Nokea
To help the postpartum woman avoid constipation, the nurse should teach her to:
- A. Avoid intake of foods such as milk, cheese, or yogurt.
- B. Take a laxative for the first 3 postpartum days.
- C. Drink at least 1600 mL of noncaffeinated fluids daily.
- D. Limit her walking until the episiotomy is fully healed.
Correct Answer: C
Rationale: Drinking at least 1600 mL of noncaffeinated fluids daily helps to prevent constipation by promoting hydration, which is essential in the postpartum period.
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What is the most common reason for late postpartum hemorrhage (PPH)?
- A. Subinvolution of the uterus
- B. Defective vascularity of the decidua
- C. Cervical lacerations
- D. Coagulation disorders
Correct Answer: A
Rationale: Late postpartum hemorrhage (PPH), defined as occurring between 24 hours and up to 12 weeks after delivery, is most commonly due to subinvolution of the uterus. This occurs when the uterus fails to return to its normal pre-pregnancy size. Subinvolution can be caused by retained products of conception, uterine infection, uterine anomalies, or inadequate contraction of the uterine muscles. When the uterus does not contract effectively, it is unable to compress the blood vessels at the site of the placental attachment, leading to persistent bleeding. Subinvolution of the uterus is an important cause of late PPH and requires prompt intervention to prevent excessive blood loss and its associated complications.
A postpartum patient informs the nurse of a frequent urge and burning when attempting to urinate. The nurse reviews the patient’s medical record and associates which risk factors related to a possible urinary tract infection (UTI)? Select all that apply.
- A. Neonatal macrosomia
- B. Use of a vacuum extractor
- C. Poor oral fluid intake
- D. Urinary catheter during labor
Correct Answer: C
Rationale: The correct answer is C: Poor oral fluid intake. Postpartum patients are at increased risk for UTIs due to physiological changes and decreased fluid intake. Poor hydration can lead to concentrated urine, making it easier for bacteria to grow. Neonatal macrosomia (A) and use of a vacuum extractor (B) are not directly associated with UTIs. While a urinary catheter during labor (D) can increase the risk of UTIs, it is not the most relevant factor in this scenario compared to poor oral fluid intake.
The nurse educates the person recovering from a cesarean birth on how to care for the incision. What education is discussed?
- A. Scrub the incision well twice daily.
- B. Remove the dressing the day after birth.
- C. Staples will be removed the day after birth.
- D. Vertical incisions heal faster with less pain.
Correct Answer: A
Rationale: Proper care and cleaning of the cesarean incision are essential for recovery.
The nurse is caring for a woman who is 6 hours postpartum after a vaginal delivery. She has a history of labial varicose veins and is reporting perineal pain of 8 on a 10-point scale. What interventions should the nurse include in the plan of care?
- A. Provide the patient with an inflatable donut ring to sit on and administer her oral pain medication.
- B. Explain that this is normal after a vaginal delivery and assist her to a side-lying position.
- C. Assess the perineum for a hematoma or inflamed varicosities, and administer oral pain medication.
- D. Administer oral stool softeners and encourage fluids.
Correct Answer: C
Rationale: The correct answer is C because it addresses the patient's specific issue of perineal pain related to her history of labial varicose veins. By assessing the perineum for a hematoma or inflamed varicosities, the nurse can identify the cause of the pain and provide appropriate treatment. Administering oral pain medication targets the source of discomfort.
Choice A is incorrect because providing an inflatable donut ring may offer temporary relief but does not address the underlying cause of the pain. Administering oral pain medication alone may not be sufficient without assessing the perineum.
Choice B is incorrect because dismissing the patient's pain as normal without further assessment can lead to overlooking potential complications. Assisting the patient to a side-lying position does not address the pain.
Choice D is incorrect because administering stool softeners and encouraging fluids may be beneficial for postpartum care but does not directly address the patient's perineal pain related to varicose veins.
What important assessment should the nurse perform on all postpartum persons?
- A. Screen for PPD with the EPDS.
- B. Screen for drug use with a urine drug screen.
- C. Screen for breast-feeding failure.
- D. Screen for contraception contraindications.
Correct Answer: A
Rationale: Screening for PPD is essential during postpartum care.