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The nurse is providing care for a patient who is 1 day postpartum and exhibiting symptoms of postpartum psychosis. Which medical management does the nurse expect for this patient?
- A. Prescriptions for antidepressant/antipsychotic drugs
- B. Discharge to home with 24-hour observation in place
- C. Immediate hospitalization in a psychiatric unit
- D. Prescribed neonate visits during in-patient treatment
Correct Answer: C
Rationale: Step 1: Postpartum psychosis is a psychiatric emergency requiring immediate intervention.
Step 2: Immediate hospitalization in a psychiatric unit ensures safety and specialized care.
Step 3: Hospitalization allows for close monitoring, medication management, and therapy.
Step 4: Discharge to home or prescribed neonate visits are not appropriate due to the severity of symptoms in postpartum psychosis.
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The nurse is providing care for a patient who is 1 day postpartum and exhibiting symptoms of postpartum psychosis. Which medical management does the nurse expect for this patient?
- A. Prescriptions for antidepressant/antipsychotic drugs
- B. Discharge to home with 24-hour observation in place
- C. Immediate hospitalization in a psychiatric unit
- D. Prescribed neonate visits during in-patient treatment
Correct Answer: C
Rationale: The nurse expects the health care provider to immediately hospitalize the patient in a psychiatric unit. Maintaining the patient in the postpartum unit delays necessary psychiatric treatment.
Which client is at greatest risk for early PPH?
- A. Primiparous woman (G 2, P 1-0-0-1) being prepared for an emergency cesarean birth for fetal distress
- B. Woman with severe preeclampsia on magnesium sulfate whose labor is being
- C. Multiparous woman (G 3, P 2-0-0-2) with an 8-hour labor
- D. Primigravida in spontaneous labor with preterm twins
Correct Answer: B
Rationale: The correct answer is B because a woman with severe preeclampsia on magnesium sulfate is at the greatest risk for early postpartum hemorrhage (PPH) due to the increased risk of placental abruption, coagulopathy, and uterine atony associated with preeclampsia and magnesium sulfate use. Preeclampsia can lead to poor placental perfusion, increasing the risk of hemorrhage during and after delivery. Magnesium sulfate can also affect blood clotting mechanisms, further increasing the risk of excessive bleeding. The other choices are less likely to be at greatest risk for early PPH. Choice A involves a primiparous woman with cesarean delivery, which may have controlled bleeding. Choice C is a multiparous woman with a relatively short labor duration, which is not a significant risk factor for early PPH. Choice D is a primigravida with preterm twins, which does not inherently increase the risk of early PPH
The obstetrician has ordered that a post-op cesarean section client 's patient-controlled analgesia (PCA) be discontinued. Which of the following actions by the nurse is appropriate?
- A. Discard the remaining medication in the presence of another nurse.
- B. Recommend waiting until her pain level is zero to discontinue the medicine.
- C. Discontinue the medication only after the analgesia is completely absorbed.
- D. Return the unused portion of medication to the narcotics cabinet.
Correct Answer: A
Rationale: When discontinuing PCA, the unused medication must be discarded in the presence of another nurse to maintain security and prevent diversion.
A client, G1 P1, who had an epidural, has just delivered a daughter, Apgar 9/9, over a mediolateral episiotomy. The physician used low forceps. While recovering, the client states, 'I 'm a failure. I couldn 't stand the pain and couldn 't even push my baby out by myself! ' Which of the following is the best response for the nurse to make?
- A. You 'll feel better later after you have had a chance to rest and to eat.
- B. Don 't say that. There are many women who would be ecstatic to have that baby.
- C. I am sure that you will have another baby. I bet that it will be a natural delivery.
- D. To have things work out differently than you had planned is disappointing.
Correct Answer: D
Rationale: The nurse should acknowledge the emotional distress and disappointment while offering validation and understanding about how things didn't go as expected.
A 1-day postpartum woman states, 'I think I have a urinary tract infection. I have to go to the bathroom all the time. ' Which of the following actions should the nurse take?
- A. Assure the woman that frequent urination is normal after delivery.
- B. Obtain an order for a urine culture.
- C. Assess the urine for cloudiness.
- D. Ask the woman if she is prone to urinary tract infections.
Correct Answer: C
Rationale: Frequent urination is common postpartum, but assessing the urine for cloudiness is important in determining whether a urinary tract infection is present.