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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: The correct answer is C: Poor oral fluid intake. Postpartum patients are at increased risk for UTIs due to physiological changes and decreased fluid intake. Poor hydration can lead to concentrated urine, making it easier for bacteria to grow. Neonatal macrosomia (A) and use of a vacuum extractor (B) are not directly associated with UTIs. While a urinary catheter during labor (D) can increase the risk of UTIs, it is not the most relevant factor in this scenario compared to poor oral fluid intake.
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A client has just been transferred to the postpartum unit from labor and delivery. Which of the following tasks should the registered nurse delegate to the nursing care assistant?
- A. Assess client 's fundal height.
- B. Teach client how to massage her fundus.
- C. Take the client 's vital signs.
- D. Document quantity of lochia in the chart.
Correct Answer: C
Rationale: The nursing care assistant can take vital signs, while the registered nurse is responsible for more complex assessments like fundal height and teaching skills such as massaging the fundus.
What symptom differentiates baby blues from PPD?
- A. Baby blues last longer than 14 days.
- B. Baby blues cause hallucinations.
- C. Baby blues occur in the first few days of the postpartum period.
- D. Baby blues are treated with inpatient therapy.
Correct Answer: C
Rationale: Baby blues are typically short-lived occurring in the first few days postpartum and resolve without the need for treatment.
Hemabate has been ordered for a postpartum patient who has uncontrolled bleeding and uterine atony. Which is the appropriate nursing action?
- A. Check the patient’s vital signs first for hypotension, and lower the head of the bed.
- B. Check the patient’s blood glucose and increase the IV fluid rate.
- C. Check the patient’s record for a history of asthma, and ask the licensed provider for an order of an antidiarrheal medication.
- D. Check the patient’s record for a history of hypothyroid, and ask the licensed provider to order something for nausea.
Correct Answer: C
Rationale: The correct answer is C. The rationale is as follows:
1. Hemabate is a medication used to treat postpartum hemorrhage due to uterine atony.
2. Checking the patient's record for a history of asthma is crucial as Hemabate can exacerbate asthma symptoms.
3. Asking the provider for an antidiarrheal medication is appropriate to manage potential side effects of Hemabate.
4. Checking vital signs for hypotension (Choice A) is important but not the immediate nursing action.
5. Checking blood glucose and increasing IV fluids (Choice B) are not directly related to the administration of Hemabate.
6. Checking for a history of hypothyroid and asking for anti-nausea medication (Choice D) is irrelevant to Hemabate administration.
The nurse is caring for a birth mother who is relinquishing her newborn. What intervention is appropriate for the nurse?
- A. Use words like 'giving away your child' or 'giving up for adoption.'
- B. Tell the person not to hold the baby.
- C. Ask the person why she is giving up her baby.
- D. Ask about the patient 's expectations for having newborn photos or video.
Correct Answer: D
Rationale: The nurse should support the person's emotional needs including helping with decision-making and documenting memories.
What is characteristic of a late (secondary) PPH?
- A. occurs within the first 24 hours
- B. is caused by subinvolution of the uterus
- C. does not occur after cesarean births
- D. cannot be treated with Methergine
Correct Answer: B
Rationale: Late (secondary) postpartum hemorrhage is typically caused by subinvolution of the uterus and may occur after the first 24 hours.