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A breastfeeding client, 7 weeks postpartum, complains to an obstetrician 's triage nurse that when she and her husband had intercourse for the first time after the delivery, 'I couldn 't stand it. It was so painful. The doctor must have done something terrible to my vagina. ' Which of the following responses by the nurse is appropriate?
- A. After a delivery the vagina is always very tender. It should feel better the next time you have intercourse. '
- B. Does your baby have thrush? If so, you should be assessed for a yeast infection in your vagina. '
- C. Women who breastfeed often have vaginal dryness. A vaginal lubricant may remedy your discomfort. '
- D. Sometimes the stitches of episiotomies heal too tight. Why don 't you come in to be checked? '
Correct Answer: C
Rationale: Vaginal dryness is a common issue for breastfeeding women, and using a vaginal lubricant can help reduce discomfort during intercourse.
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A woman is receiving patient-controlled analgesia (PCA) post -cesarean section. Which of the following must be included in the patient teaching?
- A. The client should monitor how often she presses the button.
- B. The client should report any feelings of nausea or itching to the nurse.
- C. The family should press the button whenever they feel the woman is in pain.
- D. The family should inform the nurse if the client becomes sleepy.
Correct Answer: B
Rationale: It is important for the client to report any adverse effects, such as nausea or itching, to the nurse while using PCA.
The nurse works in a labor and delivery facility with new protocols for estimating postpartum blood loss. Which method for estimating blood loss is implemented in the delivery room?
- A. Ask the patient how many peripads she considered to be “soaked.”
- B. Collect blood in calibrated, under-buttocks drapes for vaginal birth.
- C. Place a basin at the foot of the delivery table to catch any blood.
- D. Rely on the primary health care provider’s estimate of blood loss.
Correct Answer: B
Rationale: The correct answer is B because collecting blood in calibrated, under-buttocks drapes for vaginal birth allows for a more accurate estimation of postpartum blood loss. This method provides a quantitative measurement, unlike the subjective method in option A. Option C does not provide a direct measurement of blood loss and may not be accurate. Option D relies on the health care provider's estimate, which may not always be precise or consistent. By using calibrated drapes, the nurse can easily measure and monitor blood loss, ensuring better patient care and outcomes.
The nurse screens for risk factors such as an infant in the neonatal intensive care unit (NICU), difficulty in role transition, birth complications, unmet social and physical needs, and lack of partner support for what complication?
- A. maladaptive parenting
- B. psychosis
- C. postpartum depression
- D. bipolar disorder
Correct Answer: C
Rationale: Risk factors such as those listed increase the likelihood of postpartum depression which affects a person's emotional and mental well-being.
What nursing diagnosis would be appropriate for the person with a coagulation disorder?
- A. risk for bleeding
- B. risk for fluid overload
- C. risk for breast-feeding failure
- D. risk for hypertension
Correct Answer: B
Rationale: Risk for bleeding is the main diagnosis in patients with coagulation disorders.
The nurse informs a postpartum woman that which of the following is the reason ibuprofen (Advil) is especially effective for afterbirth pains?
- A. Ibuprofen is taken every two hours.
- B. Ibuprofen has an antiprostaglandin effect.
- C. Ibuprofen is given via the parenteral route.
- D. Ibuprofen can be administered in high doses.
Correct Answer: B
Rationale: Ibuprofen works by inhibiting prostaglandin production, which helps to reduce afterbirth pains.