NUR 128 - Labor and Delivery, Ch. 13, 14, 15, 16 --
Ricci, Kyle & Carman Fourth Edition Questions with
Correct Answers
A woman who gave birth to her infant 1 week ago calls the clinic to
report pain with urination and increased frequency. What response
should the nurse prioritize? Correct Answer-"After birth it is easier to
develop an infection in the urinary system; we need to see you today."
Explanation:
The urinary system is more susceptible to infection during the
postpartum period. The woman needs to be checked to rule out a urinary
infection. The other responses are incorrect because they do not
acknowledge her in an appropriate manner.
A nurse is examining a client who underwent a vaginal birth 24 hours
ago. The client asks the nurse why her discharge is such a deep red
color. What explanation is most accurate for the nurse to give to the
client? Correct Answer-"The discharge consists of mucus, tissue debris,
and blood; this gives it the deep red color."
Explanation:
The nurse should explain to the client that lochia rubra is a deep red
mixture of mucus, tissue debris, and blood. Discharge consisting of
leukocytes, decidual tissue, RBCs, and serous fluid is called lochia
serosa. Discharge consisting of only RBCs and leukocytes is blood.
Discharge consisting of leukocytes and decidual tissue is called lochia
alba.
,The nurse is preparing discharge for a client who plans to bottle-feed her
infant. Which instruction should the nurse prioritize for this client in the
discharge teaching? Correct Answer-Wear a tight, supportive bra.
Explanation:
The client trying to dry up her milk supply should do as little stimulation
to the breast as possible. She needs to wear a tight, supportive bra and
use ice. Running warm water over the breasts in the shower will only
stimulate the secretion, and therefore the production, of milk. Massaging
the breasts will stimulate them to expel the milk and therefore produce
more milk, as will expressing small amounts of milk when the breasts
are full.
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? Correct Answer-You might try using a water-soluble
lubricant to ease the discomfort."
Explanation:
Discomfort during sex 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.
,A postpartum woman is concerned about constipation following
delivery. What factor(s) contribute to this problem? Select all that apply.
Correct Answer-Perineal pain
Hemorrhoidal discomfort
Iron supplements
Explanation:
After delivery, many women experience a great deal of perineal pain, as
well as hemorrhoidal pain, which leads to constipation because the
woman is reluctant to defecate, fearing pain. Additionally, iron
supplements contribute to constipation also.
A nurse is making an initial call on a new mother who gave birth to her
third baby 5 days ago. The woman says, "I just feel so down this time.
Not at all like when I had my other babies. And this one just doesn't
sleep. I feel so inadequate." What is the best response to this new
mother? Correct Answer-"It sounds like you have the 'baby blues.' They
are common after having a baby when you are not getting enough sleep,
are busy with your other children, and are still a bit uncomfortable from
the birth. They will most likely go away in a day or two."
Explanation:
A combination of factors likely contributes to the baby blues.
Psychological adjustment along with a physiologic decrease in estrogen
and progesterone appear to be the greatest contributors. Additional
contributing factors include too much activity, fatigue, disturbed sleep
patterns, and discomfort.
, A nurse is providing care to a postpartum woman who is breastfeeding
her 1-day old neonate. While observing the interaction, the woman says
to the nurse, "I have noticed some tingling in both of my breasts just
before my baby starts to feed and then for a bit during the feeding. What
is happening?" Which response by the nurse would be appropriate?
Correct Answer-"What you are feeling is the normal let-down reflex
when milk is released."
Explanation:
Typically, during the first 2 days after birth, the breasts are soft and
nontender. The woman may also report a tingling sensation in both
breasts, which is the "let-down reflex" that occurs immediately before or
during breastfeeding. This tingling is not a sign of infection or blockage
of the milk ducts. Engorgement is a postnatal physiologic painful
condition in which distension and swelling of the breast tissue occurs as
a result of an increase in blood and lymph supply as a precursor to
lactation. Breast engorgement usually peaks in 3 to 5 days postpartum
and usually subsides within the following 24 to 36 hours.
During the second day postpartum, a nurse notices that a client is
initiating breastfeeding with her infant and changing her infant's diapers
with some assistance from her partner. Which phase does the nurse
recognize that the woman is experiencing? Correct Answer-the taking-
hold phase
Explanation:
The taking-hold phase is characterized by the woman becoming more
independent and interested in learning how to care for her infant.
Learning how to be a competent parent is an important task. The taking-
in phase is characterized by the woman's dependency on and passivity
with others. Maternal needs are dominant, and talking about the birth is
an important task. The new mother follows suggestions, is hesitant about
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