Deck 30: The Postpartum Family: Early Care Needs and Home Care

Question 1

Which of the following safety devices is most appropriate for the nurse making home visits?

A)Cell phone
B)Map of the area
C)Personal handgun
D)Can of mace

Answer 1

Cell phone

Question 2

The nurse is caring for a patient who delivered by cesarean birth. The patient received a general anesthetic. The nurse would encourage which of the following in order to prevent or minimize abdominal distention?

A)Increased intake of cold beverages
B)Leg exercises every 2 hours
C)Abdominal tightening
D)Ambulation
E)Eating a high-protein general diet

Answer 2

Leg exercises every 2 hours
Abdominal tightening
Ambulation

Question 3

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?

A)Offer the patient 800 mg Advil (ibuprofen) orally with food.
B)Provide two Percocet (oxycodone with acetaminophen) by mouth.
C)Encourage use of Dermoplast topical anesthetic spray.
D)Run very warm water into the tub and assist her into the bath.

Answer 3

Offer the patient 800 mg Advil (ibuprofen) orally with food.

Question 4

The nurse is caring for a patient who plans to relinquish her baby for adoption. The nurse would implement which of the following approaches to care?

A)Encourage the patient to see and hold her infant.
B)Encourage the patient to express her emotions.
C)Respect any special requests for the birth.
D)Acknowledge the grieving process in the patient.
E)Allow for access to the infant if the patient requests it.

Question 5

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?

A)Normal newborn nursery centrally located to all patient rooms
B)A kitchen with refrigerator stocked with juice and sandwiches
C)Small, cozy rooms with a patient bed and rocking chair
D)A nursing model based on providing couplet care

Question 6

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

A)Administer analgesics as needed.
B)Encourage the patient to ambulate to the bathroom to void.
C)Encourage leg exercises every 2 hours.
D)Encourage the patient to cough and deep-breathe every 2-4 hours.
E)Encourage the use of breathing, relaxation, and distraction.

Question 7

The nurse is preparing to receive a newly delivered patient. The patient is a young single mother who is relinquishing custody of her newborn through an open adoption. What action is most important?

A)Assign the patient a room on the GYN surgical floor instead of the postpartum floor.
B)Prepare to have teaching done in time for discharging the patient at 24 hours postdelivery.
C)Make an effort to not bring up the topic of the baby, and discuss the mother's health instead.
D)Ask the patient if she wants to feed her baby, and how much contact she wants to have.

Question 8

On the second day postpartum, the patient experiences engorgement. To relieve her discomfort, the nurse should encourage the patient to:

A)Remove her bra.
B)Apply heat to her breasts.
C)Apply ice packs to her breasts.
D)Limit breastfeeding to twice daily.

Question 9

The nurse instructs the postpartum client that she can resume light housekeeping after the:

A)Six-week postpartum checkup.
B)First week at home.
C)Second day at home.
D)Second week at home.

Question 10

The nurse is caring for a 15-year-old patient that gave birth to her first child yesterday. What action is the best indicator that the nurse understands the parenting adolescent?

A)The patient's mother is included in all discussions and demonstrations.
B)The father of the baby is encouraged to change a diaper and give a bottle.
C)The nurse explains the characteristics and cues of the baby during the assessment.
D)A discussion on contraceptive methods is the first topic of teaching.

Question 11

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?

A)"We'll take good care of you and your baby.You'll be home before you know it."
B)"You'll be wearing long stockings to prevent blood clots from forming in your legs."
C)"You will have a lot of pain, but there are medications that we give when it gets bad."
D)"You won't be able to nurse until the baby is 12 hours old, because of your epidural."

Question 12

The community health nurse is presenting a seminar to new mothers about breastfeeding. When discussing weaning, which new mother's statement suggests a need for further teaching?

A)"Slow weaning should take place over a period of several months."
B)"By weaning my baby slowly, I'm giving him time to change his eating method at his own pace."
C)"If I wean my baby slowly, I am less likely to develop breast engorgement."
D)"Slowly weaning my baby is recommended to allow time for psychological adjustment."

Question 13

The nurse had completed a postpartum assessment on a patient who gave birth to her first child 12 hours ago. She is nauseated, but has not vomited in the last 2 hours. Her fundus was boggy, and firmed with massage to 1 FB ↓ U, moderately heavy lochia rubra, perineum ecchymotic and edematous, and pain rating 6 on scale of 1-10. Her partner is present and supportive. Breastfeeding has been successful three times. Which nursing diagnosis has the highest priority for this patient?

A)Acute pain related to perineal trauma
B)Risk for deficient fluid volume related to uterine bleeding and nausea
C)Readiness for enhanced family coping
D)Knowledge deficit related to newborn care

Question 14

During a home care visit, the new mother complains of breast engorgement. Which intervention is most appropriate for recommendation by the home care nurse?

A)"Apply an ice compress to your breast before nursing."
B)"Encourage your baby to suckle for an average of 5 minutes per feeding."
C)"Apply warm compresses to your breast after you finish feeding your baby."
D)"When you aren't nursing, wear a well-fitted nursing bra at all times, even when you sleep."

Question 15

The maternal home care nurse is orienting a new nurse. During orientation, they are discussing maternal psychological 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?

A)"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."
B)"For women with a history of depression, we include education about postpartum depression."
C)"Teaching about postpartum depression is a routine part of education for all maternal patients."
D)"If we suspect a woman may have developed postpartum depression, then we provide specialized education about that topic."

Question 16

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?

A)"Current research suggests there are no physical risks related to cosleeping, and this recommended as a healthy psychological approach to family bonding.
B)"Cosleeping is a safe and healthy practice, as long as you make sure your baby is sleeping on his stomach."
C)"Cosleeping is considered a risk factor for SIDS, so families who practice cosleeping need to following specific safety guidelines."
D)"If you practice cosleeping, your baby should be placed on a comforter, as opposed to directly on the mattress."

Question 17

A new parent is concerned about spoiling her newborn. The home care nurse teaches the mother that:

A)Spoiling occurs when an infant is rocked to sleep every night.
B)Newborns can be manipulative, so caution is advised.
C)Crying is good for a baby, and letting them cry it out is advised.
D)Meeting the infant's needs develops a trusting relationship.