Nokea
The lactation nurse takes a phone call from a mother who is breastfeeding her 2-month-old infant. The mother reports an area of redness and warmth on the breast and a painful burning sensation when breastfeeding. Which statement by the nurse is correct if mastitis is suspected?
- A. If your nipples are cracked, you will need to stop breastfeeding.
- B. Pump your milk and throw it away until the infection is gone.
- C. The baby gave you an infection and needs to be on antibiotics.
- D. Continuing to breastfeed will help clear up the condition.
Correct Answer: D
Rationale: Mastitis is generally self-limiting, and continued breastfeeding can help clear up the infection and condition. If antibiotic therapy is indicated, the infection generally resolves within 24 to 48 hours of antibiotic therapy.
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What is one of the initial signs and symptoms of puerperal infection in the postpartum client?
- A. Fatigue continuing for longer than 1 week
- B. Pain with voiding
- C. Profuse vaginal lochia with ambulation
- D. Temperature of 38° C (100.4° F) or higher on 2 successive days
Correct Answer: D
Rationale: The correct answer is D because a temperature of 38°C (100.4°F) or higher on 2 successive days is a key sign of puerperal infection. This is due to the body's response to infection. Fatigue (choice A) can be a symptom but is nonspecific. Pain with voiding (choice B) may indicate a urinary tract infection. Profuse vaginal lochia (choice C) may be normal postpartum.
What assessment finding would indicate a fluid volume deficit?
- A. skin tenting with testing of skin turgor
- B. hypertension
- C. bradycardia
- D. bounding pulse
Correct Answer: A
Rationale: Skin tenting is a classic sign of dehydration and fluid volume deficit due to reduced skin turgor.
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 person with a cesarean birth has additional nursing concerns beyond those of a person with a vaginal birth. What concern should the nurse anticipate for the cesarean birth?
- A. increased risk for DVT
- B. faster recovery
- C. less use of pain medication
- D. less risk for infection
Correct Answer: A
Rationale: Cesarean births involve surgical incisions which increase the risk of deep vein thrombosis (DVT) due to reduced mobility and other factors.
A woman has an 8-lb, 9-oz baby after an 18-hour labor that required a vacuum extraction. Her membranes have been ruptured for 15 hours. Based on these facts, client teaching should emphasize:
- A. Reporting foul-smelling lochia and fever.
- B. Delaying intercourse for at least 6 weeks.
- C. Eating a diet that is high in iron and vitamin C.
- D. Losing weight over at least a 6-month period.
Correct Answer: A
Rationale: Prolonged rupture of membranes increases the risk of infectionand the woman should report any signs of infection such as foul-smelling lochia or fever.