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A+ NURSING MANAGEMENT DURING THE POSTPARTUM PERIOD. QUESTIONS AND ANSWERS. 2024/2025
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A+ NURSING MANAGEMENT DURING THE POSTPARTUM PERIOD. QUESTIONS AND ANSWERS. 2024/2025
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A+ NURSING MANAGEMENT DURING THE POSTPARTUM PERIOD.QUESTIONS AND ANSWERS. 2024/2025
1. A client appears to be resting comfortably 12 hours after giving birth to her
first child. In contrast, she labored for more than 24 hours, the primary care
provider had to use forceps to deliver the baby, and she had multiple vaginal
examinations during labor. Based on this information what postpartum
complication is the client at risk for developing?
infection
depression
hemorrhage
pulmonary emboli:
infection
There are many risk factors for developing a postpartum infection: operative
procedures (e.g., forceps, cesarean section, vacuum extraction), history of
diabetes, prolonged labor (longer than 24 hours), use of Foley catheter,
anemia, multiple vaginal examinations during labor, prolonged rupture of
membranes, manual extraction of placenta, and HIV.
2. The birth center recognizes that attachment is very important in the early
stages after birth. Which policy would be inappropriate for the birth center to
implement when assisting new parents in this process?
policies that allow visitors policies that allow rooming the infant and
mother together policies that discourage unwrapping and exploring the
infant policies that allow flexibility for cultural differences: policies that
discourage unwrapping and exploring the infant
Various factors associated with the health care facility or birthing unit can
hinder attachment. These may include separation of infant and parents
immediately after birth; policies that discourage unwrapping and exploring
the infant; intensive care environment; restrictive visiting policies; staff
indifference or lack of support for the parents. Allowing the infant and mother
to room together, allowing visitors, and working with cultural differences will
enable the attachment process to occur.
3. A client who is 12 hours post birth is reporting perinea' pain. After the
assessment reveals no signs of an infection, which measure could the nurse
offer the client?
,opioid pain medication a sitz
bath a heating pad applied to
the perineum an ice pack
applied to the perineum: an ice
pack applied to the perineum
Commonly ice and/or cold measures are used in the first 24 hours following
birth to help reduce the edema and discomfort. Usually, an ice pack wrapped
in a disposable covering or clean washcloth can be applied intermittently for
20 minutes and removed for 10 minutes. After 24 hours, then the client may
use heat in the form of a sitz bath or peri bottle rinse. Opioid pain medication
would not be the first choice.
4. During a routine home visit, the couple asks the nurse when it will be
safe to resume full sexual relations. Which answer would be the best?
generally, after 12 weeks generally within 3 to 6
weeks usually within a couple weeks whenever the
couple wishes: generally, within 3 to 6 weeks
There is no set time to resume sexual intercourse after birth; each couple must
decide when they feel it is safe. Typically, once bright red bleeding has
stopped and the perineum is healed from the episiotomy or lacerations, sexual
relations can be resumed. This is usually by the third to sixth week
postpartum.
5. A nurse is inspecting the perinea' pad of a client who gave birth
vaginally to a healthy newborn 6 hours ago. The nurse observes a 5-inch stain
of lochia on the pad. The nurse would document this as:
light
.
mod
erat
e.
heav
y.
scant.: moderate.
Typically, the amount of lochia is described as follows: scant-a 1- to 2-inch
lochia stain on the perineal pad or approximately a 10-ml loss; light or
2/19
, small- an approximately 4-inch stain or a 10- to 25-ml loss; moderate- a 4-
to 6-inch stain with an estimated loss of 25 to 50 ml; and large or heavy-a
pad is saturated within 1 hour after changing it.
6. When palpating for fundal height on a postpartum woman, which
technique is preferable?
placing one hand at the base of the uterus, one on the
fundus palpating the fundus with only fingertip pressure
placing one hand on the fundus, one on the perineum
resting both hands on the fundus: placing one hand at the base of the uterus,
one on the fundus
Supporting the base of the uterus before palpation prevents the possibility of
uterine inversion with palpation.
7. A nurse is caring for a postpartum woman who is Muslim. When
developing the woman's plan of care, the nurse would make which action a
priority?
Ensure that the newborn's daily bath is performed by the nurses.
Allow time for the numerous visitors who come to see the woman and
newborn.
Provide time for prayers to be performed at the bedside.
Assign a female nurse to care for her.: Assign a female nurse to care for her.
Muslims prefer the same-sex health care provider; male-female touching is
prohibited except in emergency situations. Nurses give the daily bath for
newborns of some Japanese-American women. Numerous visitors can be
expected to visit some women of the Filipino-American culture because
families are very closely knit. Bedside prayer is common due to the strong
religious beliefs of the Filipino-American culture.
8. Seven hours ago, a multigravida woman gave birth to a male infant
weighing 4,133 g. She has voided once and calls for a nurse to check because
she states that she feels "really wet" now. Upon examination, her perinea' pad
is saturated. The immediate nursing action is to:
increase the flow of an IV.
3/19
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