Nokea
The nurse educates the postpartum person on bowel discomfort. What instructions would they give?
- A. Limit water intake.
- B. Use laxatives daily.
- C. Ambulate often.
- D. Avoid stool softeners.
Correct Answer: C
Rationale: Ambulating helps improve bowel motility and prevent constipation which can lead to bowel discomfort after childbirth.
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A client, G1 P1, who had an epidural, has just delivered a daughter, Apgar 9/9, over a mediolateral episiotomy. The physician used low forceps. While recovering, the client states, 'I 'm a failure. I couldn 't stand the pain and couldn 't even push my baby out by myself! ' Which of the following is the best response for the nurse to make?
- A. You 'll feel better later after you have had a chance to rest and to eat.
- B. Don 't say that. There are many women who would be ecstatic to have that baby.
- C. I am sure that you will have another baby. I bet that it will be a natural delivery.
- D. To have things work out differently than you had planned is disappointing.
Correct Answer: D
Rationale: The nurse should acknowledge the emotional distress and disappointment while offering validation and understanding about how things didn't go as expected.
The obstetrician has ordered that a post-op cesarean section client 's patient-controlled analgesia (PCA) be discontinued. Which of the following actions by the nurse is appropriate?
- A. Discard the remaining medication in the presence of another nurse.
- B. Recommend waiting until her pain level is zero to discontinue the medicine.
- C. Discontinue the medication only after the analgesia is completely absorbed.
- D. Return the unused portion of medication to the narcotics cabinet.
Correct Answer: A
Rationale: When discontinuing PCA, the unused medication must be discarded in the presence of another nurse to maintain security and prevent diversion.
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: The correct answer is A: precipitous labor. Precipitous labor can cause trauma to the birth canal, leading to increased risk of infection. Urinary retention (B) may lead to urinary tract infections but not necessarily postpartum infections. Breastfeeding (C) and intact perineum (D) are not direct risk factors for postpartum infections.
The nurse is assessing a patient who is 12 hours postpartum. The uterus is firm to palpation, at midline, and is 1 cm below the umbilicus with continuous heavy vaginal bleeding. What is the nurse’s first action?
- A. Massage the uterus and resume the IV Pitocin drip.
- B. Change the peri-pad and reassess the bleeding.
- C. Call the provider to check for a cervical laceration.
- D. Administer the ordered iron supplement and ibuprofen.
Correct Answer: A
Rationale: The nurse must address the uterine tone and bleeding immediately by massaging the uterus and resuming Pitocin to prevent hemorrhage.
A patient, G2 P1102, who delivered her baby 8 hours ago, now has a temperature of 100.2°F. Which of the following is the appropriate nursing intervention at this time?
- A. Notify the doctor to get an order for acetaminophen.
- B. Request an infectious disease consult from the doctor.
- C. Provide the woman with cool compresses.
- D. Encourage intake of water and other fluids.
Correct Answer: D
Rationale: A slight increase in temperature is common in the first 24 hours after delivery due to hormonal changes and dehydration. Encouraging fluid intake is an appropriate intervention.