Nokea
Choose the best independent nursing action to aid episiotomy healing in the woman who is 24 hours postpartum.
- A. Apply antibiotic cream to the area three times each day.
- B. Squirt warm water over the perineum after voiding or stooling.
- C. Maintain cold packs to the area at all times for the first 3 days.
- D. Check the leukocyte level daily and report changes.
Correct Answer: B
Rationale: Squatting warm water over the perineum after voiding or stooling helps to soothe and cleanse the area, promoting healing.
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What postpartum infection can be transferred between the breast-feeding person and newborn if both are not treated appropriately?
- A. wound infection
- B. urinary tract infection
- C. thrush
- D. mastitis
Correct Answer: C
Rationale: The correct answer is C: thrush. Thrush is a fungal infection caused by Candida that can be transmitted between the breast-feeding person and the newborn if not treated appropriately. The infection can pass back and forth during breastfeeding. Thrush manifests as white patches on the tongue and inside the mouth of the newborn and as nipple pain and redness in the breast-feeding person. Wound infection (A) typically refers to an infection at the site of a surgical incision and is not transmitted between the breast-feeding person and newborn. Urinary tract infection (B) is a bacterial infection of the urinary tract and is not typically transmitted through breastfeeding. Mastitis (D) is a bacterial infection of the breast tissue and is not directly transferred between the breast-feeding person and the newborn.
A patient who has been on prolonged bedrest for bleeding associated with placenta previa was taken to the operating room for an emergency cesarean delivery. Sixteen hours postoperatively, the patient complains that her left leg is hurting. The nurse finds that the entire left leg is swollen and has pitting edema, while the right leg appears to be normal. Which order does the nurse anticipate when paging the health care provider to the room?
- A. White blood cell count (WBC)
- B. Ultrasound of the leg
- C. X-ray of the leg
- D. Serum creatinine
Correct Answer: B
Rationale: The swollen and painful leg may indicate a deep vein thrombosis (DVT), and an ultrasound is the appropriate diagnostic test.
A postpartum patient calls the clinic 4 days after the birth of her newborn because she is extremely tired and her vaginal bleeding is heavier. Which does the nurse anticipate when advising her to come in to the office right now?
- A. A hematocrit will be drawn, and the licensed provider will check for retained placental fragments.
- B. Her stress level and sleep deprivation will be evaluated, and a prescription for sleeping medication will be given.
- C. The perineum will be evaluated for lacerations that were missed.
- D. Reassure the client that this is all normal and provide a prescription for slow-release iron tablets.
Correct Answer: A
Rationale: The patient is presenting symptoms of postpartum hemorrhage and retained placental fragments, which requires prompt evaluation.
Nurses need to understand the basic definitions and incidence data regarding PPH. Which statement regarding this condition is most accurate?
- A. PPH is easy to recognize early; after all, the woman is bleeding.
- B. Traditionally, it takes more than 1000 ml of blood after vaginal birth and 2500 ml after cesarean birth to define the condition as PPH.
- C. If anything, nurses and physicians tend to overestimate the amount of blood loss.
- D. Traditionally, PPH has been classified as early PPH or late PPH with respect to birth.
Correct Answer: B
Rationale: The correct answer is B because it accurately defines the criteria for postpartum hemorrhage (PPH). PPH is traditionally defined as losing more than 1000 ml of blood after vaginal birth and 2500 ml after cesarean birth. This definition helps healthcare providers recognize and manage PPH effectively.
Now, let's analyze why the other choices are incorrect:
A: This statement is incorrect because PPH may not always be easy to recognize early based solely on visible bleeding. Other signs and symptoms, such as tachycardia and hypotension, also play a crucial role in identifying PPH.
C: This statement is incorrect because underestimating, rather than overestimating, the amount of blood loss in PPH can lead to delayed intervention and potentially worsen the patient's condition.
D: This statement is incorrect because PPH is not classified based on timing (early or late PPH), but rather on the amount of blood loss as defined in choice B.
The nurse develops a plan to increase a patient’s milk supply. What is an intervention they can implement?
- A. Pump between nursing sessions.
- B. Nurse every 6 hours.
- C. Keep newborn in bassinet between sessions.
- D. Offer a pacifier when newborn cries.
Correct Answer: A
Rationale: The correct answer is A: Pump between nursing sessions. This intervention helps stimulate milk production by emptying the breasts more frequently. Pumping increases demand for milk, signaling the body to produce more. Nursing every 6 hours (B) reduces milk supply due to less frequent stimulation. Keeping newborn in bassinet (C) limits nursing opportunities. Offering a pacifier (D) may decrease milk supply by reducing nursing frequency. Therefore, option A is the most effective intervention to increase milk supply.