Complications of Postpartum

Complications of Postpartum Related

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The nurse is collecting information during a follow-up OB appointment with a patient who delivered 3 months ago. The patient reports her partner has become cynical, irritable, and verbally abusive. The nurse will screen for which risks related to paternal postnatal depression (PPND)? Select all that apply.

  • A. The father exhibited depression during the pregnancy
  • B. The birth of this fourth child was unexpected and unplanned
  • C. The father expresses feeling bored and underappreciated in his job
  • D. The father is recently estranged from his parents and siblings
Correct Answer: B

Rationale: The correct answer is B. The birth of a fourth child being unexpected and unplanned can be a risk factor for paternal postnatal depression (PPND) due to increased stress and pressure. Choice A is incorrect because past depression during pregnancy doesn't directly correlate with PPND. Choice C is incorrect as feeling bored and underappreciated at work is not a direct risk factor for PPND. Choice D is incorrect as being recently estranged from family members doesn't directly relate to PPND.

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Lacerations of the cervix, vagina, or perineum are also causes of PPH. Which factors influence the causes and incidence of obstetric lacerations of the lower genital tract? (Select all that apply.)

  • A. Operative and precipitate births
  • B. Adherent retained placenta
  • C. Abnormal presentation of the fetus
  • D. Congenital abnormalities of the maternal soft tissue
Correct Answer: A

Rationale: The correct answer is A because operative and precipitate births increase the risk of obstetric lacerations due to the rapid delivery or use of instruments. Operative births involve interventions like forceps or vacuum extraction, which can cause trauma. Precipitate births, characterized by rapid labor and delivery, may lead to tearing of the lower genital tract. Choices B, C, and D are incorrect as they do not directly influence the causes and incidence of obstetric lacerations. Adherent retained placenta, abnormal fetal presentation, and congenital abnormalities of maternal soft tissue are not primary factors contributing to lacerations during childbirth.

The nurse is preparing a postpartum patient for discharge. For which reasons does the nurse instruct the patient to call the primary care provider? Select all that apply.

  • A. Foul-smelling lochia
  • B. Hot, red, painful breasts
  • C. Mild headache
  • D. Not sleeping well
Correct Answer: A

Rationale: Foul-smelling lochia is a sign of infection. Hot, red, painful breasts are a sign of infection. Frequent, painful urination is a sign of infection.

A Muslim woman requests something to eat after the delivery of her baby. Which of the following meals would be most appropriate for the nurse to give her?

  • A. Ham sandwich.
  • B. Bacon and eggs.
  • C. Spaghetti with sausage.
  • D. Chicken and dumplings.
Correct Answer: D

Rationale: In Islam, pork is prohibited. Chicken is a halal option that adheres to dietary restrictions.

The nurse is taking the postpartum patient’s vital signs. The newborn is across the room in the bassinet, and the postpartum person refuses to hold the newborn. What should the nurse do?

  • A. Call CPS for risk of child abuse
  • B. Ask the person if they are feeling depressed, hopeless, afraid, or overwhelmed.
  • C. Ask the health-care provider to order an antidepressant.
  • D. Discuss how good parents hold and talk to their newborns.
Correct Answer: B

Rationale: Assessing for signs of depression or anxiety is important if a postpartum person is disengaged from their newborn.

The nurse notices the uterus is boggy and the bladder is full. What intervention should the nurse perform next?

  • A. Call for help.
  • B. Start IV bolus.
  • C. Get the person out of bed to walk to restroom.
  • D. Massage the fundus and assess the lochia.
Correct Answer: D

Rationale: Massaging the fundus and assessing the lochia is critical to manage uterine atony.

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