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The nurse is discussing contraception with a couple before discharge following the birth of a first child. The couple are uncertain about the method but are certain about avoiding pregnancy for at least 2 years. Which method does the nurse recommend?
- A. Emergency contraceptives
- B. Oral estrogen/progesterone pill
- C. Depo-Provera
- D. Natural family planning
Correct Answer: C
Rationale: The correct answer is C: Depo-Provera. The rationale is as follows:
1. Depo-Provera is a long-acting reversible contraceptive method that provides effective contraception for up to 3 months.
2. The couple's certainty about avoiding pregnancy for at least 2 years aligns with the duration of protection offered by Depo-Provera.
3. Compared to other methods, such as emergency contraceptives, oral estrogen/progesterone pill, and natural family planning, Depo-Provera provides a more reliable and sustained contraceptive effect.
4. Emergency contraceptives are not suitable for long-term contraception. The oral pill requires daily adherence, which may not be ideal for the couple's situation. Natural family planning relies on cycle tracking and may not provide the desired level of effectiveness for the couple's goal.
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The nurse is providing care for a new mother during a follow-up visit 6 weeks after a vaginal delivery. The mother begins to cry and reports difficulty with eating and sleeping. The nurse identifies postpartum blues and cites which reason as the most likely cause?
- A. Fatigue related to a 'fussy' baby
- B. Frustration over physical appearance
- C. Changes in hormonal levels
- D. Stress related to new mother role
Correct Answer: C
Rationale: The correct answer is C: Changes in hormonal levels. Postpartum blues are typically attributed to hormonal fluctuations after childbirth, leading to mood swings and emotional distress. During the postpartum period, the sudden drop in estrogen and progesterone levels can affect a mother's emotional well-being. This can manifest as feelings of sadness, crying spells, difficulty sleeping, and changes in appetite. The other answer choices are incorrect because fatigue related to a 'fussy' baby (A), frustration over physical appearance (B), and stress related to the new mother role (D) do not directly address the physiological changes in hormonal levels that are primarily responsible for postpartum blues.
The nurse is collecting the urine of a postpartum patient who is passing large clots. For which reason does the nurse examine the large collected clots?
- A. To validate the presence of clotting
- B. To determine the presence of tissue
- C. To obtain an accurate description
- D. To document the number of clots
Correct Answer: B
Rationale: Step 1: The nurse examines the large collected clots to determine the presence of tissue.
Step 2: Presence of tissue may indicate retained placental fragments, which can lead to postpartum hemorrhage.
Step 3: Identifying tissue is crucial for proper management and prevention of complications.
Step 4: Validating clotting (Choice A) is important but not the primary reason for examining the clots.
Step 5: Obtaining an accurate description (Choice C) and documenting the number of clots (Choice D) are less critical compared to identifying tissue.
The nurse is providing care for a new mother during a follow-up visit 6 weeks after a vaginal delivery. The mother begins to cry and reports difficulty with eating and sleeping. The nurse identifies postpartum blues and cites which reason as the most likely cause?
- A. Fatigue related to a 'fussy' baby
- B. Frustration over physical appearance
- C. Changes in hormonal levels
- D. Stress related to new mother role
Correct Answer: C
Rationale: Correct Answer: C - Changes in hormonal levels
Rationale:
1. Postpartum blues typically occur due to fluctuating hormone levels after childbirth.
2. Estrogen and progesterone levels drop significantly after delivery, leading to mood changes.
3. Symptoms like crying, difficulty eating, and sleeping align with hormonal imbalance postpartum.
Summary:
A: Fatigue related to a 'fussy' baby - Not directly related to hormonal changes causing postpartum blues.
B: Frustration over physical appearance - Not a primary cause of postpartum blues, which is more hormone-related.
D: Stress related to new mother role - While stress can contribute, hormonal changes are the primary cause.
The nurse is discussing contraception with a couple before discharge following the birth of a first child. The couple are uncertain about the method but are certain about avoiding pregnancy for at least 2 years. Which method does the nurse recommend?
- A. Emergency contraceptives
- B. Oral estrogen/progesterone pill
- C. Depo-Provera
- D. Natural family planning
Correct Answer: C
Rationale: The correct answer is C: Depo-Provera.
Rationale:
1. Long-acting: Depo-Provera is a highly effective contraceptive method lasting for 3 months.
2. High efficacy: It has a very low failure rate (<1%).
3. Reversible: Fertility returns after discontinuation.
4. Patient certainty: The couple's certainty about avoiding pregnancy for 2 years aligns well with the 3-month duration of Depo-Provera.
Summary:
A: Emergency contraceptives are for immediate post-coital use, not long-term contraception.
B: Oral estrogen/progesterone pills require daily adherence, not suitable for long-term certainty.
D: Natural family planning relies on timing of ovulation, not as reliable for couples seeking certainty.
The nurse is preparing to do a morning assessment on a 24-hour postpartum patient. Which nursing intervention is most appropriate initially?
- A. Massage the fundus until it is firm.
- B. Instruct the mother to void prior to the assessment.
- C. Assess the lochia flow while massaging the fundus.
- D. Lower the head of the bed and have the mother lie flat.
Correct Answer: B
Rationale: The correct initial nursing intervention is to instruct the mother to void prior to the assessment (choice B). This is important as a full bladder can interfere with the accuracy of the fundal assessment. By ensuring the mother voids first, the nurse can accurately assess the fundus for any signs of excessive bleeding or abnormalities. This step is crucial in monitoring the postpartum patient's well-being.
Choice A is incorrect as massaging the fundus should come after assessing the lochia flow to prevent potential complications. Choice C is also incorrect as assessing the lochia flow should occur before massaging the fundus. Choice D is incorrect as lowering the head of the bed and having the mother lie flat is not necessary for a postpartum assessment.