Postpartum Hormonal Changes

Postpartum Hormonal Changes Related

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The postpartum patient who continually repeats the story of her labor, birth, and recovery experiences is performing which of the following tasks?

  • A. Making the birth experience “real”
  • B. Accepting her response to labor and birth
  • C. Providing others with her knowledge of events
  • D. Taking hold of the events leading to her labor and birth
Correct Answer: A

Rationale: The correct answer is A: Making the birth experience "real." This choice aligns with the concept of emotional processing and integration in the postpartum period. By continually repeating her birth story, the patient is trying to make sense of and come to terms with her experience, making it feel more "real" to her. This process helps her emotionally process the events and transitions she has gone through during labor and birth.

Choices B, C, and D are incorrect:
B: Accepting her response to labor and birth - This choice focuses more on the patient's emotional response rather than the act of repeating the story.
C: Providing others with her knowledge of events - This choice is more about sharing information rather than the internal emotional processing the patient is likely engaging in.
D: Taking hold of the events leading to her labor and birth - This choice suggests a sense of control over the events, which may not necessarily be the primary motivation behind the patient's behavior.

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A serum electrolyte report for a client, 1 day post-cesarean delivery for eclampsia, has just been received by the nurse. The client is receiving 5% dextrose in 1/2 normal saline IV at 125 mL/hr and magnesium sulfate 2 G/hr IV via infusion pump. Which of the following values should the nurse report to the surgeon?

  • A. Magnesium 7 mg/dL.
  • B. Sodium 136 mg/dL.
  • C. Potassium 3.0 mg/dL.
  • D. Calcium 9 mg/dL.
Correct Answer: A

Rationale: Elevated magnesium levels indicate toxicity.

Which measure is optimal in order to prevent abdominal distention following a cesarean birth?

  • A. Rectal suppositories
  • B. Carbonated beverages
  • C. Early and frequent ambulation
  • D. Tightening and relaxing abdominal muscles
Correct Answer: C

Rationale: The correct answer is C: Early and frequent ambulation. This measure is optimal to prevent abdominal distention following a cesarean birth because it helps promote bowel motility and gas expulsion. Ambulation stimulates peristalsis, preventing gas accumulation and reducing the risk of distention. Rectal suppositories (A) may help with constipation but do not address the root cause of distention. Carbonated beverages (B) can exacerbate bloating and gas production. Tightening and relaxing abdominal muscles (D) may provide some relief but are not as effective as promoting ambulation for preventing abdominal distention.

A nurse is teaching a mother how to care for her 3-day-old son's circumcised penis. Which of the following actions demonstrates that the mother has learned the information?

  • A. The mother cleanses the glans with a cotton swab dipped in hydrogen peroxide.
  • B. The mother covers the glans with antifungal ointment after rinsing off any discharge.
  • C. The mother squeezes soapy water from the wash cloth over the glans.
  • D. The mother replaces the dry sterile dressing before putting on the diaper.
Correct Answer: D

Rationale: Proper care involves keeping the area clean and dry, with a sterile dressing if necessary.

A client is receiving an IV heparin drip at 16 mL/hr via an infusion pump for a diagnosis of deep vein thrombosis. The label on the 1/2 liter bag of D5W indicates 25,000 units of heparin have been added. How many units of heparin is the client receiving per hour? (Calculate to the nearest whole.)

  • A. 800
  • B. NA
  • C. NA
  • D. NA
Correct Answer: A

Rationale: Calculation: 25,000 units ÷ 500 mL × 16 mL = 800 units.

A postpartum patient calls the clinic and reports to the nurse feelings of fatigue, tearfulness, and anxiety. What is the nurse’s most appropriate response at this time?

  • A. “When did these symptoms begin?”
  • B. “Sounds like normal postpartum depression.”
  • C. “Are you having trouble getting enough sleep?”
  • D. “Are you able to get out of bed and provide care for your baby?”
Correct Answer: A

Rationale: The correct answer is A: "When did these symptoms begin?" The nurse's response should address the patient's concerns and gather more information to assess the situation accurately. By asking when the symptoms began, the nurse can determine the duration and severity of the symptoms, enabling appropriate intervention.

Choice B is incorrect because assuming the symptoms are due to "normal postpartum depression" without further assessment is premature and may overlook other potential causes. Choice C focuses solely on sleep and may not address the underlying issues causing the patient's symptoms. Choice D assumes the patient's ability to provide care for the baby without first addressing the patient's emotional well-being.

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