Nokea
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.
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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.
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 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.
A G1P1 has just experienced a 24-hour labor that included a 3-hour second stage. The woman states to the nurse, "I just can't feed my baby now. All I want to do is sleep." What is the appropriate response from the nurse?
- A. Discuss with the woman that the needs of her infant should come first
- B. Recognize this as a behavior of the taking-hold stage
- C. Record the behavior as ineffective bonding/attachment
- D. Reassure the woman that it is okay for her to rest at this time
Correct Answer: D
Rationale: The correct answer is D: Reassure the woman that it is okay for her to rest at this time.
Rationale:
1. The woman has just undergone a 24-hour labor with a 3-hour second stage, which is physically and emotionally exhausting.
2. It is important for the nurse to prioritize the woman's well-being and allow her to rest to recover.
3. Rest is crucial for the woman's recovery and ability to care for her baby effectively.
4. By reassuring her that it is okay to rest, the nurse promotes self-care and maternal well-being.
Other choices:
A: Discuss with the woman that the needs of her infant should come first - This is not the appropriate response as the woman's well-being should also be considered.
B: Recognize this as a behavior of the taking-hold stage - This is incorrect as the woman's exhaustion is likely due to the physically demanding labor.
C: Record the behavior as ineffective bonding/attachment - This is not appropriate
A G1P1 has just experienced a 24-hour labor that included a 3-hour second stage. The woman states to the nurse, "I just can't feed my baby now. All I want to do is sleep." What is the appropriate response from the nurse?
- A. Discuss with the woman that the needs of her infant should come first
- B. Recognize this as a behavior of the taking-hold stage
- C. Record the behavior as ineffective bonding/attachment
- D. Reassure the woman that it is okay for her to rest at this time
Correct Answer: D
Rationale: The correct answer is D: Reassure the woman that it is okay for her to rest at this time. After a long and exhausting labor, it is crucial for the woman to rest and recover. Encouraging rest will promote her well-being and ability to care for her baby later. Choice A is incorrect as it may add unnecessary pressure on the woman. Choice B is incorrect as it refers to a different stage of maternal adaptation. Choice C is incorrect as it labels the behavior negatively without considering the context of the situation.
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 answer is B: Instruct the mother to void prior to the assessment. This is the most appropriate initial nursing intervention because a full bladder can impede proper assessment of the fundus and lochia flow. Voiding before assessment ensures accurate findings and reduces the risk of discomfort for the patient.
A: Massaging the fundus until it is firm is important but should not be the initial step as assessing the bladder status is crucial first.
C: Assessing the lochia flow while massaging the fundus is important but should come after ensuring the bladder is empty.
D: Lowering the head of the bed and having the mother lie flat does not address the immediate need to empty the bladder for accurate assessment.