Which information would the nurse include in the discharge teaching of a postpartum client quizlet?

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Terms in this set (32)

The charge nurse is assessing several postpartum clients. Which client has the greatest risk for postpartum hemorrhage?

A) The client who was overdue and delivered vaginally
B) The client who delivered by scheduled cesarean delivery
C) The client who had oxytocin augmentation of labor
D) The client who delivered vaginally at 36 weeks

C

The nurse is assisting a multiparous woman to the bathroom for the first time since her delivery 3 hours ago. When the client stands up, blood runs down her legs and pools on the floor. The client turns pale and feels weak. What would be the first action of the nurse?

A) Assist the client to empty her bladder
B) Help the client back to bed to check the fundus
C) Assess her blood pressure and pulse
D) Begin an IV of lactated Ringer's solution

B

A client is experiencing excessive bleeding immediately after the birth of her newborn. After speeding up the IV fluids containing oxytocin, with no noticeable decrease in the bleeding, the nurse should anticipate the physician requesting which medications?

Select all that apply.
A) Methergine
B) Coumadin
C) Misoprostol
D) Serotonin reuptake inhibitors (SSRIs)
E) Nonsteroidal anti-inflammatory drugs

A,C

The client has experienced a hemorrhage at 6 hours postpartum. After controlling the hemorrhage, the client's partner asks what would cause a hemorrhage. How should the nurse respond?

A) "Sometimes the uterus relaxes and excessive bleeding occurs."
B) "The blood collected in the vagina and poured out when your partner stood up."
C) "Bottle-feeding prevents the uterus from getting enough stimulation to contract."
D) "The placenta had embedded in the uterine tissue abnormally."

A

A client had a cesarean birth 3 days ago. She has tenderness, localized heat, and redness of the left leg. She is afebrile. As a result of these symptoms, what would the nurse anticipate would be the next course of action?

A) That the client would be encouraged to ambulate freely
B) That the client would be given aspirin 650 mg by mouth
C) That the client would be given Methergine IM
D) That the client would be placed on bed rest

D

The postpartum client is concerned about mastitis because she experienced it with her last baby. Preventive measures the nurse can teach include which of the following?

A) Wearing a tight-fitting bra
B) Limiting breastfeedings
C) Frequent breastfeedings
D) Restricting fluid intake

C

A postpartum client reports sharp, shooting pains in her nipple during breastfeeding and flaky, itchy skin on her breasts. Which of the following does the nurse suspect?

A) Nipple soreness
B) Engorgement
C) Mastitis
D) Letdown reflex

C

Which relief measure would be most appropriate for a postpartum client with superficial thrombophlebitis?

A) Urge ambulation
B) Apply ice to the leg
C) Elevate the affected limb
D) Massage her calf

C

Which of the following would be considered a clinical sign of hemorrhage?

A) Increased blood pressure
B) Increasing pulse
C) Increased urinary output
D) Hunger

B

Which findings would indicate the presence of a perineal wound infection?

Select all that apply.
A) Redness
B) Tender at the margins
C) Vaginal bleeding
D) Hardened tissue
E) Purulent drainage

A, B, D, E

A postpartum woman is at increased risk for developing urinary tract problems because of which of the following?

A) Decreased bladder capacity
B) Inhibited neural control of the bladder following the use of anesthetic agents
C) Increased bladder sensitivity
D) Abnormal postpartum diuresis

B

Which of the following is a risk factor for urinary retention after childbirth?

A) Multiparity
B) Precipitous labor
C) Unassisted childbirth
D) Not sufficiently recovering from the effects of anesthesia

D

The nurse is calling clients at 4 weeks postpartum. Which of the following clients should be seen immediately?

A) The client who describes feeling sad all the time
B) The client who reports hearing voices talking about the baby
C) The client who states she has no appetite and wants to sleep all day
D) The client who says she needs a refill on her sertraline (Zoloft) next week

B

To prevent the spread of infection, the nurse teaches the postpartum client to do which of the following?

A) Address pain early
B) Change peri-pads frequently
C) Avoid overhydration
D) Report symptoms of uterine cramping

B

A postpartal client recovering from deep vein thrombosis is being discharged. What areas of teaching on self-care and anticipatory guidance should the nurse discuss with the client?

Select all that apply.
A) Avoid crossing the legs.
B) Avoid prolonged standing or sitting.
C) Take frequent walks.
D) Take a daily aspirin dose of 650 mg.
E) Avoid long car trips.

A, B, C

The postpartum multipara is breastfeeding her new baby. The client states that she developed mastitis with her first child, and asks whether there is something she can do to prevent mastitis this time. What would the best response of the nurse be?

A) "Massage your breasts on a daily basis, and if you find a hardened area, massage it towards the nipple."
B) "Most first-time moms experience mastitis. It is really quite unusual for a woman having her second baby to get it again."
C) "Apply cabbage leaves to any areas that feel thickened or firm to relieve the swelling."
D) "Take your temperature once a day. This will help you to pick up the infection early, before it becomes severe."

A

The postpartum client states that she doesn't understand why she can't enjoy being with her baby. What would the nurse be concerned about?

A) Postpartum psychosis
B) Postpartum infection
C) Postpartum depression
D) Postpartum blues

C

The nurse understands that the classic symptom of endometritis in a postpartum client is which of the following?

A) Purulent, foul-smelling lochia
B) Decreased blood pressure
C) Flank pain
D) Breast is hot and swollen

A

The client delivered her second child 1 day ago. The client's temperature is 101.4° F, her pulse is 100, and her blood pressure is 110/70. Her lochia is moderate, serosanguinous, and malodorous. She is started on IV antibiotics. The nurse provides education for the client and her partner. Which statement indicates that teaching has been effective?

A) "This condition is called parametritis."
B) "Gonorrhea is the most common organism that causes this type of infection."
C) "My positive Beta-strep culture might have contributed to this problem."
D) "If I had walked more yesterday, this probably wouldn't have happened."

C

The postpartum client has developed thrombophlebitis in her right leg. Which finding requires immediate intervention?

A) The client reports she had this condition after her last pregnancy.
B) The client develops pain and swelling in her left lower leg.
C) The client appears anxious, and describes pressure in her chest.
D) The client becomes upset that she cannot go home yet.

C

A nurse suspects that a postpartum client has mastitis. Which data support this assessment?

Select all that apply.
A) Shooting pain between breastfeedings
B) Late onset of nipple pain
C) Pink, flaking, pruritic skin of the affected nipple
D) Nipple soreness when the infant latches on
E) Pain radiating to the underarm area from the breast

A, B, C

The postpartum client who delivered 2 days ago has developed endometritis. Which entry would the nurse expect to find in this client's chart?

A) "Cesarean birth after extended labor with ruptured membranes."
B) "Unassisted childbirth and afterbirth."
C) "External fetal monitoring used throughout labor."
D) "The client has history of pregnancy-induced hypertension."

A

The nurse suspects that a client has developed a perineal hematoma. What assessment findings would lead the nurse to this conclusion?

A) Facial petechiae
B) Large, soft hemorrhoids
C) Tense tissues with severe pain
D) Elevated temperature

C

The postpartum client is suspected of having acute cystitis. Which symptoms would the nurse expect to see in this client?

Select all that apply.
A) High fever
B) Frequency
C) Suprapubic pain
D) Chills
E) Nausea and vomiting

B, C

The client delivered vaginally 2 hours ago after receiving an epidural analgesia. She has a slight tingling sensation in both lower extremities, but normal movement. She sustained a second-degree perineal laceration. Her perineum is edematous and ecchymotic. What should the nurse include in the plan of care for this client?

A) Assist the client to the bathroom in 2 hours to void.
B) Place a Foley catheter now.
C) Apply warm packs to the perineum three times a day.
D) Allow the client to rest for the next 8 hours.

A

Risk factors associated with increased risk of thromboembolic disease include which of the following?

Select all that apply.
A) Diabetes mellitus
B) Varicose veins
C) Hypertension
D) Adolescent pregnancy
E) Malignancy

A, B, E

A postpartum client with endometritis is being discharged home on antibiotic therapy. The new mother plans to breastfeed her baby. What should the nurse's discharge instruction include?

A) The client can douche every other day.
B) Sexual intercourse can be resumed when the client feels up to it.
C) Light housework will provide needed exercise.
D) The baby's mouth should be examined for thrush.

D

The client delivered by cesarean birth 3 days ago and is being discharged. Which statement should the nurse include in the discharge teaching?

A) "If your incision becomes increasingly painful, call the doctor."
B) "It is normal for the incision to ooze greenish discharge in a few days."
C) "Increasing redness around the incision is a part of the healing process."
D) "A fever is to be expected because you had a surgical delivery."

A

The client delivered her second child yesterday, and is preparing to be discharged. She expresses concern to the nurse because she developed an upper urinary tract infection (UTI) after the birth of her first child. Which statement indicates that the client needs additional teaching about this issue?

A) "If I start to have burning with urination, I need to call the doctor."
B) "Drinking 8 glasses of water each day will help prevent another UTI."
C) "I will remember to wipe from front to back after I move my bowels."
D) "Voiding 2 or 3 times per day will help prevent a recurrence."

D

The postpartum client who is being discharged from the hospital experienced severe postpartum depression after her last birth. What should the nurse include in the plan of follow-up care for this client?

A) One visit from a home care nurse, to take place in 2 days
B) Two visits from a public health nurse over the next month
C) An appointment with a mental health counselor
D) Follow-up with the obstetrician in 6 weeks

C

Clinical features of posttraumatic stress disorder (PTSD) include which of the following?

SELECT ALL THAT APPLY
A) Difficulty sleeping
B) Acute awareness
C) Flashbacks
D) The need to be constantly around others
E) Irritability

A, C, E,

A patient who is hemorrhaging after a vaginal delivery is being considered for a uterine tamponade. What should the nurse instruct the patient about this process?

Select all that apply.
1. A balloon is inserted into the uterus
2. The balloon is kept in place for 12 hours
3. The balloon is inflated with 300 to 500 mL of saline
4. After removal, the uterus is packed with sterile gauze
5. The tube has an open tip to permit bleeding to be visualized

1, 3, 5

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