Nokea
Which patient would be most likely to have severe afterbirth pains and request a narcotic analgesic?
Correct Answer: A
Rationale: The correct answer is A - Gravida 5, para 5. Afterbirth pains are caused by uterine contractions as the uterus returns to its pre-pregnancy size. The more pregnancies a woman has had, the more stretched and prone to stronger contractions her uterus becomes. In this case, a gravida 5, para 5 patient has had multiple pregnancies and deliveries, leading to a higher likelihood of severe afterbirth pains. The other choices are incorrect because a primipara (B) would have less uterine stretching, a patient bottle feeding her first child (C) would still experience afterbirth pains due to uterine contractions, and a patient breastfeeding her second child (D) would experience milder afterbirth pains due to the release of oxytocin during breastfeeding which helps the uterus contract and reduce bleeding.