tablets (Percocet) by mouth
3) Encouraging use of the prescribed topical anesthetic spray
4) Running very warm water into the tub and assisting her into the bath

Question 11

The nurse is teaching a postpartum client when light housekeeping can be resumed. Which response by the client indicates accurate understanding of the information provided?
1) "I can resume light housekeeping after the 6-week postpartum checkup."
2) "I can resume light housekeeping during my first week at home."
3) "I can resume light housekeeping during my second day at home."
4) "I can resume light housekeeping after my second week at home."

Question 12

The nurse is teaching a postpartum client information regarding weaning her infant from breastfeeding. Which client statement suggests a need for further teaching?
1) "Slow weaning should take place over a period of several months."
2) "By weaning my baby slowly, I'm giving him time to change his eating method at his own pace."
3) "If I wean my baby slowly, I am less likely to develop breast engorgement."
4) "Slowly weaning my baby is recommended to allow time for my psychologic adjustment."

Question 13

The nurse is instructing a postpartum client on the use of perineal pads. Which statements should the nurse include in the teaching session? Select all that apply.
1) "Apply the pad from back to front."
2) "Change the pad after each perineal cleansing."
3) "Place the pad so that it applies pressure to the perineum."
4) "Change the pad each time you use the bathroom."
5) "Your pad should be loose to allow the perineum to 'breathe.' "

Question 14

The nurse is providing postpartum care to a client who is lesbian and her life partner. Which nursing actions are appropriate when providing care to this couple? Select all that apply.
1) Providing the couple with the same rights and care as those given to heterosexual couples
2) Educating the couple about contraception during the postpartum period
3) Teaching the couple about when it is safe to resume sexual relations
4) Encouraging the couple to join a support group of other postpartum lesbian couples
5) Inviting both the client and the partner to share their parenting concerns

Question 15

The maternal home care nurse, who is orienting a new nurse, discusses maternal psychologic adaptations and stressors. Which statement by the maternal home care nurse reflects the correct approach to addressing potential and actual postpartum depression in maternal patients?
1) "Because emotional disorders and imbalances are a very sensitive subject, we try not to offend patients by routinely bringing up the topic of postpartum depression."
2) "For women with a history of depression, we include education about postpartum depression."
3) "Teaching about postpartum depression is a routine part of education for all maternal patients."
4) "If we suspect a woman may have developed postpartum depression, then we provide specialized education about that topic."

Question 16

The nurse is providing care to a postpartum client who is relinquishing custody of her newborn through an open adoption. Which nursing action is most important?
1) Assigning the client a room on the GYN surgical floor instead of the postpartum floor
2) Preparing to have teaching done in time for discharging the client at 24 hours postdelivery
3) Making an effort not to bring up the topic of the baby, and discuss the mother's health instead
4) Asking the client if she wants to feed her baby, and how much contact she wants to have

Question 17

Which is the obese postpartum client at a greater risk for experiencing? Select all that apply.
1) Injury
2) Infection
3) Breast engorgement
4) Deep vein thrombosis
5) Respiratory complications

Question 18

The client having her second child is scheduled for a cesarean birth because the baby is in a breech presentation. The client states, "I'm wondering what will be different this time compared with my first birth, which was vaginal." Which response by the nurse is most appropriate?
1) "We'll take good care of you and your baby. You'll be home before you know it."
2) "You'll be wearing sequential compression devices to prevent blood clots from forming in your legs."
3) "You will have a lot of pain, but there are medications that we give when it gets bad."
4) "You won't be able to nurse until the baby is 12 hours old because of your epidural."

Question 19

Which safety device is most appropriate for the nurse who conducts home care visits to postpartum mothers?
1) Cellular phone
2) Map of the area
3) Personal handgun
4) Can of Mace

Question 20

During a home care visit, a couple expresses a desire for cosleeping, or sleeping in the same bed with their newborn baby. Which nursing response is most appropriate?
1) "Current research suggests there are no physical risks related to cosleeping, and this recommended as a healthy psychologic approach to family bonding.
2) "Cosleeping is a safe and healthy practice, as long as you make sure your baby is sleeping on the stomach."
3) "Cosleeping is considered a risk factor for SIDS, so families who practice cosleeping need to following specific safety guidelines."
4) "Cosleeping is not recommended; however, if you wish to do this, place your baby on a comforter, as opposed to directly on the mattress."

Question 21

The nurse is conducting discharge teaching for a postpartum client who has an episiotomy. Which client actions indicate correct understanding of the information presented? Select all that apply.
1) Using topical anesthetics regularly
2) Remaining in the sitz bath for 20 minutes
3) Using the peri-bottle to cleanse the site after urination
4) Stating that she will loosen her buttocks prior to sitting down
5) Stating that she will continue to use an ice pack for pain after discharge

Question 22

Which will the nurse include in the family assessment for the postpartum client? Select all that apply.
1) Parental roles
2) Bonding behaviors
3) Sibling adjustment
4) Signs and symptoms of infection
5) Level of comfort with newborn care