A home care nurse is following up with a postpartum client. Which of the following is a risk factor that places this client at risk for postpartum depression?

Correct Answer: C

Rationale: In the context of postpartum depression, hormonal changes play a significant role in predisposing women to this condition. Option C, "Hormonal changes with a rapid decline in estrogen and progesterone," is the correct answer because the sudden drop in these hormones after childbirth can impact neurotransmitters in the brain, leading to mood changes and increasing the risk of postpartum depression. Option A, "History of anxiety," is a general risk factor for mental health conditions but may not specifically relate to postpartum depression caused by hormonal changes. Option B, "Socioeconomic status," can contribute to stress levels but is not a direct physiological factor like hormonal changes. Option D, "Support from family members," is crucial for overall well-being but does not address the physiological changes that occur postpartum. Educationally, understanding the physiological factors contributing to postpartum depression can help healthcare providers identify at-risk individuals and provide appropriate support and interventions. It is essential for nurses to recognize the multifactorial nature of postpartum depression to deliver holistic care to postpartum clients effectively.

Correct Answer: D

Rationale: The correct answer is D) Mother Rh negative; Coombs negative; baby Rh positive. This scenario indicates that the mother is Rh-negative, meaning she lacks the Rh antigen on her red blood cells. If the baby is Rh-positive (inheriting the Rh antigen from the father), there is a risk that the mother's immune system may produce antibodies against the Rh antigen. RhoGAM is administered to Rh-negative mothers to prevent this immune response. In this case, if the baby is Rh positive, the mother will receive RhoGAM post-delivery to prevent sensitization. Option A is incorrect because if the mother is Rh positive, there is no need for RhoGAM as she already has the Rh antigen. Option B is incorrect because a Coombs positive result indicates an immune response is already occurring, making RhoGAM ineffective post-delivery. Option C is incorrect because if both the mother and baby are Rh positive, there is no risk of Rh incompatibility. Understanding these scenarios is crucial for nurses caring for pregnant women to prevent hemolytic disease of the newborn, making this knowledge essential in maternal newborn care.

Correct Answer: B

Rationale: In the first trimester of pregnancy, hormonal changes play a significant role in causing indigestion and heartburn. Progesterone, which is elevated during pregnancy, causes relaxation of the cardiac sphincter, the valve that separates the esophagus from the stomach. This relaxation allows stomach acid to reflux back into the esophagus, leading to symptoms of indigestion and heartburn. Option A is incorrect because estrogen, another hormone present in pregnancy, does not directly cause increased appetite. Option C is incorrect because although HCG hormone levels are elevated in early pregnancy, it does not lead to increased gastric acidity. Option D is incorrect because while the growing uterus can contribute to feelings of fullness and pressure in the stomach, it is not the primary cause of indigestion and heartburn in early pregnancy. Understanding the physiological changes that occur during pregnancy is crucial for nurses providing education to pregnant clients. By explaining the specific hormonal effects on the digestive system, nurses can empower clients to make informed lifestyle and dietary choices to manage symptoms effectively and promote overall maternal well-being.

Correct Answer: B

Rationale: In caring for a client experiencing urinary incontinence, recommending Kegel exercises (Option B) is crucial. Kegel exercises strengthen the pelvic floor muscles, which support the bladder and urethra, helping to improve bladder control and reduce incontinence episodes. This intervention is evidence-based and widely recommended in the management of urinary incontinence. Option A is incorrect as drinking large amounts of water before bedtime can actually worsen urinary incontinence by increasing the frequency of urination during the night. Option C is incorrect because fiber is important for maintaining bowel regularity and should not be limited to avoid bowel irritation. Option D is also incorrect because caffeinated and carbonated beverages can irritate the bladder, leading to increased urinary urgency and incontinence. In an educational context, it is essential for nurses to understand the underlying causes of urinary incontinence and the appropriate interventions to help clients manage this condition effectively. By teaching clients about Kegel exercises, nurses empower them to take an active role in improving their bladder control and quality of life.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Muscle and joint pain. Anastrozole, an aromatase inhibitor used in breast cancer treatment, can lead to musculoskeletal side effects such as muscle and joint pain. This occurs due to decreased estrogen levels in the body, impacting bone density and joint health. Option A) Weight gain is incorrect because anastrozole is not typically associated with weight gain. Option C) Night sweats are more commonly seen with hormonal changes like menopause, not specifically linked to anastrozole. Option D) Increased appetite is not a typical side effect of anastrozole. Educationally, it is essential for nurses to understand the side effects of medications used in breast cancer treatment to provide comprehensive care. By knowing the specific side effects of medications like anastrozole, nurses can anticipate and manage potential issues, improving patient outcomes and quality of life. Patient education about expected side effects is crucial to ensure adherence to treatment and timely reporting of any concerning symptoms.