Nokea
What type of lochia is bright to dark red and occurs on days 1 -3 postpartum?
- A. rubra
- B. serosa
- C. placental
- D. alba
Correct Answer: A
Rationale: Lochia rubra is red in color and occurs for the first 1-3 days postpartum as the body sheds blood decidua and trophoblastic tissue.
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The nurse develops a plan to increase a patient’s milk supply. What is an intervention they can implement?
- A. Pump between nursing sessions.
- B. Nurse every 6 hours.
- C. Keep newborn in bassinet between sessions.
- D. Offer a pacifier when newborn cries.
Correct Answer: A
Rationale: Pumping between nursing sessions can increase milk supply.
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: The correct answer is B. The birth of a fourth child being unexpected and unplanned can be a risk factor for paternal postnatal depression (PPND) due to increased stress and pressure. Choice A is incorrect because past depression during pregnancy doesn't directly correlate with PPND. Choice C is incorrect as feeling bored and underappreciated at work is not a direct risk factor for PPND. Choice D is incorrect as being recently estranged from family members doesn't directly relate to PPND.
Which client is at greatest risk for early PPH?
- A. Primiparous woman (G 2, P 1-0-0-1) being prepared for an emergency cesarean birth for fetal distress
- B. Woman with severe preeclampsia on magnesium sulfate whose labor is being
- C. Multiparous woman (G 3, P 2-0-0-2) with an 8-hour labor
- D. Primigravida in spontaneous labor with preterm twins
Correct Answer: B
Rationale: Magnesium sulfate administration during labor poses a risk for PPH. Magnesium acts as a smooth muscle relaxant, thereby contributing to uterine relaxation and atony. A primiparous woman being prepared for an emergency cesarean birth for fetal distress, a multiparous woman with an 8-hour labor, and a primigravida in spontaneous labor with preterm twins do not indicate risk factors or causes of early PPH
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.
An Asian client 's temperature 10 hours after delivery is 100.2°F, but when encouraged she refuses to drink her ice water. Which of the following nursing actions is most appropriate?
- A. Replace the ice water with hot water.
- B. Notify the client 's health care provider.
- C. Reassess the temperature in one half hour.
- D. Remind the client that drinking is very important.
Correct Answer: A
Rationale: Cultural preferences may influence responses to care. In some cultures, hot liquids are preferred, and providing hot water is culturally appropriate.