Nokea
To prevent infection, the nurse teaches the postpartum client to perform which of the following tasks?
- A. Apply antibiotic ointment to the perineum daily.
- B. Change the peripad at each voiding.
- C. Void at least every two hours.
- D. Spray the perineum with povidone-iodine after toileting.
Correct Answer: B
Rationale: Changing peripads frequently helps prevent the growth of bacteria and reduces the risk of infection.
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The nurse notices the uterus is boggy and the bladder is full. What intervention should the nurse perform next?
- A. Call for help.
- B. Start IV bolus.
- C. Get the person out of bed to walk to restroom.
- D. Massage the fundus and assess the lochia.
Correct Answer: D
Rationale: A boggy uterus and full bladder may indicate uterine atonyand fundal massage is the first intervention to promote uterine contraction.
A woman who has recently given birth complains of pain and tenderness in her leg. On physical examination, the nurse notices warmth and redness over an enlarged, hardened area. Which condition should the nurse suspect, and how will it be confirmed?
- A. Disseminated intravascular coagulation (DIC); asking for laboratory tests
- B. von Willebrand disease (vWD); noting whether bleeding times have been extended
- C. Thrombophlebitis; using real-time and color Doppler ultrasound
- D. Idiopathic or immune thrombocytopenic purpura (ITP); drawing blood for laboratory analysis
Correct Answer: C
Rationale: The correct answer is C: Thrombophlebitis; using real-time and color Doppler ultrasound. Thrombophlebitis is the inflammation of a vein with the formation of a blood clot. In this scenario, the woman's symptoms of pain, tenderness, warmth, redness, and an enlarged, hardened area in her leg are indicative of thrombophlebitis. Using real-time and color Doppler ultrasound will confirm the diagnosis by visualizing the blood clot in the affected vein. This diagnostic method is effective in detecting thrombosis and determining the extent of the clot, guiding appropriate treatment.
Incorrect choices:
A: Disseminated intravascular coagulation (DIC) is a systemic process causing widespread clotting in small blood vessels, leading to bleeding. Asking for laboratory tests wouldn't be the appropriate way to confirm thrombophlebitis.
B: von Willebrand disease (vWD) is a genetic bleeding disorder, and checking
What postpartum infection is caused by STIs and chorioamnionitis?
- A. mastitis
- B. pneumonia
- C. cesarean wound infection
- D. postpartum endometritis
Correct Answer: D
Rationale: Postpartum endometritis is a common infection caused by STIs and chorioamnionitis.
A medication order reads: Methergine (ergonovine) 0.2 mg po q 6 h × 4 doses. Which of the following assessments should be made before administering each dose of this medication?
- A. Apical pulse.
- B. Lochia flow.
- C. Blood pressure.
- D. Episiotomy.
Correct Answer: C
Rationale: Methergine can raise blood pressure, so it is important to assess the patient's blood pressure before administering each dose.
The nurse works in a labor and delivery facility with new protocols for estimating postpartum blood loss. Which method for estimating blood loss is implemented in the delivery room?
- A. Ask the patient how many peripads she considered to be “soaked.”
- B. Collect blood in calibrated, under-buttocks drapes for vaginal birth.
- C. Place a basin at the foot of the delivery table to catch any blood.
- D. Rely on the primary health care provider’s estimate of blood loss.
Correct Answer: B
Rationale: Collecting blood in calibrated, under-buttocks drapes for vaginal birth and then weighing the drapes is the easiest way to estimate blood loss in the delivery room.