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The nurse in a postpartum unit evaluates new parents for risk factors that can indicate problems with bonding/attachment. Which situations does the nurse NOT recognize as a cause for bonding/attachment problems?
- A. The mother experienced eclampsia in the third trimester of pregnancy.
- B. The neonate is being treated for meconium aspiration syndrome.
- C. The mother experienced dystocia in the second phase of labor.
- D. The father of the neonate is in the military and not yet home on leave.
Correct Answer: D
Rationale: The correct answer is D. The absence of the father due to military duty does not directly impact bonding/attachment problems.
Rationale:
1. Choice A: Eclampsia can lead to complications during pregnancy but does not directly affect bonding.
2. Choice B: Meconium aspiration syndrome treatment focuses on the neonate's health, not parental bonding.
3. Choice C: Dystocia during labor may lead to physical challenges but does not necessarily affect bonding.
In summary, choices A, B, and C involve medical conditions that could indirectly impact bonding, whereas choice D does not have a direct correlation to bonding/attachment issues.
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The nurse is assessing her patient, who is 1 day postpartum. The nurse notes that the fundus is firm and at midline, the lochia is moderate in amount, and the presence of rubra with two dime-sized clots is on her peri-pad. What should the nurse determine from these assessment findings?
- A. They are normal.
- B. They indicate the presence of infection.
- C. The physician should be notified of the abnormal findings.
- D. The patient should be instructed to increase her fluid intake.
Correct Answer: A
Rationale: The correct answer is A, as the assessment findings described are normal for a patient who is 1 day postpartum. A firm and midline fundus indicates proper uterine involution. Moderate lochia is expected at this stage, and the presence of small clots is normal. The overall picture suggests the normal process of healing after childbirth.
Choice B is incorrect because the assessment findings do not indicate signs of infection such as foul-smelling lochia, fever, or elevated white blood cell count.
Choice C is incorrect as there are no abnormal findings that would warrant immediate notification of the physician.
Choice D is incorrect as there is no indication from the assessment findings that the patient needs to increase her fluid intake; the findings are within the expected range for a patient 1 day postpartum.
The nurse is palpating a patient's uterus 12 hours after a vaginal delivery. For which reason does the nurse place one hand just above the symphysis pubis?
- A. To prevent uterine prolapse.
- B. To prevent uterine movement
- C. To prevent uterine hemorrhage
- D. To prevent uterine inversion
Correct Answer: D
Rationale: The correct answer is D: To prevent uterine inversion. Placing a hand just above the symphysis pubis during uterine palpation helps prevent uterine inversion by providing support to the lower segment of the uterus. Uterine prolapse (A) is the downward displacement of the uterus, which is not prevented by this action. Uterine movement (B) is a natural occurrence and not a concern during palpation. Uterine hemorrhage (C) is more related to postpartum bleeding management and is not directly impacted by the hand placement.
The nurse is educating a new postpartum woman about peri-care. Which action by the client indicates understanding?
- A. The woman applied her peri-pad from back to front.
- B. The woman performed peri-care three times a day.
- C. The woman washed her hands before and after performing peri-care.
- D. The woman mixed tap water and hydrogen peroxide in her peri-bottle.
Correct Answer: C
Rationale: The correct answer is C because washing hands before and after peri-care is crucial to prevent the spread of infection. Before performing peri-care, clean hands reduce the risk of introducing harmful bacteria to the perineal area. After peri-care, hand hygiene prevents potential contamination from the perineum to other body parts or surfaces.
Explanation of why other choices are incorrect:
A: Applying the peri-pad from back to front can introduce bacteria from the rectal area to the urethra, increasing the risk of urinary tract infections.
B: While performing peri-care multiple times a day is important, it is not the best indicator of understanding peri-care principles.
D: Mixing tap water and hydrogen peroxide in the peri-bottle may be harmful and is not a standard practice for peri-care.
The nurse is providing care to a patient who is postpartum. Using anatomy and physiology knowledge, which expectation does the nurse relate to the cardiovascular system?
- A. Patient reporting of being cold related to blood loss
- B. WBC laboratory level of 30,000/mm a few hours after delivery
- C. Risk for hemorrhage due to decrease in circulating clotting factors
- D. A normal postpartum hemoglobin laboratory value of less than 11 g/dL
Correct Answer: B
Rationale: Step 1: Postpartum patients may have an increased WBC count due to the stress of delivery.
Step 2: A WBC level of 30,000/mm postpartum indicates a normal physiological response.
Step 3: This increase helps the body fight potential infections post-delivery.
Step 4: Therefore, choice B is correct as it aligns with normal postpartum physiology.
Summary: Choices A, C, and D are incorrect as they do not directly relate to postpartum physiology. A is more related to thermoregulation, C is about clotting factors, and D is about hemoglobin levels which may vary postpartum.
The nurse is providing care to a patient who is postpartum. Using anatomy and physiology knowledge, which expectation does the nurse relate to the cardiovascular system?
- A. Patient reporting of being cold related to blood loss
- B. WBC laboratory level of 30,000/mm a few hours after delivery
- C. Risk for hemorrhage due to decrease in circulating clotting factors
- D. A normal postpartum hemoglobin laboratory value of less than 11 g/dL
Correct Answer: B
Rationale: The correct answer is B. A postpartum WBC level of 30,000/mm is expected due to the physiological response to labor and delivery, known as leukocytosis. This is a normal finding as the body increases white blood cell production to fight off potential infections postpartum.
A: Patient feeling cold related to blood loss is more indicative of hypovolemia, a result of excessive blood loss, not a normal cardiovascular response postpartum.
C: Risk for hemorrhage due to decrease in clotting factors is incorrect as postpartum women actually have an increase in circulating clotting factors to prevent excessive bleeding.
D: A normal postpartum hemoglobin level of less than 11 g/dL is incorrect because a hemoglobin level below 11 g/dL would indicate anemia, not a normal postpartum finding.