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What is one difference between recovery from a cesarean birth versus a vaginal birth?
- A. Breast-feeding is discouraged after cesarean birth due to pain medications taken.
- B. Lochia will be heavier after a cesarean birth.
- C. Pain with movement is more intense after a cesarean birth.
- D. Gas pain is more intense after a vaginal birth.
Correct Answer: C
Rationale: Recovery from a cesarean birth typically involves more intense pain due to abdominal incisions and a longer recovery period.
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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 postpartum cesarean patient comes into the rural health clinic at 1 week postdelivery for an incision check by the nurse. The vital signs reveal a temperature of 100.5°F, and the patient reports moderate foul-smelling lochia. The nurse determines that the skin incision is healing normally, but when palpating the uterus, she discovers the patient to have uterine and pelvic tenderness. What are the most appropriate nursing actions?
- A. Explain to the patient that she may have an infection of her uterus, and blood will need to be drawn to determine if this is the cause of her pain and excess bleeding.
- B. Explain that the client should rest more to help the bleeding slow and that she should return to the clinic if she isn’t feeling better in a few days.
- C. Explain to the patient that she is experiencing normal postoperative pain and bleeding and to come back for her scheduled 6-week postpartum checkup.
- D. Explain to the patient that the incision appears to be healing nicely. Have her take Tylenol for the elevated temperature and continue with the ordered pain medication until her next visit.
Correct Answer: D
Rationale: The foul-smelling lochia, fever, and uterine tenderness point toward a uterine infection, requiring further investigation.
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 can result from untreated STIs and chorioamnionitis and typically presents as fever and uterine tenderness.
A postpartum patient calls the clinic 4 days after the birth of her newborn because she is extremely tired and her vaginal bleeding is heavier. Which does the nurse anticipate when advising her to come in to the office right now?
- A. A hematocrit will be drawn, and the licensed provider will check for retained placental fragments.
- B. Her stress level and sleep deprivation will be evaluated, and a prescription for sleeping medication will be given.
- C. The perineum will be evaluated for lacerations that were missed.
- D. Reassure the client that this is all normal and provide a prescription for slow-release iron tablets.
Correct Answer: A
Rationale: The patient is presenting symptoms of postpartum hemorrhage and retained placental fragments, which requires prompt evaluation.
The nurse is providing care for a patient who is 1 day postpartum and exhibiting symptoms of postpartum psychosis. Which medical management does the nurse expect for this patient?
- A. Prescriptions for antidepressant/antipsychotic drugs
- B. Discharge to home with 24-hour observation in place
- C. Immediate hospitalization in a psychiatric unit
- D. Prescribed neonate visits during in-patient treatment
Correct Answer: C
Rationale: The nurse expects the health care provider to immediately hospitalize the patient in a psychiatric unit. Maintaining the patient in the postpartum unit delays necessary psychiatric treatment.