Nokea
The third stage of labor has just ended for a client who has decided to bottle feed her baby. Which of the following maternal hormones will increase sharply at this time?
- A. Estrogen.
- B. Prolactin.
- C. Human placental lactogen.
- D. Human chorionic gonadotropin.
Correct Answer: B
Rationale: After delivery, prolactin levels rise to stimulate milk production, even if the mother has decided to bottle feed. Estrogen and other hormones also fluctuate, but prolactin will be the most significant in this case.
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A client, 2 days postoperative from a cesarean section, complains to the nurse that she has yet to have a bowel movement since the surgery. Which of the following responses by the nurse would be appropriate at this time?
- A. That is very concerning. I will request that your physician order an enema for you.
- B. Two days is not that bad. Some patients go four days or longer without a movement.
- C. You have been taking antibiotics through your intravenous. That is probably why you are constipated.
- D. Fluids and exercise often help to combat constipation. Take a stroll around the unit and drink lots of fluid.
Correct Answer: B
Rationale: It is not uncommon for postpartum clients to experience delayed bowel movements due to the effects of anesthesia, immobility, and decreased peristalsis.
When teaching the postpartum woman about peripads, the nurse should tell her that:
- A. She can change to tampons when the initial perineal soreness goes away.
- B. Pads having cold packs within them usually hold more lochia than regular pads.
- C. Blood-soaked pads must be returned in a plastic bag to the hospital after discharge.
- D. The pads should be applied and removed in a front to back direction.
Correct Answer: D
Rationale: The pads should be applied and removed in a front-to-back direction to reduce the risk of infection.
A physician has ordered an iron supplement for a postpartum woman. The nurse strongly suggests that the woman take the medicine with which of the following drinks?
- A. Skim milk.
- B. Ginger ale.
- C. Orange juice.
- D. Chamomile tea.
Correct Answer: C
Rationale: Iron absorption is enhanced by vitamin C, and orange juice is rich in vitamin C, making it an appropriate drink to take with the supplement.
Which is the initial treatment for the client with vWD who experiences a PPH?
- A. Cryoprecipitate
- B. Factor VIII and von Willebrand factor (vWf)
- C. Desmopressin
- D. Hemabate
Correct Answer: C
Rationale: The correct initial treatment for vWD client with PPH is desmopressin (Choice C) because it stimulates the release of von Willebrand factor and factor VIII from storage sites, helping to improve clotting. Cryoprecipitate (Choice A) contains multiple clotting factors and is usually reserved for severe bleeding. Factor VIII and vWf (Choice B) can be used for severe cases but are not typically the initial treatment. Hemabate (Choice D) is a medication used for postpartum hemorrhage due to uterine atony, not specifically for vWD-related bleeding.
A patient, G2 P1102, who delivered her baby 8 hours ago, now has a temperature of 100.2°F. Which of the following is the appropriate nursing intervention at this time?
- A. Notify the doctor to get an order for acetaminophen.
- B. Request an infectious disease consult from the doctor.
- C. Provide the woman with cool compresses.
- D. Encourage intake of water and other fluids.
Correct Answer: D
Rationale: A slight increase in temperature is common in the first 24 hours after delivery due to hormonal changes and dehydration. Encouraging fluid intake is an appropriate intervention.