Question 1

A patient is preparing to take a sitz bath for the first time. The nurse will:

Accepted Answer

Placing a call bell within reach and checking on the patient frequently ensures the patient's safety during the sitz bath. While allowing privacy is important, it is also necessary to ensure the patient's well-being. Discouraging the patient from taking a sitz bath is not appropriate without a valid medical reason. Checking on the patient after the sitz bath is not proactive enough to prevent any issues during the bath.

Question 2

The hospital is developing a new maternity unit. What aspects should be included in the planning of the new unit to best promote family wellness?

Accepted Answer

Providing couplet care, in which the same nurse cares for both the mother and newborn, promotes bonding and can enhance family wellness. A normal newborn nursery can be helpful but is not essential, and a kitchen is not directly related to family wellness. Cozy rooms may be beneficial but are not as crucial as a nursing care model focused on couplet care.

Question 3

A new grandmother comments that when her children were born, they stayed in the nursery. The grandmother asks the nurse why her daughter's baby stays mostly in the room instead of the nursery. How should the nurse respond?

Accepted Answer

Current research shows that early parent-infant contact promotes bonding and attachment. Hospitals now encourage parents to keep their infants in their rooms and provide resources to help parents care for their infants.

Question 4

RhoGAM is given to the postpartum patient for the purpose of:

Accepted Answer

RhoGAM is given to prevent sensitization from the fetomaternal transfusion of Rh-positive fetal red blood cells. This is important to prevent hemolytic disease of the newborn in future pregnancies.

Question 5

The postpartum patient delivered 4 hours ago. She has a mediolateral episiotomy and large hemorrhoids. She is rating her pain at 7 on a scale of 1- 10. She has a history of anaphylactic reaction to Tylenol (acetaminophen). Which nursing action would be best?

Accepted Answer

Ibuprofen is a suitable alternative for pain relief in this case, as it does not contain acetaminophen, to which the patient is allergic.

Question 6

A patient who delivered 2 hours ago tells the nurse that she is exhausted and feels guilty because her friends told her how euphoric they felt after giving birth. How should the nurse respond?

Accepted Answer

The nurse should reassure the patient that everyone is different and that both responses (feeling euphoric or feeling exhausted) are normal. This can help the patient feel less guilty and more validated in her experience.

Question 7

The patient having her second child is scheduled for a cesarean birth because the baby is in a breech presentation. The patient states, "I'm wondering what will be different this time compared with my first birth, which was vaginal." What response is best?

Accepted Answer

The best response is factual and directly addresses a specific difference the patient will experience with a cesarean birth compared to a vaginal birth. Sequential compression devices are used to prevent blood clots and are typically not used in vaginal births, making this information relevant and specific to her situation.

Question 8

Which statement by a nursing student preparing to care for a postpartum lesbian mother would indicate the need for further teaching?

Accepted Answer

The answer of Which statement by a nursing student preparing...

Question 9

The nurse assesses the postpartum patient to have moderate lochia rubra with clots. Which nursing intervention would be appropriate?

Accepted Answer

Moderate lochia rubra with clots warrants an assessment of the uterine fundus and bladder status to ensure that there is no retained products of conception or bladder distension which could lead to increased bleeding. Catheterization and administration of medication should not be done without a medical order and contacting the physician immediately may be necessary if there are any significant changes or concerns.

Question 10

The nurse is providing education to the new family. Which is best?

Accepted Answer

This question is asking for the best education to provide to the new family. Option C is the best as it directly pertains to the care of the newborn and the mother's postpartum recovery. Option A and B may be helpful but do not require as much expertise from the nurse. Option D is irrelevant and may come across as judgmental.

Question 11

The postpartum nurse provides anticipatory guidance for the new mother as well as teaching on self-care and infant care before discharge. Which topics should be included?

Accepted Answer

The postpartum nurse should provide anticipatory guidance on topics such as role changes, lifestyle adjustments, potential complications, and sexuality and contraception. However, toilet-training and preschool options are not relevant topics for the immediate postpartum period and are better addressed at a later time.

Question 12

The nurse is teaching a new mother about ways to manage fatigue after she returns home. Which instructions should the nurse include?

Accepted Answer

A new mother can manage fatigue by taking frequent rest periods, napping when the newborn is sleeping, avoiding overdoing housework and unnecessary chores, and utilizing friends and family to provide help and support, such as cooking a meal. It is also important to avoid having others come to the house to do housework and interfere with rest. Therefore, options A, B, C, and E are the best choices.

Question 13

The postpartum patient expresses concern about getting back to her prepregnant shape, and asks the nurse when she will be able to run again. Which statement by the patient indicates that teaching was effective?

Accepted Answer

Option B is the correct answer because it shows an understanding of the need to gradually increase physical activity and listen to the body's cues. Option A is incorrect because there is no set timeline for when a postpartum woman should start running again and breastfeeding can be done immediately after. Option C is incorrect because running is safe for breastfeeding women as long as they stay hydrated and wear a supportive bra. Option D is incorrect because sleep is important for postpartum recovery, but it is not the only factor that determines when a woman can start running again.

Question 14

The nurse is caring for a patient who had a cesarean birth 4 hours ago. Which interventions would the nurse implement at this time?

Accepted Answer

The answer of The nurse is caring for a patient...

Question 15

The breastfeeding patient asks the nurse about appropriate contraception. The nurse's best response is:

Accepted Answer

It is important for the nurse to inform the patient that breastfeeding does not serve as a reliable method of contraception and that it is possible to get pregnant before the menstrual period returns. Therefore, the nurse should discuss different contraceptive options with the patient.

Question 16

A postpartum patient has just received a rubella vaccination. The patient demonstrates understanding of the teaching associated with administration of this vaccine when she states:

Accepted Answer

The rubella vaccine is a live attenuated vaccine and should be avoided during pregnancy or for one month after the vaccine is given to prevent any risks to the fetus. Option A is incorrect because a single dose of rubella vaccine is considered protective for life. Option C is incorrect because rubella and chickenpox are different diseases and require different vaccines. Option D is incorrect because the rubella vaccine is given to protect the mother from rubella infection and not to directly protect the newborn.

Question 17

What information should the nurse include when teaching the postpartal patient and partner about resumption of sexual activity?

Accepted Answer

- A) It's important to wait until the episiotomy is healed and lochial flow has stopped to prevent infection and ensure comfort.- B) Vaginal dryness can be a common issue postpartum, especially among breastfeeding mothers due to hormonal changes, so lubrication can be helpful.- E) Fatigue from caring for a newborn can significantly impact the desire and ability to resume sexual activity, and this is a normal experience for new parents.

Question 18

On the 3rd day postpartum, a patient who is not breastfeeding experiences engorgement. To relieve her discomfort, the nurse should encourage the patient to:

Accepted Answer

Since the patient is not breastfeeding, using a breast pump would not be a good solution. Removing her bra might add to the discomfort. Applying heat to the breasts would increase blood flow and exacerbate symptoms. The best solution for engorgement is to apply cold packs to decrease blood flow and reduce inflammation.

Question 19

The advantage of using patient-controlled analgesia (PCA) following a cesarean birth is that the patient:

Accepted Answer

PCA allows the patient to have control over their pain management, leading to a greater sense of autonomy and less dependence on nursing staff. A bolus of medication is dispensed when the button is pressed, but it may not provide immediate pain relief. Additionally, there are limits to the number of doses that can be delivered within a specified time frame to prevent over-medication.

Question 20

What maternity unit policies promote postpartal family wellness and shared parenting?

Accepted Answer

Mother-baby care, also known as couplet care, promotes shared parenting and encourages the father to be involved in infant care. Skin-to-skin contact between the mother, father, and baby promotes bonding and breastfeeding. Self-demand feeding schedules allow parents to feed their infant when the infant is hungry, which promotes responsive parenting and can increase breastfeeding success. Keeping the newborn in the nursery can lead to fewer opportunities for parents to bond with their infant and can interrupt the establishment of breastfeeding. Limited visiting hours for the father can also limit opportunities for shared parenting and bonding.

Quiz 36: The Postpartum Family: Needs and Care