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A client, 2 days postpartum from a spontaneous vaginal delivery, asks the nurse about postpartum exercises. Which of the following responses by the nurse is appropriate?
- A. You must wait to begin to perform exercises until after your six-week postpartum checkup.
- B. You may begin Kegel exercises today, but do not do any other exercises until the doctor tells you that it is safe.
- C. By next week you will be able to return to the exercise schedule you had during your prepregnancy.
- D. You can do some Kegel exercises today and then slowly increase your toning exercises over the next few weeks.
Correct Answer: D
Rationale: Kegel exercises can be started early postpartum to help strengthen pelvic floor muscles. Other exercises can be gradually increased after approval from the healthcare provider.
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A client is receiving an epidural infusion of a narcotic for pain relief after a cesarean section. The nurse would report to the anesthesiologist if which of the following were assessed?
- A. Respiratory rate 8 rpm.
- B. Complaint of thirst.
- C. Urinary output of 250 mL/hr.
- D. Numbness of feet and ankles.
Correct Answer: A
Rationale: A respiratory rate of 8 breaths per minute indicates respiratory depression, which must be reported immediately as a potential complication of narcotic use.
A breastfeeding patient who is 5 weeks postpartum calls the clinic and reports that she is achy all over, has a temperature of 100.2°F, and has pain and tenderness in her right breast. What is the nurse’s best response?
- A. You need to come to the clinic to be evaluated, as your symptoms indicate a possible breast infection.
- B. You are having normal signs of engorgement with breastfeeding. More frequent breastfeeding will relieve your symptoms.
- C. Please stop breastfeeding until you can come to see the clinic provider, as you may have a breast infection.
- D. You may be experiencing sleep deprivation, which can make you feel achy and sore. Try to sleep when the newborn sleeps.
Correct Answer: A
Rationale: The correct answer is A because the patient's symptoms of achiness, fever, and pain in the breast are indicative of mastitis, a common breast infection in breastfeeding women. Prompt evaluation and treatment are necessary to prevent complications.
Choice B is incorrect as engorgement typically occurs in the first few days postpartum, not at 5 weeks.
Choice C is incorrect because stopping breastfeeding can worsen the infection and affect milk production.
Choice D is incorrect as the symptoms described are more likely due to an infection rather than just sleep deprivation.
A postpartum patient informs the nurse of a frequent urge and burning when attempting to urinate. The nurse reviews the patient’s medical record and associates which risk factors related to a possible urinary tract infection (UTI)? Select all that apply.
- A. Neonatal macrosomia
- B. Use of a vacuum extractor
- C. Poor oral fluid intake
- D. Urinary catheter during labor
Correct Answer: C
Rationale: Neonatal macrosomia, which can cause edema around the urethra, is a risk factor for UTI. Operative vaginal deliveries, forceps, or vacuum extractor, which can cause edema around the urethra, is a risk factor for UTI. Poor oral fluid intake and urinary catheter insertion during the labor process are also risk factors.
The lactation nurse takes a phone call from a mother who is breastfeeding her 2-month-old infant. The mother reports an area of redness and warmth on the breast and a painful burning sensation when breastfeeding. Which statement by the nurse is correct if mastitis is suspected?
- A. If your nipples are cracked, you will need to stop breastfeeding.
- B. Pump your milk and throw it away until the infection is gone.
- C. The baby gave you an infection and needs to be on antibiotics.
- D. Continuing to breastfeed will help clear up the condition.
Correct Answer: D
Rationale: The correct answer is D: Continuing to breastfeed will help clear up the condition.
Rationale:
1. Continuing to breastfeed helps to empty the breast and prevent milk stasis, which can worsen mastitis.
2. Breastfeeding helps maintain milk production and prevents engorgement, which can exacerbate the infection.
3. Breast milk has antibacterial properties that can help fight the infection.
4. Stopping breastfeeding abruptly can lead to more serious complications like abscess formation.
Summary:
A: Incorrect. Stopping breastfeeding abruptly can lead to complications and does not address the underlying infection.
B: Incorrect. Pumping and throwing away milk does not address the underlying infection and can lead to decreased milk supply.
C: Incorrect. Mastitis is not caused by the baby, and antibiotics are not always necessary if managed promptly with breastfeeding and self-care.
When referring to the 4 T’s of PPH, what does tissue refer to?
- A. Placental tissue or membranes are retained.
- B. Tissue of the perineum is torn.
- C. Tissue of the uterus is torn.
- D. Tissue is not perfused.
Correct Answer: A
Rationale: Tissue refers to retained placental tissue, which is a leading cause of PPH.