ATI RN
Postpartum Hormonal Changes Questions
Question 1 of 5
A client, 1 day postpartum (PP), is being monitored carefully after a significant postpartum hemorrhage. Which of the following should the nurse report to the obstetrician?
Correct Answer: A
Rationale: In the postpartum period, monitoring a client after a significant hemorrhage is crucial to detect any signs of complications early. In this scenario, the nurse should report the urine output of 200 mL for the past 8 hours to the obstetrician. This finding indicates inadequate renal perfusion, potentially due to hypovolemia from the hemorrhage. Low urine output can be a sign of acute kidney injury, which can worsen if not addressed promptly. The weight decrease of 2 pounds since delivery (option B) is a common postpartum finding attributed to the loss of the baby, placenta, and amniotic fluid. It is not a cause for concern unless it is rapid and accompanied by other symptoms. A drop in hematocrit of 2% since admission (option C) is expected due to intravenous fluid administration during delivery, and a pulse rate of 68 beats per minute (option D) is within the normal range for a postpartum client. Educationally, understanding the significance of urine output in the postpartum period after a hemorrhage reinforces the importance of assessing for signs of hypovolemia and organ perfusion. This knowledge equips nurses to provide comprehensive care and advocate for timely interventions to prevent complications in postpartum clients.
Question 2 of 5
A postpartum woman has been diagnosed with postpartum psychosis. Which of the following signs/symptoms would the client exhibit?
Correct Answer: A
Rationale: In the context of postpartum psychosis, the correct answer is A) Hallucinations. Postpartum psychosis is a severe mental health condition that can occur in some women following childbirth. Hallucinations, which involve perceiving things that are not actually present, are a common symptom of postpartum psychosis. These hallucinations can be auditory, visual, or tactile in nature and can significantly impact the woman's perception of reality. The incorrect options are B) Polyphagia, C) Induced vomiting, and D) Weepy sadness. Polyphagia refers to excessive hunger, which is not typically associated with postpartum psychosis. Induced vomiting is not a characteristic symptom of postpartum psychosis and is more commonly seen in eating disorders. Weepy sadness, while a common symptom of postpartum depression, is not specific to postpartum psychosis, which involves more severe symptoms like hallucinations and delusions. Educationally, it is crucial for healthcare providers and caregivers to recognize the signs and symptoms of postpartum psychosis to ensure early intervention and appropriate treatment. Understanding the distinguishing features of postpartum psychosis, such as hallucinations, can help in prompt identification and referral for specialized mental health support for the affected woman. This knowledge is essential for providing comprehensive care and support to women experiencing postpartum mental health challenges.
Question 3 of 5
A woman states that all of a sudden her 4-day-old baby is having trouble feeding. On assessment, the nurse notes that the mother's breasts are firm, red, and warm to the touch. The nurse teaches the mother manually to express a small amount of breast milk from each breast. Which observation indicates that the nurse's intervention has been successful?
Correct Answer: B
Rationale: In this scenario, the correct answer is B) The baby swallows after every 5th suck. This observation indicates successful intervention because it demonstrates effective milk transfer and feeding by the infant. When a baby swallows, it signifies that they are extracting milk from the breast successfully. Option A) The mother's nipples being soft to the touch is not a reliable indicator of successful breastfeeding as it does not directly relate to the baby's feeding ability. Option C) The baby's pre- and postfeed weight change of 20 milliliters might indicate successful feeding, but it is not as immediate or direct an observation as the baby swallowing during feeds. Option D) The mother squeezing her nipples during manual expression is unrelated to the baby's feeding ability and does not provide insight into the infant's feeding success. In an educational context, it is crucial for healthcare providers to understand the signs of effective breastfeeding to support mothers and babies in establishing successful breastfeeding relationships. Observing infant feeding cues, such as swallowing, is essential for assessing breastfeeding effectiveness and ensuring adequate milk transfer for the baby's nourishment and growth.
Question 4 of 5
A nurse is caring for a client, PP2, who is preparing to go home with her infant. The nurse notes that the client's blood type is O− (negative), the baby's type is A+ (positive), and the direct Coombs' test is negative. Which of the following actions by the nurse is appropriate?
Correct Answer: B
Rationale: The correct answer is B: Make sure that the client receives a RhoGAM injection before she is discharged from the hospital. In the context of postpartum care, when a mother is Rh-negative and the baby is Rh-positive, there is a risk of Rh incompatibility. If fetal blood enters the maternal circulation during childbirth, the mother's immune system can mount an immune response against the Rh-positive blood cells, leading to potential issues in subsequent pregnancies. RhoGAM is administered to Rh-negative mothers to prevent this immune response. It works by binding to any fetal Rh-positive cells in the mother's bloodstream, preventing her immune system from reacting to them. Administering RhoGAM within 72 hours postpartum is crucial to prevent sensitization in future pregnancies. The other options are incorrect because: A) Waiting until the end of the week for the RhoGAM injection is too late to be effective. C) The baby's negative Coombs' test does not negate the need for the mother to receive RhoGAM. D) Discharge timing should not delay the administration of RhoGAM, as it is time-sensitive. Understanding the rationale behind the administration of RhoGAM in Rh-negative mothers is essential for nurses to provide safe and effective care to postpartum clients and their infants. It highlights the importance of timely interventions to prevent complications in future pregnancies due to Rh incompatibility.
Question 5 of 5
The physician declares after delivering the placenta of a client during a cesarean section that it appears that the client has a placenta accreta. Which of the following maternal complications would be consistent with this diagnosis?
Correct Answer: A
Rationale: In the scenario described, the correct answer is A) Blood loss of 2,000 mL. Placenta accreta is a condition where the placenta attaches too deeply into the uterine wall. During delivery, separating the placenta can lead to severe bleeding as the placenta cannot detach properly. This can result in significant blood loss, which is a common complication associated with placenta accreta. Option B) Blood pressure of 160/110 is not directly related to placenta accreta but could indicate hypertension, which is a different condition. Option C) Jaundiced skin color is not typically associated with placenta accreta. Jaundice usually occurs due to liver or bile duct issues, not directly related to placental attachment abnormalities. Option D) Shortened prothrombin time is not a common complication of placenta accreta. Prothrombin time measures how long it takes for blood to clot, and in placenta accreta, the main concern is excessive bleeding rather than clotting abnormalities. Understanding the maternal complications of placenta accreta is crucial for healthcare providers managing postpartum care. Recognizing the signs and symptoms can aid in prompt diagnosis and appropriate management to prevent severe maternal outcomes. It is essential for healthcare professionals to be well-versed in these complications to ensure the best possible care for their patients during the postpartum period.