Question 1

After a prolonged labor,a woman vaginally delivered a 10 pound,3 ounce infant boy.In the immediate postpartum period,the nurse would be alert for the development of:

Accepted Answer

Delivering a large infant and a prolonged labor are risk factors for hematoma formation.

Question 2

The nurse is caring for a woman who had a cesarean birth yesterday.Varicose veins are visible on both legs.To prevent thrombus formation the nurse would:

Accepted Answer

Early ambulation and range-of-motion exercises are valuable aids to preventing thrombus formation in the postpartum woman.

Question 3

When the 4-week postpartum patient with mastitis asks the nurse if she can continue to breastfeed,the nurse's most helpful response is:

Accepted Answer

The woman with mastitis can continue to breastfeed unless an abscess forms.

Question 4

A woman had a vaginal delivery two days ago and is preparing for discharge.To help prevent postpartum complications,the nurse plans to teach the woman to report any:

Accepted Answer

Increased temperature is a sign of infection.The other choices are normal in the postpartum period.

Question 5

The nurse assesses a boggy uterus with the fundus above the umbilicus and deviated to the side.The nurse should next assess:

Accepted Answer

Bladder distention can cause uterine atony.The uterus is massaged to firmness and then the bladder is emptied.

Question 6

The first sign of hypovolemic shock from postpartum hemorrhage is likely to be:

Accepted Answer

Tachycardia is usually the first sign of inadequate blood volume.

Question 7

The best response to a postpartum woman who tells the nurse that she feels "tired and sick all of the time since I had the baby 3 months ago" is:

Accepted Answer

If a postpartum woman seems depressed,it is important to explore her feelings to determine if they are persistent and pervasive.

Question 8

During a postpartum assessment,a woman reports that her right calf is painful.The nurse observes edema and redness along the saphenous vein in the right lower leg.Based on this finding,the nurse explains that the probable treatment will involve:

Accepted Answer

Anticoagulant therapy is continued with heparin or warfarin (Coumadin)for 6 weeks after birth to minimize the risk of embolism.

Question 9

While caring for a postpartum patient who had a vaginal delivery yesterday,the nurse assesses both a firm uterine fundus and a trickle of bright blood.The nurse is:

Accepted Answer

The bright trickle of blood with a firm uterus suggests a cervical laceration.

Question 10

A woman has had persistent lochia rubra for two weeks after her delivery and is experiencing pelvic discomfort.When subinvolution is diagnosed,the nurse explains that the usual treatment for this disorder is:

Accepted Answer

Medical treatment for subinvolution is selected to correct the cause.Treatment may include dilation of the cervix and curettage to remove retained placental fragments from the uterine wall.

Question 11

Five days after a spontaneous vaginal delivery,a woman comes to the emergency room because she has a fever and persistent cramping.The nurse recognizes that the cause of these signs and symptoms may be:

Accepted Answer

Fever after 24 hours following delivery is suggestive of an infection.Severe cramping and fever are manifestations of endometritis.

Question 12

At her 6-week postpartum checkup,a woman mentions to the nurse that she cannot sleep and is not eating.She feels guilty because sometimes she believes her infant is dead.The nurse recognizes this woman's symptoms as:

Accepted Answer

Major depression is a disorder characterized by deep feelings of worthlessness,guilt,serious sleep and appetite disturbances,and sometimes delusions about the infant being dead.

Question 13

The statement that would indicate to the nurse on a postpartum home visit that the patient understands the signs of late postpartum hemorrhage is:

Accepted Answer

When the nurse teaches the postpartum woman about normal changes in lochia,it is important to explain that a return to red bleeding after it has changed to pink or white may indicate a late postpartum hemorrhage.

Question 14

The nurse's first action when postpartum hemorrhage from uterine atony is suspected is to:

Accepted Answer

When the uterus is boggy,the nurse should immediately massage it until it becomes firm.

Question 15

The one-day postpartum patient shows a temperature elevation,cough,and slight shortness of breath on exertion.Based on these symptoms the nurse should:

Accepted Answer

Symptoms of early pulmonary embolism may not be dynamic.The cough with shortness of breath and temperature elevation is a clue to this possible complication.

Question 16

The nurse determines that a woman with mastitis understands treatment instructions when she says she will:

Accepted Answer

Moist heat promotes blood flow to the area,comfort,and complete emptying of the breast.

Question 17

If massage and putting the infant to breast is not effective in controlling a boggy uterus,the nurse explains that the physician may order:

Accepted Answer

Oxytocin (Pitocin)is the most common drug ordered to control uterine atony.

Question 18

Although the nurse has massaged the uterus every 15 minutes it remains flaccid,and the patient continues to pass large clots.The nurse recognizes that these signs indicate uterine:

Accepted Answer

Atony describes a lack of normal muscle tone.If the uterus is atonic,then muscle fibers are flaccid and will not compress bleeding vessels.

Question 19

Three weeks after delivering her first child,a woman tells the nurse,"I waited so long for this baby and now that she is here,I can't believe how different my life is from what I expected." The best nursing response to the woman's statement is:

Accepted Answer

The nurse may help the woman by being a sympathetic listener.The nurse should elicit the new mother's feelings about motherhood and her infant.

Question 20

One day after discharge,the postpartum patient calls the clinic complaining of a reddened area on her lower leg,temperature elevation of 37 ° C (99.8° F),rust-colored lochia,and sore breasts.From these symptoms,the nurse suspects:

Accepted Answer

The complaints related to the leg are indicative of phlebitis.The other signs are normal in the postpartum patient.

Quiz 10: Nursing Care of Women with Complications After Birth