Question 1

The maternal nurse educator is conducting a presentation for antepartum patients describing the identification and care of women diagnosed with postpartum psychiatric disorders. Which information should the maternal nurse educator include in her teaching content?

A)Postpartum depression occurs in as many as 50% to 70% of mothers and is characterized by mild depression interspersed with happier feelings.
B)Postpartum depression is typically mild and usually self-limiting, lasting up to 6 weeks.
C)Even if she is asymptomatic, a woman with a history of postpartum depression should be referred to a mental health professional for counseling and biweekly visits postpartum.
D)Women with postpartum depression have a history of exposure to an extremely traumatic personal event that involves actual or threatened death or serious injury and evokes intense fear, helplessness, or horror.

Accepted Answer

Referring a woman with a history of postpartum depression to a mental health professional for counseling and biweekly visits postpartum is an important aspect of care to prevent future occurrences of postpartum psychiatric disorders. The other options are incorrect. Postpartum depression actually occurs in around 10% to 20% of mothers and is characterized by persistent feelings of sadness, hopelessness, and emptiness. It can last for several months and can be severe enough to interfere with daily activities. Women with postpartum depression do not necessarily have a history of exposure to trauma.

Question 2

The postpartum multipara is breastfeeding her new baby. The patient states that she developed mastitis with her first child, and asks if there is something she can do to prevent mastitis this time. The best response of the nurse is:

A)"Massage your breasts on a daily basis, and if you find a hardened area, massage it towards the nipple to unblock that duct."
B)"Most first-time moms experience mastitis.It is really quite unusual for a woman having her second baby to get it again."
C)"Apply cold packs to any areas that feel thickened or firm in order to relieve the swelling and stasis of the milk in that area."
D)"Take your temperature once a day.This will help you to pick up the infection early, before it becomes severe."

Accepted Answer

Massaging the breasts on a daily basis and unblocking any hardened areas towards the nipple can help prevent the development of mastitis. This action can help keep milk flowing smoothly and prevent blockages that can lead to infection. The other answer choices are incorrect.

Question 3

The patient at 3 days postpartum has come to the maternity clinic with complaints of urinary urgency and dysuria. Which statement is most important for the nurse to make?&#10;A)&#34;Void into this sterile cup without touching the inside of the cup.&#34;&#10;B)&#34;Be sure to wipe from back to front after you have a bowel movement.&#34;&#10;C)&#34;Call the clinic if you develop nausea and vomiting or constipation.&#34;&#10;D)&#34;Decrease your fluid intake for a few days, but eat a lot of vegetables.&#34;

Accepted Answer

The most important statement for the nurse to make is to instruct the patient to void into a sterile cup without touching the inside of the cup. This will allow the healthcare provider to obtain a urine specimen for analysis to determine if the patient has a urinary tract infection. The other statements, while important, are not as immediately relevant to addressing the patient's current symptoms.

Question 4

A nurse suspects that a postpartum patient has mastitis. The following assessment provides what data to support this assessment?&#10;A)Shooting pain in her nipple during breastfeeding.&#10;B)Late onset of nipple pain&#10;C)Pink, flaking, pruritic skin of the affected nipple.&#10;D)Nipple soreness when the infant latches on.

Accepted Answer

The answer of A nurse suspects that a postpartum patient...

Question 5

The postpartum patient who delivered 2 days ago has developed endometritis. Which charting entry would the nurse expect to find in this patient's chart?&#10;A)&#34;Cesarean birth performed secondary to arrest of dilation.&#34;&#10;B)&#34;Rupture of membranes occurred 2 hours prior to delivery.&#34;&#10;C)&#34;External fetal monitoring used throughout labor.&#34;&#10;D)&#34;Patient has history of pregnancy-induced hypertension.&#34;

Accepted Answer

Endometritis is an infection of the uterus that can occur after delivery, particularly after a complicated labor and delivery such as a cesarean birth performed for an arrest of dilation. The other options listed are not necessarily related to the development of endometritis.

Question 6

Which method of initial assessment would best indicate whether a patient has a urinary complication?&#10;A)Urine pH&#10;B)Calculation of urine output&#10;C)Urine-specific gravity&#10;D)Calculation of intake

Accepted Answer

Calculation of urine output can indicate if a patient has a urinary complication such as urinary retention or urinary incontinence. A decrease in urine output could indicate obstruction or decreased kidney function, while an increase in urine output could indicate overactive bladder or diabetes insipidus. Urine pH and urine-specific gravity may provide information about hydration status and possible urinary tract infections, but are not as reliable in indicating urinary complications. Calculation of intake may be important in managing fluid balance, but does not specifically indicate a urinary complication.

Question 7

The nurse is revising the care plan of a 26-year-old woman who has developed mastitis. Which nursing diagnosis is most appropriate for inclusion in this patient's updated plan of care?&#10;A)Ineffective Peripheral Tissue Perfusion related to obstructed venous return&#10;B)Risk for Trauma related to lack of information about appropriate breastfeeding practices.&#10;C)Deficient Knowledge related to self-care after discharge on anticoagulant therapy&#10;D)Acute Pain related to tissue hypoxia and edema secondary to vascular obstruction

Accepted Answer

Mastitis is an inflammation of breast tissue that sometimes involves an infection. The condition can result in pain, swelling, warmth, and redness in the breast. A common cause of mastitis, especially in breastfeeding women, is poor breastfeeding practices or techniques, which can lead to milk stasis and infection. Therefore, "Risk for Trauma related to lack of information about appropriate breastfeeding practices" is the most appropriate nursing diagnosis as it addresses the potential for worsening of the condition or injury due to inadequate knowledge on how to properly breastfeed, which is a key factor in the prevention and management of mastitis.

Question 8

The charge nurse is reviewing the plan of care for maternal patients currently admitted for postpartum care. During the course of her chart review, which intervention requires immediate consideration for revision?

A)Daily prothrombin time (PT) measurements for coagulation assessment in a woman receiving heparin for treatment of thrombophlebitis.
B)Use of the REEDA scale for assessment every 8 hours in the care of a patient diagnosed with puerperal infection.
C)Misoprostol (Cytotec) administration to a patient who demonstrates uterine atony and bleeding after receiving oxytocic medications.
D)Inserting a straight catheter to drain the overdistended bladder of a woman during the early postpartum period of her care.

Accepted Answer

Heparin therapy is monitored using the activated partial thromboplastin time (aPTT) rather than prothrombin time (PT), which is used for monitoring warfarin therapy. This indicates a need for immediate revision of the care plan.

Question 9

The nurse is assisting a multiparous woman to the bathroom for the first time since her delivery 3 hours ago. When the patient stands up, blood runs down her legs and pools on the floor. The patient turns pale and feels weak. The first action of the nurse is to:

A)Assist the patient to empty her bladder.
B)Help the patient back to bed to check her fundus.
C)Assess her blood pressure and pulse.
D)Begin an IV of Lactated Ringer's infusion.

Accepted Answer

Helping the patient back to bed to check her fundus is the first action the nurse should take. This is because the scenario described suggests postpartum hemorrhage, a common and serious complication after childbirth. The fundus (top of the uterus) should be firm to help control bleeding by compressing the blood vessels. Checking the fundus can help determine if uterine atony (lack of muscle tone) is the cause of the bleeding, which is a common reason for postpartum hemorrhage.

Question 10

The postpartum patient has developed thrombophlebitis in her right leg. Which finding requires immediate intervention? The patient:&#10;A)The postpartum patient has developed thrombophlebitis in her right leg.Which finding requires immediate intervention? The patient:&#10;B)Develops pain and swelling in her left lower leg.&#10;C)Appears anxious, and describes pressure in her chest.&#10;D)Becomes upset that she can't go home yet.

Accepted Answer

The patient's chest pressure and anxiety may suggest pulmonary embolism, which is a serious complication associated with thrombophlebitis. Immediate medical attention is required to prevent further complications. Option B may indicate deep vein thrombosis in the other leg, which also requires intervention but not as urgently as option C. Option D is not a priority compared to the potential life-threatening condition of pulmonary embolism.

Question 11

A patient is experiencing excessive bleeding immediately after the birth of her newborn. After speeding up the IV fluids containing oxytocin, with no noticeable decrease in the bleeding, the nurse should anticipate the physician requesting which medications?

A)Methergine
B)Stadol
C)Misoprostol
D)Betamethasone

Accepted Answer

The answer of A patient is experiencing excessive bleeding immediately...

Deck 31: The Postpartum Family at Risk