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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: 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.
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Choose the signs and symptoms that suggest postpartum hemorrhage causing a hematoma.
- A. Rectal pain accompanied by a rising pulse
- B. Cramping accompanied by a steady trickle of blood
- C. Soft uterine fundus and falling blood pressure
- D. Heavy lochia accompanied by tachypnea and dyspnea
Correct Answer: A
Rationale: Hematomas may cause pain and lead to hemodynamic changes such as a rising pulse. Rectal pain is a common sign of a perineal hematoma.
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.
The nurse educates the person with a newborn in the NICU. What guidance does the nurse provide?
- A. Breast milk is not good for a premature baby.
- B. Premature babies breast-feed easily.
- C. Skin-to-skin contact helps both baby and breast-feeding person.
- D. A bottle is recommended for all feedings.
Correct Answer: C
Rationale: The correct answer is C because skin-to-skin contact promotes bonding, regulates the baby's temperature, and encourages breastfeeding. This guidance is crucial for newborns in the NICU to establish a strong connection with their caregiver and support breastfeeding. Choice A is incorrect as breast milk is highly beneficial for premature babies. Choice B is incorrect because premature babies may struggle with breastfeeding due to their developmental stage. Choice D is incorrect as bottles are not recommended for all feedings, especially for premature infants who may have difficulty latching and feeding effectively.
A breastfeeding client, G10 P6408, delivered 10 minutes ago. Which of the following assessments is most important for the nurse to perform at this time?
- A. Pulse.
- B. Fundus.
- C. Bladder.
- D. Breast.
Correct Answer: B
Rationale: After delivery, the most critical assessment is to evaluate the fundus to ensure uterine contraction and prevent hemorrhage.
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.