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Prep U Chapter 15: Postpartum Adaptations – Qs & As
Prep U Chapter 15: Postpartum Adaptations – Qs & As
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Prep U Chapter 15: Postpartum Adaptations – Qs & AsThe nurse, assessing the lochia of a client, attempts to separate a clot and
identifies the presence of tissue. Which observation would indicate the
presence of tissue? Correct Ans - postpartum diuresis
The nurse should identify postpartum diuresis as the potential cause for
urinary frequency. Urinary overflow occurs if the bladder is not completely
emptied. Urinary tract infection may be accompanied by fever and a
burning sensation. Trauma to pelvic muscles does not affect urinary
frequency.
The nurse, assessing the lochia of a client, attempts to separate a clot and
identifies the presence of tissue. Which observation would indicate the
presence of tissue? Correct Ans - difficult to separate clots
If tissue is identified in the lochia, it is difficult to separate clots. Yellowish-
white lochia indicates increased leukocytes and decreased fluid content.
Easily separable lochia indicates the presence of clots only. Foul-smelling
lochia indicates endometritis.
A client gave birth to a healthy boy 2 days ago. Both mother and baby have
had a smooth recovery. The nurse enters the room and tells the client that
she and her baby will be discharged home today. The client states, "I do not
want to go home." What is the nurse's most appropriate response?
Correct Ans - Ask the client to explain why she does not want to go
home.
It is important for the nurse to identify the client's concerns and reasons
for wanting to stay in the hospital. Open-ended questioning facilitates both
effective and therapeutic communication and allows the nurse to address
concerns appropriately. Asking about supports at home implies that the
nurse has made assumptions about why the client may not want to go
home. Informing the care provider or telling the client that discharge is
hospital policy is not appropriate at this time because the nurse has not
addressed the underlying reason for the client's comment. The client may
have safety-related concerns, undisclosed fears, or a need for increased
support before discharge. It is imperative that the nurse not make
assumptions but further explore concerns.
,A nurse is monitoring the vital signs of a client 24 hours after birth. She
notes that the client's blood pressure is 100/60 mm Hg. Which postpartum
complication should the nurse most suspect in this client, based on this
finding? Correct Ans - bleeding
Blood pressure should also be monitored carefully during the postpartum
period because a decrease in BP can also indicate bleeding. In contrast, an
elevation above 140 mm Hg systolic or 90 mm Hg diastolic may indicate the
development of postpartum gestational hypertension, an unusual but
serious complication of the puerperium. An infection would best be
indicated by an elevated oral temperature. Diabetes would be indicated by
an elevated blood glucose level.
While caring for a client following a lengthy labor and birth, the nurse
notes that the client repeatedly reviews her labor and birth and is very
dependent on her family for care. The nurse is correct in identifying the
client to be in which phase of maternal role adjustment? Correct Ans -
taking-in
The taking-in phase occurs during the first 24 to 48 hours following the
birth of the newborn and is characterized by the mother taking on a very
passive role in caring for herself, as well as recounting her labor
experience. The second maternal adjustment phase is the taking-hold
phase and usually lasts several weeks after the birth. This phase is
characterized by both dependent and independent behavior, with
increasing autonomy. During the letting-go phase the mother reestablishes
relationships with others and accepts her new role as a parent.
Acquaintance/attachment phase is a newer term that refers to the first 2 to
6 weeks following birth when the mother is learning to care for her baby
and is physically recuperating from the pregnancy and birth.
A nurse is describing the many changes that will occur during the early
postpartum period with a group of young parents. The nurse reviews
common reports experienced as the woman's body returns to her
prepregnancy state. The nurse determines that the teaching was successful
when the participants identify which report as being most common during
the first week that will indicate their fluid volume is returning to normal?
Correct Ans - diaphoresis
, The profuse diaphoresis is common during the early postpartum period.
Many women will wake up drenched with perspiration. This diaphoresis is
a mechanism to reduce the amount of fluids retained during pregnancy and
restore prepregnant body fluid levels. It is common, especially at night
during the first week after birth. Nocturia, urinary frequency, or urinary
urgency are not associated with this fluid shift.
A woman comes to the clinic. She gave birth about 2 months ago to a
healthy term male newborn. During the visit, the woman tells the nurse,
"I've noticed that I'm a bit uncomfortable now when we have sexual
intercourse. Is there anything that I can do?" The woman's menstrual
period has not yet resumed. Which suggestion by the nurse would be most
appropriate?
You Selected: Correct Ans - "You might try using a water-soluble
lubricant to ease the discomfort."
Coital discomfort and localized dryness usually plague most postpartum
women until menstruation returns. Water-soluble lubricants can reduce
discomfort during intercourse. Although it may take some time for the
woman's body to return to its prepregnant state, telling the woman this
does not address her concern. Telling her that dyspareunia is normal and
that it takes time to resolve also ignores her concern. Kegel exercises are
helpful for improving pelvic floor tone but would have no effect on vaginal
dryness.
While providing care to a postpartum client on her first day at home, the
nurse observes which behavior that would indicate the new mother is in
the taking-hold phase? Correct Ans - Showing increased confidence
when caring for the newborn
Independence with self-care is an important aspect of the taking-hold
phase. During the letting-go phase, the woman assumes responsibility and
care for the newborn with increased confidence. Recounting her labor
experience is usually part of the taking-in phase. Identifying specific
features of the newborn is typical of the taking-in phase. Feelings of grief,
guilt, and anxiety are part of the letting-go phase where the mother accepts
the infant as it is and lets go of any fantasies.
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