Nokea
A woman tells you she has been teary for most of the 2 weeks since the birth of her baby. Although the infant appears to be cared for appropriately, the mother states that she feels too tired to spend as much time with him as she should. She has lost her appetite and cannot sleep at night. She has been too ashamed to tell anyone before now. The nurse's best response is to:
- A. Tell her that this is normal postpartum blues and she will get over it in a few more days.
- B. Suggest that she get help to care for the baby and that with more rest she will feel fine.
- C. Listen to her feelings carefully and then acknowledge that something is wrong.
- D. Suggest that she spend time away from the baby to rest from the constant infant care.
Correct Answer: C
Rationale: The mother is displaying signs of postpartum depression which requires a thoughtful response and appropriate interventions to address her emotional well-being.
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During a home visit, the nurse assesses a client 2 weeks after delivery. Which of the following signs/symptoms should the nurse expect to see?
- A. Diaphoresis.
- B. Lochia alba.
- C. Cracked nipples.
- D. Hypertension.
Correct Answer: B
Rationale: By the second week postpartum, lochia typically transitions to alba (white or yellowish discharge).
A multigravid, postpartum woman reports severe abdominal cramping whenever she nurses her baby. Which of the following responses by the nurse is appropriate?
- A. Suggest that the woman bottle feed for a few days.
- B. Instruct the patient on how to massage her fundus.
- C. Instruct the patient to feed using an alternate position.
- D. Discuss the action of breastfeeding hormones.
Correct Answer: D
Rationale: Breastfeeding stimulates the release of oxytocin, which causes uterine contractions that may lead to cramping.
The nurse is caring for a Seventh Day Adventist woman who delivered a baby boy by cesarean section. Which of the following questions should be asked regarding this woman 's care?
- A. Would you like me to order a vegetarian clear liquid diet for you?
- B. Is there anything special you will need for your Sabbath on Sunday?
- C. Would you like to telephone your clergy to set up a date for the baptism?
- D. Will a rabbi be performing the circumcision on your baby?
Correct Answer: B
Rationale: Seventh Day Adventists observe the Sabbath on Saturday. The nurse should ask if special arrangements are needed for Sabbath observance.
What assessment data increases the risk of postpartum infection?
- A. precipitous labor
- B. urinary retention
- C. breast-feeding
- D. intact perineum
Correct Answer: A
Rationale: Precipitous labor can increase the risk of infection due to the rapid and potentially traumatic delivery process.
The nurse on a postpartum unit observes a patient who delivered 2 days ago. The nurse notices extreme agitation and depressed mood. The patient states, “I think that my baby is deformed inside and we have to fix him.” Which risk factor is most strongly related to possible postpartum psychosis (PPP)?
- A. Separation from the baby’s father
- B. Personal history of bipolar disorder
- C. Prolonged labor resulting in cesarean
- D. Loss of first child from a heart defect
Correct Answer: B
Rationale: A patient history of either bipolar disorder or affective disorder can result in postpartum psychosis (PPP).