Nokea
What is a risk factor for PPH found in the prenatal record?
- A. primipara
- B. rubella nonimmune
- C. von Willebrand disorder
- D. history of appendectomy
Correct Answer: C
Rationale: Von Willebrand disorder increases the risk of bleeding and PPH.
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What is one of the initial signs and symptoms of puerperal infection in the postpartum client?
- A. Fatigue continuing for longer than 1 week
- B. Pain with voiding
- C. Profuse vaginal lochia with ambulation
- D. Temperature of 38° C (100.4° F) or higher on 2 successive days
Correct Answer: D
Rationale: The correct answer is D because a temperature of 38°C (100.4°F) or higher on 2 successive days is a key sign of puerperal infection. This is due to the body's response to infection. Fatigue (choice A) can be a symptom but is nonspecific. Pain with voiding (choice B) may indicate a urinary tract infection. Profuse vaginal lochia (choice C) may be normal postpartum.
The nurse assesses for signs of depression or postpartum blues. How can the nurse explain the difference?
- A. PPD is less severe and resolves in a few weeks.
- B. Postpartum blues can last up to a year.
- C. PPD is a normal expectation of postpartum.
- D. Postpartum blues symptoms include irritability and sadness.
Correct Answer: D
Rationale: Postpartum blues are more temporary and less severe whereas postpartum depression (PPD) involves more severe symptoms and requires treatment.
The nurse and provider estimate the blood loss at delivery to be 400 mL in the measuring drape; now when doing the initial perineal care, the nurse finds a large amount of blood underneath the patient. What action reflects safe and accurate nursing care?
- A. Estimate the amount of blood loss from the sheet and client clothing, and notify the physician.
- B. Encourage the mother to report any additional bleeding or clots.
- C. Draw the ordered hematocrit and notify the provider if the result is less than 28.
- D. Weigh the blood-soaked linens and notify the provider of the additional blood loss.
Correct Answer: D
Rationale: The correct answer is D. Weighing the blood-soaked linens provides an accurate measurement of the additional blood loss, which is crucial for assessing the patient's condition accurately. Here's the rationale step-by-step:
1. Weighing the blood-soaked linens is an objective and precise method to quantify the additional blood loss.
2. This measurement helps to determine the total blood loss accurately, which is essential for assessing postpartum hemorrhage.
3. Providing this quantitative data to the provider enables them to make informed decisions about further interventions.
4. Estimating blood loss visually is subjective and can be inaccurate, leading to potential underestimation or overestimation.
5. Drawing hematocrit levels (choice C) may provide valuable information but does not directly address the immediate need to quantify the additional blood loss.
6. Encouraging the mother to report bleeding (choice B) is important for ongoing assessment but does not provide an objective measurement of the blood loss.
In summary
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.
What symptom differentiates baby blues from PPD?
- A. Baby blues last longer than 14 days.
- B. Baby blues cause hallucinations.
- C. Baby blues occur in the first few days of the postpartum period.
- D. Baby blues are treated with inpatient therapy.
Correct Answer: A
Rationale: Baby blues typically last for a few days, while PPD lasts longer and includes more severe symptoms.