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Which best represents the process of postpartum diuresis in a postpartum client?
- A. A nervous response to vasomotor changes
- B. Elimination of excess fluid through the skin
- C. Underarm perspiration that occurs after ambulation
- D. Loss of fluid from expulsion of the placenta and amniotic fluid
Correct Answer: D
Rationale: Postpartum diuresis is the increased urine output that occurs after childbirth. The correct answer, D, explains this process accurately as the loss of fluid from expulsion of the placenta and amniotic fluid triggers the body to eliminate excess fluid through increased urination. Choice A is incorrect as it does not directly relate to the process of postpartum diuresis. Choice B is incorrect because excess fluid is primarily eliminated through urine, not the skin. Choice C is incorrect as underarm perspiration is not a significant factor in postpartum diuresis.
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Which best represents the process of postpartum diuresis in a postpartum client?
- A. A nervous response to vasomotor changes
- B. Elimination of excess fluid through the skin
- C. Underarm perspiration that occurs after ambulation
- D. Loss of fluid from expulsion of the placenta and amniotic fluid
Correct Answer: D
Rationale: The correct answer is D because postpartum diuresis occurs due to the loss of fluid from the expulsion of the placenta and amniotic fluid. This process helps the body eliminate excess fluid retained during pregnancy. A is incorrect as it refers to a nervous response, not a physiological process. B is incorrect as diuresis involves elimination through urine, not the skin. C is incorrect as underarm perspiration is not directly related to postpartum diuresis. In summary, D is the best representation as it directly links the process to the expulsion of placenta and amniotic fluid.
The nurse is providing care to a patient who is postpartum. Using anatomy and physiology knowledge, which expectation does the nurse relate to the cardiovascular system?
- A. Patient reporting of being cold related to blood loss
- B. WBC laboratory level of 30,000/mm a few hours after delivery
- C. Risk for hemorrhage due to decrease in circulating clotting factors
- D. A normal postpartum hemoglobin laboratory value of less than 11 g/dL
Correct Answer: B
Rationale: The correct answer is B. A postpartum WBC level of 30,000/mm is expected due to the physiological response to labor and delivery, known as leukocytosis. This is a normal finding as the body increases white blood cell production to fight off potential infections postpartum.
A: Patient feeling cold related to blood loss is more indicative of hypovolemia, a result of excessive blood loss, not a normal cardiovascular response postpartum.
C: Risk for hemorrhage due to decrease in clotting factors is incorrect as postpartum women actually have an increase in circulating clotting factors to prevent excessive bleeding.
D: A normal postpartum hemoglobin level of less than 11 g/dL is incorrect because a hemoglobin level below 11 g/dL would indicate anemia, not a normal postpartum finding.
The nurse is observing a new mother interact with her baby and notices the mother holding the baby close to her body. However, the nurse also notices that the mother does not hold the baby in an enface position. Which question is most appropriate for the nurse to ask?
- A. Can I help you with a nice position in which to hold your baby?'
- B. What can you tell me about your family's beliefs with new babies?'
- C. Is there some reason that I have not seen you look into your baby's eyes?'
- D. Your baby is so expressive, have you looked into his eyes yet?'
Correct Answer: B
Rationale: The correct answer is B because it focuses on understanding the mother's cultural background and beliefs related to interacting with a new baby. This question allows the nurse to gain insight into the mother's perspective and approach to parenting, which can help tailor support and guidance effectively.
Choice A focuses on positioning, which is not the main concern in this scenario. Choice C assumes a negative reason for the mother's behavior without any evidence, potentially causing unnecessary worry. Choice D is too direct and may not be culturally sensitive, as some cultures have different norms regarding eye contact with infants.
The nurse is palpating a patient's uterus 12 hours after a vaginal delivery. For which reason does the nurse place one hand just above the symphysis pubis?
- A. To prevent uterine prolapse.
- B. To prevent uterine movement
- C. To prevent uterine hemorrhage
- D. To prevent uterine inversion
Correct Answer: D
Rationale: The correct answer is D: To prevent uterine inversion. Placing a hand just above the symphysis pubis during uterine palpation helps prevent uterine inversion by providing support to the lower segment of the uterus. Uterine prolapse (A) is the downward displacement of the uterus, which is not prevented by this action. Uterine movement (B) is a natural occurrence and not a concern during palpation. Uterine hemorrhage (C) is more related to postpartum bleeding management and is not directly impacted by the hand placement.
The nurse is assessing her patient, who is 1 day postpartum. The nurse notes that the fundus is firm and at midline, the lochia is moderate in amount, and the presence of rubra with two dime-sized clots is on her peri-pad. What should the nurse determine from these assessment findings?
- A. They are normal.
- B. They indicate the presence of infection.
- C. The physician should be notified of the abnormal findings.
- D. The patient should be instructed to increase her fluid intake.
Correct Answer: A
Rationale: Step-by-step rationale for why choice A is correct:
1. Fundus is firm and at midline: Indicates normal involution of the uterus post-delivery.
2. Lochia is moderate with rubra and small clots: Expected findings in the early postpartum period.
3. Overall assessment findings within normal range: Indicate normal postpartum recovery.
Summary of why other choices are incorrect:
B. Presence of infection would usually be indicated by abnormal signs such as foul-smelling lochia or fever, which are absent in this case.
C. No abnormal findings are present that would necessitate physician notification.
D. Fluid intake is important postpartum, but there are no signs in this scenario indicating a need for increased fluid intake.