Needs of Maternal and Reproductive Health Clients

Needs of Maternal and Reproductive Health Clients Related

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A patient postdelivery is concerned about getting back to her prepregnancy weight as soon as possible. She had only gained 15 lb during her pregnancy. Which assessment factor would be of concern at her 6-week postpartum checkup?

  • A. Patient has lost 30 lb during the 6-week period prior to her scheduled checkup.
  • B. Patient states that she is eating healthy and limiting intake of processed foods.
  • C. Patient relates increased consumption of fruits and vegetables in her diet postbirth.
  • D. Patient has resumed her usual exercise pattern of walking around the neighborhood for 10 minutes each night.
Correct Answer: A

Rationale: The correct answer is (A) because losing 30 lb in the 6-week postpartum period is concerning as it is excessive and may indicate underlying health issues like hyperthyroidism or inadequate nutrition. This rapid weight loss can also affect the mother's energy levels, milk production, and overall health.

Choice (B) is incorrect as eating healthy and limiting processed foods is a positive behavior that supports weight management. Choice (C) is also incorrect as increased consumption of fruits and vegetables is beneficial for overall health. Choice (D) is incorrect because resuming a light exercise routine like walking is generally encouraged postpartum, as long as it is done safely and does not lead to excessive strain.

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The nurse should encourage the laboring client to begin pushing when

  • A. There is only an anterior or posterior lip of cervix left
  • B. The client describes the need to have a bowel movement
  • C. The cervix is completely dilated
  • D. The cervix is completely effaced
Correct Answer: C

Rationale: Pushing begins with the second stage of labor, i.e., when the cervix is completely dilated (C), the cervix can become edematous and may never completely dilate, necessitating an operative delivery. Many primigravidas begin active labor 100% effaced and then proceed to dilate.

A pregnant patient arrives for her first prenatal visit at the clinic. She informs the nurse that she has been taking an additional 400 mcg of folic acid prior to becoming pregnant. Based on the patient's history, she has reached 8 weeks' gestation. Which recommendation would the nurse provide regarding folic acid supplementation?

  • A. Have the patient continue to take 400 mcg folic acid throughout her pregnancy.
  • B. Tell the patient that she no longer has to take additional folic acid because it will be included in her prenatal vitamins.
  • C. Have the patient increase her folic acid intake to 1000 mcg throughout the rest of her pregnancy.
  • D. Schedule the patient to go for an AFP (alpha-fetoprotein) test.
Correct Answer: B

Rationale: Step 1: The patient has been taking an additional 400 mcg of folic acid prior to pregnancy.
Step 2: Folic acid is crucial in the early stages of pregnancy for neural tube development.
Step 3: By 8 weeks' gestation, the neural tube has already formed.
Step 4: Prenatal vitamins typically contain the recommended amount of folic acid.
Step 5: Therefore, the nurse would recommend the patient to stop taking additional folic acid as it's included in prenatal vitamins.

The nurse is caring for a postpartum client who is complaining of severe pain and a feeling of pressure in her perineum. Her fundus is firm, and she has a moderate lochia flow. On inspection the nurse finds that a perineal hematoma is beginning to form. Which assessment findings show the nurse obtain first?

  • A. Abdominal contour and bowel sounds
  • B. Hemoglobin and hematocrit
  • C. Heart rate and blood pressure
  • D. Urinary output and IV fluid intake
Correct Answer: C

Rationale: Hematomas can cause significant blood loss, so assessing heart rate and blood pressure (C) is critical.

Which nursing intervention is an independent function of the professional nurse?

  • A. Administering oral analgesics
  • B. Requesting diagnostic studies
  • C. Teaching the patient perineal care
  • D. Providing wound care to a surgical incision
Correct Answer: C

Rationale: Teaching is an independent nursing function, whereas administering medications or requesting diagnostic studies are dependent functions requiring physician orders.

Which clinical finding is associated with inadequate maternal weight gain during pregnancy?

  • A. Prolonged labor
  • B. Preeclampsia
  • C. Gestational diabetes
  • D. Low-birth-weight infant
Correct Answer: D

Rationale: The correct answer is D: Low-birth-weight infant. Inadequate maternal weight gain during pregnancy is associated with an increased risk of delivering a low-birth-weight infant due to insufficient fetal growth and development. When a mother does not gain enough weight during pregnancy, it can result in the baby being born smaller than expected, which can lead to various health issues. Prolonged labor (choice A) is not directly linked to inadequate weight gain. Preeclampsia (choice B) and gestational diabetes (choice C) are more commonly associated with excessive weight gain or other factors. Therefore, the correct choice is D as it directly correlates with inadequate maternal weight gain.

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