A new father tells a nurse friend that his wife is agitated and acting in a bizarre fashion. She says that she hears voices. Her baby is 2 weeks old. The father is concerned about the care the mother is giving the baby. The nurse should:

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Tell the father to call the physician immediately and not to leave the woman alone with the baby. This response is crucial because the mother is displaying symptoms of postpartum psychosis, a serious condition that requires immediate medical attention. Postpartum psychosis can pose a risk to both the mother and the baby's safety. By advising the father to contact the physician, the nurse ensures that the mother receives the necessary medical intervention promptly. Option A is incorrect because dismissing the symptoms as postpartum blues and suggesting they will pass with support is dangerous in this case of potential psychosis. Option B is inadequate as the situation requires urgent medical attention rather than casual conversation. Option C, while acknowledging the need for psychotherapy, falls short of the immediate action needed to address the severity of the mother's symptoms. Educationally, this scenario highlights the importance of recognizing and responding to postpartum mental health issues promptly. Nurses and healthcare providers must be vigilant in assessing and addressing postpartum complications to ensure the well-being of both the mother and the baby. Early intervention and appropriate referrals can significantly impact the outcomes for families experiencing postpartum mental health challenges.

Correct Answer: D

Rationale: The correct answer is D) Lochia increases. Postpartum, as the uterus shrinks in size (involution), it leads to increased blood flow to the area to aid in the healing process. This increased blood flow contributes to the shedding of the uterine lining, known as lochia, which is a normal postpartum discharge consisting of blood, mucus, and uterine tissue. Option A) Edema increases is incorrect because the shrinking of the uterus and increased blood flow do not typically lead to increased edema postpartum. Option B) Cardiac output increases is incorrect as the shrinking of the uterus does not directly impact cardiac output. Cardiac output may increase during labor and delivery but typically stabilizes postpartum. Option C) Temperature rises is incorrect as the process of involution and increased blood flow to the uterus does not directly cause a rise in temperature postpartum. Elevated temperature could indicate infection rather than a normal postpartum change. Understanding the physiological changes in the postpartum period is crucial for healthcare professionals caring for postpartum women. Recognizing these changes helps in identifying normal versus abnormal postpartum signs and symptoms, enabling timely interventions and improving the overall care provided to postpartum individuals.

Correct Answer: B

Rationale: In postpartum care, assessing the fundus is crucial to monitor for uterine atony, a common cause of postpartum hemorrhage. In this scenario, a boggy, elevated, and deviated fundus indicates uterine atony, a condition where the uterus fails to contract effectively after delivery. Option B, a full bladder, is the correct answer as a distended bladder can displace the uterus, preventing it from contracting properly. This can lead to excessive bleeding and delayed involution. Option A, uterine rupture, is unlikely in this case as the fundus would typically be firm and displaced high in the abdomen. Option C, perineal laceration, would not directly cause the fundus to be boggy and elevated. Option D, hematoma, may cause localized pain and swelling but would not typically result in a boggy, elevated fundus. Educationally, understanding the importance of fundal assessment postpartum is crucial for nurses to identify and manage complications promptly. Proper assessment skills help prevent and address postpartum hemorrhage, a leading cause of maternal mortality worldwide. Nurses must be adept at differentiating between normal involution and abnormal findings to provide optimal care for postpartum mothers.

Correct Answer: C

Rationale: The correct answer is C) postpartum depression. Postpartum depression is a common complication that affects many new mothers and can have serious effects on both the mother and the baby. Screening for risk factors such as an infant in the NICU, difficulty in role transition, birth complications, unmet social and physical needs, and lack of partner support is crucial in identifying women who may be at risk for developing postpartum depression. Option A) maladaptive parenting is incorrect because it does not specifically address the mental health aspect of the situation. Option B) psychosis is also incorrect as it is a severe mental disorder characterized by a loss of contact with reality, which is not the primary concern in this scenario. Option D) bipolar disorder is incorrect as it is a mood disorder characterized by fluctuations between depressive and manic episodes, which is not the most likely complication based on the risk factors provided. In an educational context, understanding the risk factors and signs of postpartum depression is essential for healthcare professionals working with new mothers. By recognizing these factors early, nurses can provide appropriate support, referrals, and interventions to help prevent or manage postpartum depression, ultimately improving outcomes for both the mother and the baby.

Correct Answer: D

Rationale: In the context of pharmacology and postpartum complications, it is crucial for nurses to understand the differences between postpartum blues and postpartum depression (PPD) to provide appropriate care and support to new mothers. Option D, "Postpartum blues symptoms include irritability and sadness," is the correct answer. Postpartum blues typically occur within the first few days to weeks after childbirth and are characterized by mild mood swings, tearfulness, irritability, and feelings of being overwhelmed. These symptoms are considered normal and usually resolve on their own without intervention. By recognizing these common signs, nurses can reassure new mothers and provide education on self-care practices. The incorrect options can be explained as follows: A) PPD is less severe and resolves in a few weeks: This statement is incorrect as PPD is a more serious condition that can last for months if left untreated. It requires professional intervention and support to manage effectively. B) Postpartum blues can last up to a year: This is inaccurate as postpartum blues are transient and typically resolve within a few weeks, unlike postpartum depression, which can persist for a longer duration. C) PPD is a normal expectation of postpartum: This is a misleading statement. While it is common for new mothers to experience mood changes postpartum, PPD is not a normal expectation and should be taken seriously and treated promptly to prevent complications. Educationally, understanding the nuances between postpartum blues and PPD equips nurses with the knowledge to provide timely assessments, interventions, and referrals for mothers experiencing postpartum mood disorders. It reinforces the importance of early detection and support in promoting maternal mental health and well-being during the postpartum period.