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A nurse is teaching about home safety with a client who is 2 days postpartum. Which of the following instructions should the nurse include in the teaching?
- A. Bathe your baby immediately after a feeding.
- B. Place a bumper pad in your baby’s crib.
- C. Put a soft mattress in your baby’s crib.
- D. Wash your baby’s face with plain water.
Correct Answer: D
Rationale: The correct answer is D: Wash your baby's face with plain water. This instruction is important because it helps prevent irritation or infection on the baby's delicate skin. Washing the baby's face with plain water is gentle and safe for newborns.
A: Bathing the baby immediately after a feeding is not recommended as it may lead to discomfort or spitting up.
B: Placing a bumper pad in the baby's crib can pose a suffocation hazard for the newborn.
C: Putting a soft mattress in the baby's crib increases the risk of sudden infant death syndrome (SIDS) as it may cause suffocation.
Overall, washing the baby's face with plain water is the safest and most appropriate instruction for home safety with a 2-day postpartum client.
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A nurse is assessing a client who is 6 hr postpartum and has endometritis. Which of the following findings should the nurse expect?
- A. Temperature 37.4°C (99.3°F)
- B. WBC count 9,000/mm3
- C. Uterine tenderness
- D. Scant lochia
Correct Answer: C
Rationale: The correct answer is C: Uterine tenderness. Endometritis is an infection of the uterine lining that can occur postpartum. Uterine tenderness is a common finding in clients with endometritis due to inflammation and infection. A: A temperature of 37.4°C (99.3°F) is within normal range and may not specifically indicate endometritis. B: A WBC count of 9,000/mm3 is also within normal limits and may not be specific to endometritis. D: Scant lochia may be seen in clients with endometritis, but it is not a defining characteristic.
A nurse is reviewing the chart of a client who is 2 days postpartum following a vaginal delivery and reports constipation. Which of the following findings should the nurse identify as a contraindication to the use of a suppository?
- A. Vaginal candidiasis
- B. Abdominal distention
- C. Afterpains
- D. Third-degree perineal laceration
Correct Answer: D
Rationale: The correct answer is D: Third-degree perineal laceration. Using a suppository in a client with a third-degree perineal laceration can increase the risk of infection or further trauma to the area. It is crucial to allow the laceration to heal properly without introducing any foreign substances.
A: Vaginal candidiasis - This is not a contraindication to using a suppository for constipation.
B: Abdominal distention - This is not a contraindication to using a suppository for constipation.
C: Afterpains - This is not a contraindication to using a suppository for constipation.
In summary, the other choices do not directly impact the safety or effectiveness of using a suppository for constipation postpartum, making them incorrect options.
A nurse is reviewing the medical record of a client who had a vaginal delivery 3 hr ago. Which of the following findings place the client at risk for postpartum hemorrhage? (Select all that apply.)
- A. Labor induction with oxytocin
- B. Newborn weight 2.948 kg (6 lb 8 oz)
- C. Vacuum-assisted delivery
- D. History of uterine atony
- E. History of human papillomavirus
Correct Answer: A,C,D
Rationale: The correct answers are A, C, and D. Labor induction with oxytocin can lead to uterine hyperstimulation, increasing the risk of postpartum hemorrhage. Vacuum-assisted delivery can cause trauma to the birth canal and uterus, also increasing the risk. History of uterine atony indicates a previous inability of the uterus to contract effectively after delivery, predisposing the client to postpartum hemorrhage.
Incorrect answers:
B: Newborn weight is not directly related to the risk of postpartum hemorrhage.
E: History of human papillomavirus does not increase the risk of postpartum hemorrhage.
In summary, choices A, C, and D are directly linked to postpartum hemorrhage risk due to their impact on uterine contraction and trauma during delivery, while choices B and E are not causative factors.
A nurse is providing teaching to a client who is 2 days postpartum and wants to continue using her diaphragm for contraception. Which of the following instructions should the nurse include?
- A. You should have your provider refit you for a new diaphragm.'
- B. You should use an oil-based vaginal lubricant when inserting your diaphragm.'
- C. You should keep the diaphragm in place for at least 4 hours after intercourse.'
- D. You should store your diaphragm in sterile water after each use.'
Correct Answer: A
Rationale: Correct Answer: A. The nurse should instruct the client to have her provider refit her for a new diaphragm because the body undergoes changes postpartum, affecting the size and shape of the cervix and vaginal canal. A new fitting ensures proper size and fit for effective contraception.
B: Using oil-based vaginal lubricant can damage the diaphragm and increase the risk of breakage.
C: Keeping the diaphragm in place for a prolonged period increases the risk of toxic shock syndrome and infection, so it should be removed within 24 hours.
D: Storing the diaphragm in sterile water can lead to bacterial growth, increasing the risk of infection. It should be stored in a dry, cool place.
Select the 3 findings that require immediate follow-up.
- A. Lateral deviation of the uterus
- B. Deep tendon reflexes 1+
- C. Pain rating of 3 on a scale of 0 to 10 (increased)
- D. Peripheral edema 2+ bilateral lower extremities
- E. Uterine tone soft
- F. Large amount of lochia rubra
- G. Blood pressure 136/86 mm Hg
Correct Answer: A,B,C
Rationale: The correct choices for immediate follow-up are A, B, and C. A lateral deviation of the uterus could indicate a possible complication like uterine atony or retained products of conception. Deep tendon reflexes of 1+ could suggest hyporeflexia or neurological issues. A pain rating of 3 on a scale of 0 to 10, especially if it has increased, may indicate worsening pain or a new issue. Choices D, E, F, and G do not present immediate concerns that require urgent follow-up compared to choices A, B, and C. Peripheral edema 2+ in bilateral lower extremities, soft uterine tone, large amount of lochia rubra, and a blood pressure of 136/86 mm Hg are important findings but do not necessitate immediate intervention or follow-up.