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The postpartum nurse is planning a home visit to a mother who delivered her baby 1 week ago. Which finding indicates to the nurse a possible problem with mother–infant bonding?
- A. The mother is pleased to have the nurse visit her home and baby.
- B. The baby's grandmother is present and involved with mother/baby care.
- C. The mother focuses the visit on her physical recovery and concerns.
- D. The baby's father is on 'paternity leave' and involved with the baby.
Correct Answer: C
Rationale: The correct answer is C because when a mother primarily focuses on her physical recovery and concerns during a home visit, it may indicate a possible problem with mother-infant bonding. This is because bonding involves emotional connection, interaction, and care between the mother and baby, which goes beyond physical recovery.
A: The mother being pleased to have the nurse visit her home and baby is a positive sign of engagement and interest in the baby's well-being.
B: The baby's grandmother being present and involved with mother/baby care can actually enhance bonding by providing support and assistance.
D: The baby's father being on 'paternity leave' and involved with the baby is another positive sign of family support and involvement in bonding.
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The nurse is providing postpartum care to a patient 24 hours after a vaginal delivery. Which action does the nurse perform prior to assessing the patient's uterus?
- A. Place the patient on the left side.
- B. Assess the passage of lochia.
- C. Ask the patient to void.
- D. Administer a dose of oxytocin.
Correct Answer: C
Rationale: The correct answer is C: Ask the patient to void. It is important to ask the patient to void before assessing the uterus to ensure that the bladder is empty, which allows for a more accurate assessment of the uterus size and position. This helps prevent displacement of the uterus due to a full bladder, leading to a more accurate assessment of postpartum hemorrhage risk. Placing the patient on the left side (A) is done after assessing the uterus to facilitate uterine involution. Assessing the passage of lochia (B) is important but not a priority before assessing the uterus. Administering oxytocin (D) may be indicated but should be based on assessment findings rather than being the first action.
A nurse is providing postpartum care to a G4P4 woman who gave birth vaginally 48 hours ago to a 9 pound 10 ounce boy with only a pudendal block for anesthesia. The physician has written orders for the woman to have a sitz bath three times a day. Which information is most closely correlated with the order?
- A. The woman is multiparous.
- B. The woman has an episiotomy.
- C. The woman had a vaginal birth.
- D. The woman received a pudendal block for anesthesia.
Correct Answer: B
Rationale: The correct answer is B: The woman has an episiotomy. The rationale is that a sitz bath is commonly recommended postpartum for women who have had an episiotomy to promote healing and reduce discomfort. An episiotomy is a surgical incision made in the perineum during childbirth to widen the vaginal opening. In this case, the woman had a vaginal birth and received a pudendal block for anesthesia, which are not directly correlated with the sitz bath order. Being multiparous (choice A) does not necessarily indicate the need for a sitz bath. Therefore, the most closely correlated information with the sitz bath order is the presence of an episiotomy.
Prior to discharge from the birthing center, the nurse informs the patient that she will receive vaccines for rubella, hepatitis B, pertussis, and influenza. For which reason does the nurse explain the need for the vaccinations?
- A. Discharge with a neonate is discouraged if the mother is not vaccinated.
- B. Vaccinating the mother will protect the neonate from serious illnesses.
- C. The mother's immune system has been suppressed during pregnancy.
- D. Vaccination is more easily accomplished while the mother is under medical care.
Correct Answer: B
Rationale: Step-by-step rationale for why choice B is correct:
1. Vaccinating the mother will protect the neonate: Maternal vaccination can provide passive immunity to the newborn through transplacental transfer of antibodies.
2. Protect from serious illnesses: Rubella, hepatitis B, pertussis, and influenza can have severe consequences for newborns.
3. Immunization of the mother is a preventive measure: It reduces the risk of neonatal infections.
4. Ensures the health and well-being of the newborn: By preventing potential diseases.
Summary of other choices:
A: Discharge with a neonate is not solely dependent on the mother's vaccination status.
C: Pregnancy does not suppress the immune system to the extent that vaccination is contraindicated.
D: Vaccination timing is based on the immunization schedule and not solely dependent on medical care availability.
The postpartum nurse is planning a home visit to a mother who delivered her baby 1 week ago. Which finding indicates to the nurse a possible problem with mother–infant bonding?
- A. The mother is pleased to have the nurse visit her home and baby.
- B. The baby's grandmother is present and involved with mother/baby care.
- C. The mother focuses the visit on her physical recovery and concerns.
- D. The baby's father is on 'paternity leave' and involved with the baby.
Correct Answer: C
Rationale: The correct answer is C. The mother focusing the visit on her physical recovery and concerns indicates a possible problem with mother-infant bonding. This is because bonding involves emotional connection and interaction between the mother and the baby, not just physical care. A mother who is solely focused on her physical recovery may not be engaging emotionally with her baby, which can impact bonding.
A: The mother being pleased to have the nurse visit her home and baby is a positive sign of engagement and interest in the baby's well-being.
B: The baby's grandmother being present and involved with mother/baby care is also a positive sign of family support and involvement, which can enhance bonding.
D: The baby's father being on 'paternity leave' and involved with the baby is also a positive sign of parental involvement, which is important for bonding.
A new mother expresses frustration about how to know what her baby wants. The mother states, 'I don't know what I expect, but then, the baby doesn't know either.' Which situation does the nurse use as an example of neonate communication?
- A. The baby is content to lie still on the mother's abdomen.
- B. The baby is easily awakened if irritated by loud noises.
- C. The baby resists eye contact if bored or disinterested.
- D. The baby roots for the breast when the cheek is stroked.
Correct Answer: D
Rationale: The correct answer is D because rooting reflex is a clear example of neonate communication. When the baby's cheek is stroked, the baby turns its head in the direction of the touch, indicating a desire for feeding. This reflexive behavior demonstrates the baby's ability to communicate its needs for nourishment.
A: The baby being content to lie still on the mother's abdomen does not directly relate to communication.
B: Being easily awakened by loud noises is a sensory response but not specifically a form of communication.
C: Resisting eye contact if bored or disinterested involves more complex social cues and is not typically seen in neonatal communication.
In summary, choice D is correct as it directly involves a neonatal communication reflex, while the other choices do not demonstrate clear communication cues in the context of a newborn baby.