Nokea
A 3-day-breastfeeding client who is not immune to rubella is to receive the rubella vaccine at discharge. Which of the following must the nurse include in her discharge teaching regarding the vaccine?
- A. The woman should not become pregnant for at least 4 weeks.
- B. The woman should pump and dump her breast milk for 1 week.
- C. Surgical masks must be worn by the mother when she holds the baby.
- D. Antibodies transported through the breast milk will protect the baby.
Correct Answer: A
Rationale: The rubella vaccine is a live vaccine, and it is contraindicated during pregnancy. Women should avoid pregnancy for at least 4 weeks after receiving the vaccine to ensure no risk to the developing fetus.
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A client, 2 days postoperative from a cesarean section, complains to the nurse that she has yet to have a bowel movement since the surgery. Which of the following responses by the nurse would be appropriate at this time?
- A. That is very concerning. I will request that your physician order an enema for you.
- B. Two days is not that bad. Some patients go four days or longer without a movement.
- C. You have been taking antibiotics through your intravenous. That is probably why you are constipated.
- D. Fluids and exercise often help to combat constipation. Take a stroll around the unit and drink lots of fluid.
Correct Answer: B
Rationale: It is not uncommon for postpartum clients to experience delayed bowel movements due to the effects of anesthesia, immobility, and decreased peristalsis.
What postpartum infection is caused by STIs and chorioamnionitis?
- A. mastitis
- B. pneumonia
- C. cesarean wound infection
- D. postpartum endometritis
Correct Answer: D
Rationale: Postpartum endometritis can result from untreated STIs and chorioamnionitis and typically presents as fever and uterine tenderness.
What symptom can partners of persons with PPD experience?
- A. depression
- B. psychosis
- C. bipolar disorder
- D. mania
Correct Answer: A
Rationale: Partners of those with PPD can experience depression as they may feel overwhelmed and stressed by the challenges of caregiving.
A woman who is 18 hours postpartum says she is having 'hot flashes ' and 'sweats all the time. ' The appropriate nursing response is to:
- A. Report her signs and symptoms of hypovolemic shock.
- B. Tell her that her body is getting rid of unneeded fluid.
- C. Notify her nurse-midwife that she may have an infection.
- D. Limit her intake of caffeine-containing fluids.
Correct Answer: B
Rationale: Hot flashes and sweating are common during the postpartum period as the body gets rid of excess fluids. It is not an indicator of hypovolemic shock or infection.
A bottle-feeding woman, 11 1/2 weeks postpartum from a vaginal delivery, calls the obstetric office to state that she has saturated 2 pads in the past 1 hour. Which of the following responses by the nurse is appropriate?
- A. You must be doing too much. Lie down for a few hours and call back if the bleeding has not subsided.
- B. You are probably getting your period back. You will bleed like that for a day or two and then it will lighten up.
- C. It is not unusual to bleed heavily every once in a while after a baby is born. It should subside shortly.
- D. It is important for you to be examined by the doctor today. Let me check to see when you can come in.
Correct Answer: D
Rationale: Saturating 2 pads in 1 hour could indicate abnormal bleeding or a complication. Immediate evaluation by a healthcare provider is necessary.