Postpartum Hormonal Changes

Postpartum Hormonal Changes Related

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The nurse is conducting discharge teaching for a patient going home after a cesarean birth. Which signs and symptoms should the patient be taught to report? (Select all that apply.)

  • A. Mild incisional pain
  • B. Feeling of pelvic fullness
  • C. Lochia changing from red to pink in color
  • D. Frequency, urgency, or burning on urination
Correct Answer: D

Rationale: The correct answer is D because frequency, urgency, or burning on urination could indicate a urinary tract infection, a common post-cesarean complication. Reporting these symptoms promptly can prevent further complications.

A, B, and C are incorrect. A mild incisional pain is normal after a cesarean birth and is expected during the healing process. Feeling of pelvic fullness may be due to postpartum changes in the body and is not necessarily concerning. Lochia changing from red to pink is a normal progression of lochia color and does not typically indicate a problem unless there are other concerning symptoms present.

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What is the term for the separation found in the midline of the abdomen after birth?

  • A. uterine subinvolution
  • B. umbilical hernia
  • C. striae
  • D. diastasis recti abdominus
Correct Answer: D

Rationale: The correct answer is D: diastasis recti abdominus. This term refers to the separation of the rectus abdominis muscles along the midline of the abdomen. This condition commonly occurs after pregnancy due to the stretching of the abdominal muscles. It is important to differentiate diastasis recti from other conditions such as uterine subinvolution, which is the delayed return of the uterus to its normal size postpartum; umbilical hernia, which is a protrusion of abdominal contents through the umbilical ring; and striae, which are stretch marks caused by rapid stretching of the skin. Diastasis recti is characterized by a visible gap between the muscles, often causing a bulge in the midline of the abdomen. Treatment usually involves specific exercises to strengthen the abdominal muscles and improve the condition.

The nurse notes the following vital signs of a postoperative cesarean client during the immediate postpartum period: 100.0°F, P 68, R 12, BP 130/80. Which of the following is a correct interpretation of the findings?

  • A. Temperature is elevated, a sign of infection.
  • B. Pulse is too low, a sign of vagal pathology.
  • C. Respirations are too low, a sign of medication toxicity.
  • D. Blood pressure is elevated, a sign of preeclampsia.
Correct Answer: C

Rationale: Low respirations may indicate opioid toxicity.

A client is postpartum 24 hours from a spontaneous vaginal delivery with rupture of membranes for 42 hours. Which of the following signs/symptoms should the nurse report to the client's health care practitioner?

  • A. Foul-smelling lochia.
  • B. Engorged breasts.
  • C. Cracked nipples.
  • D. Cluster of hemorrhoids.
Correct Answer: A

Rationale: Foul-smelling lochia indicates infection.

A postpartum woman has been diagnosed with postpartum psychosis. Which of the following signs/symptoms would the client exhibit?

  • A. Hallucinations.
  • B. Polyphagia.
  • C. Induced vomiting.
  • D. Weepy sadness.
Correct Answer: A

Rationale: Hallucinations are characteristic of psychosis.

To promote bonding and attachment immediately after birth, which action should the nurse take?

  • A. Assist the mother in feeding her baby.
  • B. Allow the mother quiet time with her infant.
  • C. Teach the mother about the concepts of bonding and attachment.
  • D. Assist the mother in assuming an en face position with her newborn.
Correct Answer: D

Rationale: The correct answer is D because assuming an en face position (face-to-face) with the newborn promotes bonding and attachment by facilitating eye contact, skin-to-skin contact, and mutual recognition between the mother and baby. This physical closeness immediately after birth helps establish a strong emotional connection.

A: Assisting with feeding is important but does not specifically address bonding and attachment immediately after birth.
B: Allowing quiet time is beneficial but may not actively promote bonding and attachment.
C: Teaching about bonding and attachment is valuable but does not directly facilitate the immediate connection between mother and baby.

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