A breastfeeding client, 7 weeks postpartum, complains to an obstetrician 's triage nurse that when she and her husband had intercourse for the first time after the delivery, 'I couldn 't stand it. It was so painful. The doctor must have done something terrible to my vagina. ' Which of the following responses by the nurse is appropriate?

Correct Answer: C

Rationale: The correct response, option C, is appropriate because it addresses a common issue faced by breastfeeding mothers - vaginal dryness. During breastfeeding, hormonal changes can lead to decreased estrogen levels, resulting in vaginal dryness and discomfort during intercourse. Suggesting a vaginal lubricant is a safe and effective way to alleviate this symptom without medical intervention. Option A is incorrect as it oversimplifies the issue and may lead to the patient assuming her discomfort is normal post-delivery, potentially delaying proper treatment if needed. Option B is also incorrect as it focuses on a different issue (yeast infection) that is not likely the cause of the patient's pain during intercourse. Option D is incorrect because it jumps to a conclusion about episiotomy stitches without gathering more information or assessing the patient first. It is important in healthcare to follow a systematic approach and not make assumptions without proper evaluation. In an educational context, this scenario highlights the importance of considering physiological changes postpartum and the impact of breastfeeding on vaginal health. It also emphasizes the need for healthcare providers to listen attentively to patients, provide appropriate guidance, and offer practical solutions to address their concerns effectively.

Correct Answer: B

Rationale: In the context of pharmacology, understanding the importance of Kegel exercises during the postpartum period is crucial for nurses to educate their patients effectively. Option B, which states that the woman should practice by stopping the urine flow midstream every time she voids, is the correct choice. This option is correct because it accurately describes the process of performing Kegel exercises. Stopping the urine flow midstream helps the woman identify the correct muscles to contract, which are the pelvic floor muscles. By regularly practicing this technique, women can strengthen their pelvic floor muscles, which can help prevent urinary incontinence and promote faster recovery after childbirth. The other options are incorrect for several reasons. Option A, contracting and relaxing rectal and thigh muscles, does not target the pelvic floor muscles specifically, which are the muscles involved in Kegel exercises. Option C, getting on hands and knees, is not necessary for performing Kegel exercises and may confuse the patient. Option D, linking toned pubococcygeal muscles to decreased blood loss, is a misleading statement as Kegel exercises primarily target pelvic floor muscle strength and are not directly related to blood loss. In an educational context, nurses must provide accurate and evidence-based information to empower women to take control of their postpartum recovery. By explaining the correct method of performing Kegel exercises, nurses can help women improve their pelvic floor muscle strength and overall well-being during the postpartum period.

Correct Answer: B

Rationale: In the postpartum period, Lochia alba is the expected discharge 2 weeks after delivery. Lochia alba is the final stage of lochia, characterized by a yellowish-white discharge containing leukocytes, decidual tissue, and mucus. This discharge indicates normal healing of the uterine lining post-delivery. Diaphoresis, excessive sweating, is common in the immediate postpartum period as the body eliminates excess fluid accumulated during pregnancy. However, it typically decreases by 2 weeks postpartum. Cracked nipples are common breastfeeding complications but are not specifically expected at 2 weeks postpartum. Hypertension is not a typical sign of the postpartum period unless it is related to a pre-existing condition like chronic hypertension or preeclampsia. Educationally, understanding the expected physiological changes in the postpartum period is crucial for nurses to provide appropriate care and education to new mothers. Recognizing normal postpartum signs and symptoms helps in early identification of complications, promoting maternal well-being and preventing unnecessary anxiety.

Correct Answer: B

Rationale: In the postpartum period, the most critical assessment for a recently delivered breastfeeding client, like G10 P6408, is the assessment of the fundus (Option B). The fundus assessment helps in evaluating the uterine tone and detecting any excessive bleeding or potential uterine atony, a common complication after childbirth. A firm fundus indicates proper involution of the uterus, which is crucial for preventing postpartum hemorrhage. Pulse (Option A) is important but not as immediate as assessing the fundus in the early postpartum period. Monitoring the bladder (Option C) is essential to prevent urinary retention, but it is not as urgent as assessing the fundus. Breast assessment (Option D) is important for breastfeeding success but is not the priority immediately after delivery in terms of preventing complications like postpartum hemorrhage. Educationally, understanding the significance of timely fundus assessment postpartum is crucial for nurses and healthcare providers caring for postpartum clients. It highlights the importance of early detection and intervention in preventing life-threatening complications. This knowledge equips nurses to provide safe and effective care to postpartum clients and promotes positive maternal outcomes.

Correct Answer: A

Rationale: The correct answer is A) Apply an ice pack to the perineum. This intervention is appropriate for a second-degree perineal laceration as it helps to reduce swelling, inflammation, and pain in the perineal area. The application of ice packs also promotes vasoconstriction, which can help in minimizing bleeding and promoting healing of the laceration. Option B) Advise the woman to use a sitz bath after every voiding is not the most appropriate intervention at this time because using a sitz bath may not be recommended immediately after delivery, especially in the case of a recent perineal laceration. Sitz baths are generally recommended after the initial postpartum period when the perineal area has started to heal. Option C) Advise the woman to sit on a pillow may provide some comfort but does not directly address the issue of managing the perineal laceration or promoting healing. Option D) Teach the woman to insert nothing into her rectum is a general postpartum instruction to prevent infection but does not specifically address the immediate care needed for a second-degree perineal laceration. In an educational context, it is essential for nurses to understand the appropriate interventions for postpartum complications like perineal lacerations to provide optimal care and promote the well-being of their patients. Proper knowledge and application of evidence-based practices in postpartum care can help prevent complications and support the healing process for new mothers.