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The nurse is performing a uterus assessment on a patient who is 20 hours postpartum. The nurse finds the fundus of the uterus to be soft and boggy. In addition, the uterus is displaced to the left and moderate bleeding is noted. If the uterus does respond to uterine massage, which actions does the nurse implement?
- A. Assist the patient to the bathroom to void.
- B. Reassess to determine response to treatment.
- C. Administer oxytocin as prescribed.
- D. Place an emergency call to the HCP.
Correct Answer: D
Rationale: The correct answer is D: Place an emergency call to the HCP. In this scenario, the patient is displaying signs of uterine atony, a condition where the uterus fails to contract properly postpartum, leading to excessive bleeding. The soft and boggy fundus, displacement to the left, and moderate bleeding indicate a serious issue that requires immediate medical attention. By calling the healthcare provider, the nurse can ensure timely intervention and treatment to address the uterine atony and prevent further complications. The other options are not appropriate at this time: A may worsen the situation by increasing bleeding, B delays necessary action, and C may be needed but not as the first priority in this critical situation.
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The nurse is aware that some parenting skills are acquired through the process of intentional learning. Which activity does the nurse associate with intentional learning?
- A. The couple observes other individuals who are mothers and fathers.
- B. The couple attends hospital classes addressing newborn and infant care.
- C. The couple discusses with each other how they were parented.
- D. The couple watches media containing parenting roles.
Correct Answer: B
Rationale: The correct answer is B because attending hospital classes on newborn and infant care involves intentional learning, where the couple actively seeks out knowledge and skills related to parenting. This choice allows them to receive structured education and guidance from professionals in a focused setting. Observing other individuals (choice A) may provide some insights but lacks the structured learning environment. Discussing their own upbringing (choice C) may be informative but does not necessarily involve intentional learning focused on acquiring new parenting skills. Watching media (choice D) may offer some information but lacks the interactive and hands-on learning experience provided by attending hospital classes.
The nurse is providing education to a postpartum woman about exercises to strengthen the pelvis musculature. Which instruction should be included?
- A. "Ambulate three times a day."
- B. "Perform Kegel exercises."
- C. "Enroll in an aerobics class after discharge."
- D. "Do passive range-of-motion exercises while lying in bed."
Correct Answer: B
Rationale: The correct answer is B: "Perform Kegel exercises." Kegel exercises specifically target the pelvic floor muscles, which can help strengthen the pelvis musculature postpartum. This is important for improving pelvic floor support and preventing issues like urinary incontinence. Ambulating (A) is good for overall mobility but does not specifically target the pelvic muscles. Enrolling in an aerobics class (C) may be beneficial for overall fitness but does not address pelvic floor strengthening. Passive range-of-motion exercises (D) focus on joint flexibility rather than pelvic muscle strength.
A postpartum patient comes to the clinic for her 6-week postpartum checkup. When assessing the patient's cervix, how should the nurse expect the cervix to appear?
- A. Noticeable small lacerations
- B. Approximately 3 cm dilated
- C. Symmetrically round external os
- D. Firm and thick
Correct Answer: C
Rationale: The correct answer is C: Symmetrically round external os. At 6 weeks postpartum, the cervix should have healed and returned to its pre-pregnancy state. The external os should appear symmetrically round, indicating proper healing and involution. A: Noticeable small lacerations would indicate incomplete healing. B: Approximately 3 cm dilated is not expected in a postpartum patient. D: Firm and thick would not be typical findings at 6 weeks postpartum.
The nurse is preparing a postpartum patient for discharge. Which patient teaching is most important for the nurse to provide?
- A. The signs and symptoms of uterine infection
- B. The signs and symptoms of secondary hemorrhage
- C. The signs and symptoms of postpartum depression
- D. The signs and symptoms of a boggy uterus
Correct Answer: B
Rationale: The correct answer is B: The signs and symptoms of secondary hemorrhage. This is the most important teaching for the nurse to provide because it is a potentially life-threatening complication that requires immediate medical attention. Secondary hemorrhage can occur after the initial postpartum period and can lead to severe bleeding. Understanding the signs and symptoms of secondary hemorrhage can help the patient seek prompt medical care if needed.
Choice A: The signs and symptoms of uterine infection are important to know, but they are usually treated with antibiotics and are not as immediately life-threatening as secondary hemorrhage.
Choice C: Postpartum depression is a serious concern but does not require immediate medical attention like secondary hemorrhage.
Choice D: A boggy uterus is a sign of uterine atony, which can lead to hemorrhage, but teaching about secondary hemorrhage takes precedence because it directly addresses a more severe form of bleeding that requires urgent intervention.
The nurse on a postpartum unit is acutely aware that cultural influences impact the patient's process of 'becoming a mother.' For which isn't a cultural influence does the nurse assess?
- A. What amount of time the mother spends in each phase
- B. Differences in the mother's expectation related to ability to rest
- C. How the mother physically recovers from labor and delivery
- D. Mother's involvement in decision making for the first few months
Correct Answer: C
Rationale: The correct answer is C because physical recovery from labor and delivery is a biological process rather than a cultural influence. The nurse assesses cultural influences, such as beliefs and practices, which shape the mother's experience of motherhood. Choices A, B, and D are influenced by cultural factors, such as time spent in each phase, expectations related to rest, and involvement in decision-making, respectively. These aspects reflect how cultural norms, values, and traditions impact the transition to motherhood.