Deck 21: Nursing Care of the Family During the Postpartum Period

Question 1

A woman gave birth 48 hours ago to a healthy infant girl.She has decided to bottle feed.During the assessment,the nurse notices that both breasts are swollen,warm,and tender on palpation.Which guidance should the nurse provide to the client at this time?

A) Run warm water on her breasts during a shower.
B) Apply ice to the breasts for comfort.
C) Express small amounts of milk from the breasts to relieve the pressure.
D) Wearing a loose-fitting bra to prevent nipple irritation.

Answer 1

Apply ice to the breasts for comfort.

Question 2

Which physiologic factors are reliable indicators of impending shock from postpartum hemorrhage? (Select all that apply. )

A) Respirations
B) Skin condition
C) Blood pressure
D) Level of consciousness
E) Urinary output

Answer 2

Respirations
Skin condition
Level of consciousness
Urinary output

Question 3

The laboratory results for a postpartum woman are as follows: blood type,A;Rh status,positive;rubella titer,1:8 (enzyme immunoassay [EIA] 0.8);hematocrit,30%.How should the nurse best interpret these data?

A) Rubella vaccine should be administered.
B) Blood transfusion is necessary.
C) Rh immune globulin is necessary within 72 hours of childbirth.
D) Kleihauer-Betke test should be performed.

Answer 3

Rubella vaccine should be administered.

Question 4

Because a full bladder prevents the uterus from contracting normally,nurses intervene to help the woman spontaneously empty her bladder as soon as possible.If all else fails,what tactic might the nurse use?

A) Pouring water from a squeeze bottle over the woman's perineum
B) Placing oil of peppermint in a bedpan under the woman
C) Asking the healthcare provider to prescribe analgesic agents
D) Inserting a sterile catheter

Question 5

Parents who have not already done so need to make time for newborn follow-up of the discharge.According to the American Academy of Pediatrics (AAP),when should a breastfeeding infant first need to be seen for a follow-up examination?

A) 2 weeks of age
B) 7 to 10 days after childbirth
C) 4 to 5 days after hospital discharge
D) 48 to 72 hours after hospital discharge

Question 6

A primiparous woman is to be discharged from the hospital the following day with her infant girl.Which behavior indicates a need for further intervention by the nurse before the woman can be discharged?

A) The woman is weepy and asks to postpone learning about infant care.
B) The woman continues to hold and cuddle her infant after she has fed her.
C) The woman asks for several magazines to read while her infant sleeps.
D) The woman changes her infant's diaper and then shows the nurse the contents of the diaper.

Question 7

What information should the nurse understand fully regarding rubella and Rh status?

A) Breastfeeding mothers cannot be vaccinated with the live attenuated rubella virus.
B) Women should be warned that the rubella vaccination is teratogenic and that they must avoid pregnancy for at least 1 month after vaccination.
C) Rh immunoglobulin is safely administered intravenously because it cannot harm a nursing infant.
D) Rh immunoglobulin boosts the immune system and thereby enhances the effectiveness of vaccinations.

Question 8

A 25-year-old multiparous woman gave birth to an infant boy 1 day ago.Today her husband brings a large container of brown seaweed soup to the hospital.When the nurse enters the room,the husband asks for help with warming the soup so that his wife can eat it.What is the nurse's most appropriate response?

A) "Didn't you like your lunch?"
B) "Does your health care provider know that you are planning to eat that?"
C) "What is that anyway?"
D) "I'll warm the soup in the microwave for you."

Question 9

A woman gave birth vaginally to a 9-pound,12-ounce girl yesterday.Her primary health care provider has written orders for perineal ice packs,use of a sitz bath three times daily,and a stool softener.Which information regarding the client's condition is most closely correlated with these orders?

A) Woman is a gravida 2,para 2.
B) Woman had a vacuum-assisted birth.
C) Woman received epidural anesthesia.
D) Woman has an episiotomy.

Question 10

The trend in the United States is for women to remain hospitalized no longer than 1 or 2 days after giving birth.Which scenario is not a contributor to this model of care?

A) Wellness orientation model of care rather than a sick-care model
B) Desire to reduce health care costs
C) Consumer demand for fewer medical interventions and more family-focused experiences
D) Less need for nursing time as a result of more medical and technologic advances and devices available at home that can provide information

Question 11

Rh_o immune globulin will be ordered postpartum if which situation occurs?

A) Mother Rh-,baby Rh+
B) Mother Rh-,baby Rh-
C) Mother Rh+,baby Rh+
D) Mother Rh+,baby Rh-

Question 12

If a woman is at risk for thrombus but is not ready to ambulate,which nursing intervention would the nurse include in the plan of care? (Select all that apply. )

A) Putting her in antiembolic stockings
B) Having her flex,extend,and rotate her feet,ankles,and legs
C) Having her sit in a chair for at 30 uninterrupted minutes
D) Immediately notifying the healthcare provider when a positive Homans sign occurs
E) Applying sequential compression devices as prescribed

Question 13

A hospital has several different perineal pads available for use.A nurse is observed soaking several of them and writing down what is observed.What goal is the nurse attempting to achieve by performing this practice?

A) To improve the accuracy of blood loss estimation,which usually is a subjective assessment
B) To determine which pad is best
C) To demonstrate that other nurses usually underestimate blood loss
D) To reveal which brand of pad is more absorbent

Question 14

On examining a woman who gave birth 5 hours ago,the nurse finds that the woman has completely saturated a perineal pad within 15 minutes.What is the nurse's highest priority?

A) Beginning an intravenous (IV)infusion of Ringer's lactate solution
B) Assessing the woman's vital signs
C) Calling the woman's primary health care provider
D) Massaging the woman's fundus

Question 15

When caring for a newly delivered woman,what is the best measure for the nurse to implement to prevent abdominal distention after a cesarean birth?

A) Rectal suppositories
B) Early and frequent ambulation
C) Tightening and relaxing abdominal muscles
D) Carbonated beverages

Question 16

A recently delivered mother and her baby are at the clinic for a 6-week postpartum checkup.Which response by the client alerts the nurse that psychosocial outcomes have not been met?

A) The woman excessively discusses her labor and birth experience.
B) The woman feels that her baby is more attractive and cleverer than any others.
C) The woman refers to the baby as "sweetie" since she has not given the baby a name yet.
D) The woman has a partner or family members who react very positively about the baby.