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The nurse is closely monitoring a patient who is postpartum and at risk for PPH. Which assessment finding will cause the nurse to contact the primary care provider immediately?
- A. The uterus is displaced.
- B. The uterine fundus is boggy.
- C. Small clots are expressed with massage.
- D. Peripad weighs 100 g within 15 minutes.
Correct Answer: D
Rationale: The nurse will monitor the amount and characteristics of each patient’s lochia. If bleeding seems excessive, the nurse will weigh peripads to ascertain the amount of blood loss.
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Which of the following complementary therapies can a nurse suggest to a multiparous woman who is complaining of severe afterbirth pains?
- A. Lie prone with a small pillow cushioning her abdomen.
- B. Contract her abdominal muscles for a count of ten.
- C. Slowly ambulate in the hallways.
- D. Drink ice tea with lemon or lime.
Correct Answer: A
Rationale: Afterbirth pains are caused by uterine contractions. Lying prone with a pillow can help reduce discomfort by applying pressure and providing support to the abdomen. Ambulating or contracting the abdominal muscles is not generally recommended in this scenario.
What intervention by the nurse can help with PPD?
- A. encouraging the partner to let the postpartum person learn to take care of themself
- B. encouraging the family to have support available for the person and partner
- C. telling the person not to breast-feed if taking antidepressants
- D. keeping the newborn in the nursery most of the day and night
Correct Answer: B
Rationale: Support from family can be an effective intervention for those with PPD.
The nurse is closely monitoring a patient who is postpartum and at risk for PPH. Which assessment finding will cause the nurse to contact the primary care provider immediately?
- A. The uterus is displaced.
- B. The uterine fundus is boggy.
- C. Small clots are expressed with massage.
- D. Peripad weighs 100 g within 15 minutes.
Correct Answer: D
Rationale: The correct answer is D. A peripad weighing 100 g within 15 minutes indicates excessive postpartum bleeding, requiring immediate intervention to prevent hypovolemic shock. A displaced uterus (choice A) and small clots with massage (choice C) are expected findings after delivery and can be managed with appropriate interventions. A boggy uterine fundus (choice B) may indicate uterine atony but does not necessarily require immediate notification unless accompanied by excessive bleeding.
The third stage of labor has just ended for a client who has decided to bottle feed her baby. Which of the following maternal hormones will increase sharply at this time?
- A. Estrogen.
- B. Prolactin.
- C. Human placental lactogen.
- D. Human chorionic gonadotropin.
Correct Answer: B
Rationale: After delivery, prolactin levels rise to stimulate milk production, even if the mother has decided to bottle feed. Estrogen and other hormones also fluctuate, but prolactin will be the most significant in this case.
A client has been transferred to the post -anesthesia care unit from a cesarean delivery. The client had spinal anesthesia for the surgery. Which of the following interventions should the nurse perform at this time?
- A. Assess the level of the anesthesia.
- B. Encourage the client to urinate in a bedpan.
- C. Provide the client with the diet of her choice.
- D. Check the incision for signs of infection.
Correct Answer: A
Rationale: After spinal anesthesia, it's important to assess the level of anesthesia to monitor for any complications, such as a block or insufficient motor return, which can affect mobility and pain management.