Nokea
What assessment data increases the risk of postpartum infection?
- A. precipitous labor
- B. urinary retention
- C. breast-feeding
- D. intact perineum
Correct Answer: A
Rationale: The correct answer is A: precipitous labor. Precipitous labor can cause trauma to the birth canal, leading to increased risk of infection. Urinary retention (B) may lead to urinary tract infections but not necessarily postpartum infections. Breastfeeding (C) and intact perineum (D) are not direct risk factors for postpartum infections.
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A woman is 1 hour postcesarean delivery with nausea and an estimated blood loss of 1,200 mL. She is currently experiencing heavy vaginal bleeding and has a uterus that firms with massage. She has a history of asthma with a current O2 saturation of 89%. The licensed provider has ordered Cytotec 800 mcg and Methergine 0.2 mg. What collaborative communication should occur between the nurse and provider?
- A. Since the total blood loss is under 1,500 mL, Cytotec and Methergine administration could be delayed for a time.
- B. Cytotec should be given rectally because the patient is already nauseated, and the Methergine route should be ordered.
- C. Recommend that the abdominal dressing be removed to inspect for incisional bleeding.
- D. Recommend that the patient not get Methergine because she has a history of asthma.
Correct Answer: D
Rationale: Given the patient’s asthma, Methergine should not be administered and alternative treatments should be discussed.
A client, G1 P0101, postpartum 1 day, is assessed. The nurse notes that the client 's lochia rubra is moderate and her fundus is boggy 2 cm above the umbilicus and deviated to the right. Which of the following actions should the nurse take first?
- A. Notify the woman 's primary health care provider.
- B. Massage the woman 's fundus.
- C. Escort the woman to the bathroom to urinate.
- D. Check the quantity of lochia on the peripad.
Correct Answer: B
Rationale: A boggy fundus can indicate uterine atony, which can lead to postpartum hemorrhage. The first step is to massage the fundus to stimulate uterine contraction.
The nurse is collecting information during a follow-up OB appointment with a patient who delivered 3 months ago. The patient reports her partner has become cynical, irritable, and verbally abusive. The nurse will screen for which risks related to paternal postnatal depression (PPND)? Select all that apply.
- A. The father exhibited depression during the pregnancy
- B. The birth of this fourth child was unexpected and unplanned
- C. The father expresses feeling bored and underappreciated in his job
- D. The father is recently estranged from his parents and siblings
Correct Answer: B
Rationale: Exhibiting paternal depression during the pregnancy can be a risk factor for the development of PPND. An unexpected or unplanned pregnancy can be a risk factor for the development of PPND. The father’s estrangement from his parents and siblings can be a stressful life event and/or indicate a lack of social support.
Which of the following statements is true about breastfeeding mothers as compared to bottle-feeding mothers?
- A. Breastfeeding mothers usually involute completely by 3 weeks postpartum.
- B. Breastfeeding mothers have decreased incidence of diabetes mellitus later in life.
- C. Breastfeeding mothers show higher levels of bone density after menopause.
- D. Breastfeeding mothers are prone to fewer bouts of infection immediately postpartum.
Correct Answer: B
Rationale: Breastfeeding has long-term health benefits, including a decreased risk of developing type 2 diabetes later in life.
What is the most common reason for cracked, sore nipples?
- A. hungry infant
- B. pumping
- C. ineffective latch
- D. lack of supportive bra
Correct Answer: C
Rationale: The correct answer is C: ineffective latch. An ineffective latch during breastfeeding can lead to cracked, sore nipples due to improper positioning and poor attachment of the baby to the breast. This can cause friction and irritation on the nipples, leading to pain and discomfort. It is crucial for the baby to have a deep latch to ensure proper milk transfer and to prevent nipple damage.
Summary:
A: A hungry infant may lead to more frequent feedings but not necessarily cause cracked, sore nipples.
B: Pumping alone does not directly cause cracked, sore nipples; it is more related to how the baby latches during breastfeeding.
D: While a lack of supportive bra may contribute to discomfort, it is not the primary reason for cracked, sore nipples.