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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.
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The nurse is researching for evidence-based practice related to a mother's response during the postpartum period. Based on research by Rubin and Mercer, which finding will the nurse be able to easily implement to change the culture of the unit?
- A. Satisfaction questionnaires
- B. Alterations in terminology
- C. Decrease nurse/patient ratios
- D. Soliciting paternal expectations
Correct Answer: B
Rationale: The correct answer is B: Alterations in terminology. Rubin and Mercer's research emphasizes the importance of language in shaping attitudes and behaviors during the postpartum period. By changing the terminology used in the unit to promote positive and empowering language, the nurse can easily implement this finding to change the unit's culture. This can have a significant impact on how mothers perceive their experiences and how they are supported.
Incorrect choices:
A: Satisfaction questionnaires - While important for feedback, satisfaction questionnaires do not directly address changing the culture of the unit.
C: Decrease nurse/patient ratios - This may improve patient care but does not specifically relate to changing the culture of the unit.
D: Soliciting paternal expectations - While involving fathers is important, it does not directly address changing the language and culture of the unit.
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: The correct answer is A, as the assessment findings described are normal for a patient who is 1 day postpartum. A firm and midline fundus indicates proper uterine involution. Moderate lochia is expected at this stage, and the presence of small clots is normal. The overall picture suggests the normal process of healing after childbirth.
Choice B is incorrect because the assessment findings do not indicate signs of infection such as foul-smelling lochia, fever, or elevated white blood cell count.
Choice C is incorrect as there are no abnormal findings that would warrant immediate notification of the physician.
Choice D is incorrect as there is no indication from the assessment findings that the patient needs to increase her fluid intake; the findings are within the expected range for a patient 1 day postpartum.
A postpartum patient states, " am really in pain."For which sources of pain will the nurse not assess the patient?
- A. Uterine contractions
- B. Perineal trauma
- C. Breast engorgement
- D. General soreness
Correct Answer: D
Rationale: The correct answer is D: General soreness. Postpartum pain assessment typically focuses on specific sources such as uterine contractions, perineal trauma, and breast engorgement. General soreness is too vague and does not provide specific information for targeted intervention. By ruling out general soreness, the nurse can prioritize assessment and management of more specific sources of pain to provide appropriate care for the postpartum patient.
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: "What can you tell me about your family's beliefs with new babies?" This question allows the nurse to gather valuable cultural information that may explain the mother's behavior of not holding the baby in an enface position. Understanding the family's beliefs helps the nurse provide culturally sensitive care.
A: "Can I help you with a nice position in which to hold your baby?" - This question assumes the mother needs help with positioning, which may not be the case. It does not address the underlying reason for the mother's behavior.
C: "Is there some reason that I have not seen you look into your baby's eyes?" - This question is accusatory and may make the mother defensive. It does not consider cultural reasons for the behavior.
D: "Your baby is so expressive, have you looked into his eyes yet?" - This question assumes the mother has not looked into the baby's eyes, which may not be the case. It does not address the cultural
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: WBC laboratory level of 30,000/mm a few hours after delivery. Postpartum, a temporary increase in white blood cells (WBCs) is normal due to the body's response to delivery and potential inflammation. This increase is known as leukocytosis and helps the body combat potential infections. The other choices are incorrect because: A is more related to hypovolemia than to cardiovascular changes. C is incorrect as clotting factors increase postpartum to reduce the risk of hemorrhage. D is incorrect as a hemoglobin level less than 11 g/dL postpartum may indicate anemia, not normalcy.