A client who is 3 weeks postpartum tells the nurse. 'I am so tired all the time. I didn't know having a baby would be so hard.' What response should the nurse provide.

Correct Answer: A

Rationale: The correct response to the client who is 3 weeks postpartum expressing fatigue is option A) "It is common to feel exhausted for the first 3 months. Try to sleep when the baby sleeps." This response is appropriate because it acknowledges the client's feelings as normal and provides a practical suggestion to help manage fatigue. Option B) is incorrect because it minimizes the client's experience by suggesting that feeling tired is only expected for the first couple of weeks, which may invalidate the client's feelings and concerns. Option C) is not the best response as it focuses solely on housework and family support, rather than addressing the client's emotional and physical well-being. Option D) is not the optimal choice as it asks for more information without providing immediate validation or support to the client's feelings of exhaustion. In an educational context, it is essential for nurses to validate clients' experiences, provide empathetic responses, and offer practical strategies to manage common postpartum challenges. By understanding the physical and emotional demands of the postpartum period, nurses can better support clients in their transition to motherhood.

Correct Answer: B

Rationale: In this scenario, option B, "Inform and assure the mother that this is a normal weight loss," is the correct answer. It is crucial for the nurse to educate the mother that it is normal for newborns to lose weight in the first few days of life. This initial weight loss is primarily due to the loss of excess fluids and meconium. By reassuring the mother, the nurse can alleviate any concerns and prevent unnecessary anxiety. Option A, monitoring stool and urine output, while important for assessing hydration status, is not the priority in this situation. Option C, encouraging increased breastfeeding, may not be necessary and could potentially lead to overfeeding. Option D, notifying the healthcare provider, is not warranted at this stage as the weight loss is within the expected range for newborns. Educationally, this question highlights the importance of understanding normal newborn physiological changes and the role of the nurse in providing appropriate education and support to new mothers. By addressing common concerns and providing accurate information, nurses can empower parents to care for their newborns effectively.

Correct Answer: B

Rationale: In this scenario, the correct action for the nurse to take is to assess the woman's blood pressure (Option B). This is because the woman delivered a large baby via cesarean section, which puts her at higher risk for postpartum hemorrhage. The presence of bright red blood with no clots indicates active bleeding, and assessing her blood pressure can help determine if she is experiencing hypovolemic shock, a serious complication of postpartum hemorrhage. Prompt assessment and intervention are crucial in preventing further complications. Massage the fundus (Option A) is generally done to help the uterus contract and prevent excessive bleeding, but in this case, the fundus is already firm at the umbilicus, so massaging it may not be necessary and could even potentially cause discomfort. Applying an ice pack to the perineum (Option C) is commonly done for perineal pain and swelling after vaginal delivery, but it is not the priority in this situation where the focus should be on assessing and managing postpartum hemorrhage. Letting the infant breastfeed (Option D) is important for bonding and initiating breastfeeding, but it is not the most urgent action to take in this situation where the priority is to assess and manage potential postpartum hemorrhage. Educationally, this scenario highlights the importance of recognizing signs of postpartum hemorrhage and the need for prompt assessment and intervention in such situations to ensure the well-being of the mother. It emphasizes the significance of prioritizing actions based on the patient's condition and potential complications.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Continue prenatal vitamins with B12 while breastfeeding. This option is correct because as a lacto-ovo vegetarian, the mother may have an increased risk of vitamin B12 deficiency due to the absence of animal products in her diet. Continuing prenatal vitamins with B12 while breastfeeding ensures that both the mother and the infant receive an adequate amount of this essential nutrient crucial for neurological development. Option A) Avoid using lanolin-based nipple cream or ointment is incorrect as it does not directly address the nutritional needs of the mother and the infant. Option B) Offering iron-fortified supplemental formula daily is unnecessary if the mother is able to maintain a balanced diet that meets her and her infant's nutritional needs through breastfeeding. Option D) Weigh the baby weekly to evaluate the newborn's growth is important but not directly related to the specific nutritional guidance needed for a lacto-ovo vegetarian mother. Educationally, it is crucial for healthcare providers to understand the unique dietary requirements of different populations, such as lacto-ovo vegetarians, and to provide tailored guidance to support optimal health outcomes for both the mother and the infant. By explaining the rationale behind the correct answer, nurses can empower mothers to make informed decisions regarding their diet and breastfeeding practices.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Abruptio placenta. This condition involves the premature separation of the placenta from the uterine wall before delivery, leading to severe abdominal pain and a rigid abdomen due to internal bleeding and clot formation behind the placenta. Option A) Placenta previa is characterized by painless vaginal bleeding in the third trimester, not severe abdominal pain and rigidity. Option B) Oligohydramnios refers to low levels of amniotic fluid and is not typically associated with severe abdominal pain or rigidity. Option D) Chorioamnionitis is an infection of the fetal membranes and amniotic fluid, presenting with fever, uterine tenderness, and foul-smelling amniotic fluid, rather than severe abdominal pain and rigidity. Educationally, understanding these differential diagnoses is crucial for nursing students or healthcare providers working in maternity care to accurately assess and manage pregnant clients experiencing abdominal pain. Recognizing the signs and symptoms of abruptio placenta is vital for prompt intervention to ensure the well-being of both the mother and the fetus.