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Postpartum Exam with Complete Solutions 100% Solved
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Postpartum Exam with Complete Solutions 100% Solved
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Postpartum Exam with Complete Solutions 100% SolvedA physician has written a prescription to administer methylergonovine maleate (Methergine)
to a postpartum client with uterine atony. The nurse would contact the physician to verify the
prescription if which of the following conditions were present in the mother?
1 Hypertension
2 Excessive lochia
3 Difficulty locating the uterine fundus
4 Excessive bleeding and saturation of more than one peripad per hour Correct Ans-
Answer: 1
Rationale: Methylergonovine maleate (Methergine) is an ergot alkaloid. It is contraindicated
for the hypertensive woman, individuals with severe hepatic or renal disease, and during the
third stage of labor. Excessive lochia, a uterine fundus that is difficult to locate, and excessive
bleeding are clinical manifestations of uterine atony indicating the need for
methylergonovine.
Priority Nursing Tip: Methylergonovine maleate (Methergine) is an ergot alkaloid that
produces vasoconstriction. The client's blood pressure needs to be monitored closely and if an
increase is noted the medication is withheld and the physician is notified.
,Postpartum Exam with Complete Solutions 100% Solved
After delivery, the postpartum nurse instructs the client with known cardiac disease to call for
the nurse when she needs to get out of bed or when she plans to care for her newborn infant.
The nurse informs the client that this is necessary to:
1 Help the mother assume the parenting role.
2 Minimize the potential of postpartum hemorrhage.
3 Provide an opportunity for the nurse to teach newborn infant care techniques.
4 Avoid maternal or infant injury caused by the potential for syncope or overexertion.
Correct Ans-Answer: 4
Rationale: The immediate postpartum period is associated with increased risks for the cardiac
client. Hormonal changes and fluid shifts from extravascular tissues to the circulatory system
cause additional stress on cardiac functioning.
Priority Nursing Tip: Monitor the postpartum client with cardiac disease closely for signs and
symptoms of cardiac stress and decompensation. These include cough, fatigue, dyspnea, chest
pain, and tachycardia.
A nurse in the postpartum unit is assessing a newborn infant for signs of breastfeeding
problems. Which of the following indicates a problem? Select all that apply.
1 The infant exhibits dimpling of the cheeks.
2 The infant makes smacking or clicking sounds.
,Postpartum Exam with Complete Solutions 100% Solved
3 The mother's breast gets softer during a feeding.
4 Milk drips from the mother's breast occasionally.
5 The infant falls asleep after feeding less than 5 minutes.
6 The infant can be heard swallowing frequently during a feeding. Correct Ans-Answer: 1,
2, 5
Rationale: It is important for the nurse to identify breast-feeding problems while the mother
is hospitalized so that the nurse can teach the mother how to prevent and treat any problems.
Infant signs of breastfeeding problems include dimpling of the cheeks; making smacking or
clicking sounds; falling asleep after feeding less than 5 minutes; refusing to breastfeed; tongue
thrusting; failing to open the mouth at latch-on; turning the lower lip in; making short,
choppy motions of the jaw; and not swallowing audibly. Softening of the breast during
feeding, noting milk in the infant's mouth or dripping from the mother's breast occasionally,
and hearing the infant swallow are signs that the infant is receiving adequate nutrition.
Priority Nursing Tip: If the mother is breast-feeding, calorie needs increase by 200 to 500
calories per day; increased fluids and the continuance of prenatal vitamins and minerals are
important.
It has been 12 hours since the client's delivery of a newborn. The nurse assesses the client for
the process of involution and documents that it is progressing normally when palpation of the
client's fundus is noted:
, Postpartum Exam with Complete Solutions 100% Solved
1 At the level of the umbilicus
2 One finger breadth below the umbilicus
3 Two finger breadths below the umbilicus
4 Midway between the umbilicus and the symphysis pubis Correct Ans-Answer: 1
Rationale: The term "involution" is used to describe the rapid reduction in size and the return
of the uterus to a normal condition similar to its nonpregnant state. Immediately after the
delivery of the placenta, the uterus contracts to the size of a large grapefruit . The fundus is
situated in the midline between the symphysis pubis and the umbilicus. Within 6 to12 hours
after birth, the fundus of the uterus rises to the level of the umbilicus. The top of the fundus
remains at the level of the umbilicus for about a day and then descends into the pelvis
approximately one finger breadth on each succeeding day.
Priority Nursing Tip: By approximately 10 days postpartum, the uterus cannot be palpated
abdominally.
A nurse teaches a postpartum client about observation of lochia. The nurse determines the
client's understanding when the client says that on the second day postpartum , the lochia
should be:
1 Red
2 Pink
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