Ricci, Kyle & Carman: Maternity And Pediatric Nurs
Ricci, Kyle & Carman: Maternity and Pediatric Nurs
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Ricci, Kyle & Carman: Maternity and Pediatric Nursing, Second Edition: Chapter 15: Postpartum Adaptations; PrepU
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Ricci, Kyle & Carman: Maternity and Pediatric Nurs
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Ricci, Kyle & Carman: Maternity And Pediatric Nurs
A woman who is breastfeeding her newborn reports that her breasts seem quite full. Assessment reveals that her breasts are engorged. Which factor would the nurse identify as the most likely cause for this development?
inability of infant to empty breasts
For the breastfeeding mother, engorgemen...
second edition chapter 15 postpartum adaptations prepu
a woman who is breastfeeding her newborn reports that her breasts seem quite full
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Ricci, Kyle & Carman: Maternity and
Pediatric Nursing, Second Edition:
Chapter 15: Postpartum Adaptations;
PrepU
A woman who is breastfeeding her newborn reports that her breasts seem quite full.
Assessment reveals that her breasts are engorged. Which factor would the nurse
identify as the most likely cause for this development? - anwer inability of infant to
empty breasts
For the breastfeeding mother, engorgement is often the result of vascular congestion
and milk stasis, primarily caused by the infant not fully emptying the mother's breasts at
each feeding. Cracking of the nipple could lead to infection. Improper positioning may
lead to nipple tenderness or pain. Inadequate secretion of prolactin causes a decrease
in the production of milk.
The nurse is caring for a client in the postpartum period. The client has difficulty in
voiding and is catheterized. The nurse then would monitor the client for which
condition? - anwer urinary tract infection
The nurse would need to monitor the client for signs and symptoms of a urinary tract
infection, a risk associated with catheterization. Stress incontinence is caused due to
loss of pelvic muscle tone after birth. Increased urinary output is observed in diuresis.
Catheterization does not cause loss of pelvic muscle tone, increased urine output, or
stress incontinence.
A nurse is caring for a nonbreastfeeding client in the postpartum period. The client
reports engorgement. What suggestion should the nurse provide to alleviate breast
discomfort? - anwer Wear a well-fitting bra.
The nurse should suggest the client wear a well-fitting bra to provide support and help
alleviate breast discomfort. Application of warm compresses and expressing milk
frequently is suggested to alleviate breast engorgement in breastfeeding clients.
Hydrogel dressings are used prophylactically in treating nipple pain.
A client in her sixth week postpartum reports general weakness. The client has stopped
taking iron supplements that were prescribed to her during pregnancy. The nurse would
assess the client for which condition? - anwer hypovolemia
The nurse should assess the client for hypovolemia as the client must have had
hemorrhage during birth and puerperium. Additionally, the client also has discontinued
iron supplements. Hyperglycemia can be considered if the client has a history of
diabetes. Hypertension and hyperthyroidism are not related to discontinuation of iron
supplements.
,Ricci, Kyle & Carman: Maternity and
Pediatric Nursing, Second Edition:
Chapter 15: Postpartum Adaptations;
PrepU
A concerned client tells the nurse that her husband, who was very excited about the
baby before its birth, is apparently happy but seems to be afraid of caring for the baby.
What suggestion should the nurse give to the client's husband to resolve the issue? -
anwer Hold the baby frequently.
The nurse should suggest that the father care for the newborn by holding and talking to
the child. Reading up on parental care and speaking to his friends or the primary care
provider will not help the father resolve his fears about caring for the child.
During a postpartum exam on the day of birth, the woman reports that she is still so
sore that she cannot sit comfortably. The nurse examines her perineum and find the
edges of the episiotomy approximated without signs of a hematoma. Which intervention
will be most beneficial at this point? - anwer Place an ice pack.
The labia and perineum may be edematous after birth and bruised; the use of ice would
assist in decreasing the pain and swelling. Applying a warm washcloth would bring
more blood as well as fluid to the sore area, thereby increasing the edema and the
soreness. Applying a witch hazel pad needs the order of the primary care provider.
Notifying a care provider is not necessary at this time as this is considered a normal
finding.
A woman who gave birth to a healthy newborn 2 months ago comes to the clinic and
reports discomfort during sexual intercourse. Which suggestion by the nurse would be
most appropriate? - anwer "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.
For the first hour after birth, the height of the fundus is at the umbilicus or even slightly
above it. - anwer True
A client who gave birth about 12 hours ago informs the nurse that she has been voiding
small amounts of urine frequently. The nurse examines the client and notes the
, Ricci, Kyle & Carman: Maternity and
Pediatric Nursing, Second Edition:
Chapter 15: Postpartum Adaptations;
PrepU
displacement of the uterus from the midline to the right. What intervention would the
nurse perform next? - anwer Perform urinary catheterization.
Displacement of the uterus from the midline to the right and frequent voiding of small
amounts suggests urinary retention with overflow. Catheterization may be necessary to
empty the bladder to restore tone. An IV and oxytocin are indicated if the client
experiences hemorrhage due to uterine atony from being displaced. The healthcare
provider would be notified if no other interventions help the client.
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? - anwer 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 woman is bottle-feeding her baby. When the nurse comes into the room the woman
says that her breasts are painful and engorged. Which nursing intervention is
appropriate? - anwer Assist the woman in placing ice packs on her breasts.
If the breasts are engorged and the woman is bottle-feeding her newborn, instruct her to
keep a support bra on 24 hours per day. Cool compresses or an ice pack wrapped in a
towel will usually be soothing and help to suppress milk production.
Which instruction should the nurse provide to a breastfeeding woman experiencing
breast engorgement? - anwer "Take a warm shower just before feeding your infant."
Standing in a warm shower or applying warm compresses immediately before feedings
will help soften the breasts and nipples to allow the newborn to latch on more easily and
will enhance the let-down reflex. Wearing a tight supportive bra all day is appropriate for
the woman who is not breastfeeding. Frequent emptying of the breasts helps to resolve
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