A nurse is working on the postpartum unit. Which of the following patients should the nurse assess first?

Correct Answer: C

Rationale: In this scenario, the nurse should assess patient C (PP3 from vacuum delivery with hemoglobin of 7.2 g/dL) first. This patient has a significantly low hemoglobin level, indicating a potential risk of postpartum hemorrhage and anemia, which require immediate attention to prevent complications like hypovolemic shock. Assessing and managing the patient's hemoglobin level is crucial for her well-being. Option A (PP1 with burning on urination) is a common issue postpartum and can be addressed after addressing more critical conditions. Option B (PP2 with blood loss of 500 mL at delivery) is concerning but occurred at delivery, so immediate intervention may not be required unless there are signs of ongoing hemorrhage. Option D (PP4 with firm and painful breasts) is likely experiencing engorgement, a common postpartum issue that can be addressed after addressing the more acute condition of severe anemia in patient C. This educational context highlights the prioritization of nursing care based on the urgency and potential severity of the patient's condition, emphasizing the importance of critical thinking and clinical judgment in prioritizing care in a postpartum setting. It also underscores the significance of understanding postpartum complications and their implications for maternal health.

Correct Answer: A

Rationale: The correct answer is A) Gently massage the areas toward the nipple, especially during feedings. This advice is based on the understanding that tender, hard nodules in the breasts of a breastfeeding woman are likely due to blocked milk ducts, which can lead to mastitis if not addressed promptly. Massaging the area toward the nipple during feedings can help to release the blockage and improve milk flow. It is essential to maintain breastfeeding to prevent further complications and to ensure adequate milk supply for the baby. Option B) Apply ice to the areas between feedings is incorrect because applying ice can constrict blood vessels and potentially worsen the blockage. Heat therapy, such as warm compresses, is recommended instead to promote milk flow. Option C) Bottle feed for the next twenty-four hours is not advisable as it can lead to a decrease in milk production and can exacerbate the issue by not addressing the underlying cause of the blocked ducts. Option D) Apply lanolin ointment to the areas after each and every breastfeeding is also not the best course of action for treating blocked ducts. While lanolin ointment may be helpful for nipple soreness, it does not address the blockage within the milk ducts. Educationally, it is crucial for healthcare providers to understand the common postpartum breast issues that breastfeeding women may encounter, such as blocked ducts and mastitis, and be able to provide accurate and evidence-based counseling to support these women in successfully breastfeeding their babies. Providing clear guidance on how to manage these issues can help prevent complications and ensure a positive breastfeeding experience for both the mother and the baby.

Correct Answer: B

Rationale: The correct answer is B) Notify the obstetrician of the findings. This is the appropriate action because the client's vital signs and reflexes are showing signs of postpartum preeclampsia, indicated by the elevated blood pressure of 150/100. Postpartum preeclampsia can develop within the first 48 hours after delivery, even if the client did not have hypertension during pregnancy. It is crucial to notify the obstetrician promptly for further evaluation and management to prevent complications. Option A) Nothing, because the results are normal, is incorrect as the elevated blood pressure and hyperreflexia are not normal findings postpartum. Option C) Discontinuing the intravenous immediately is not the priority in this situation. The focus should be on addressing the potential postpartum preeclampsia. Option D) Reassessing the client after fifteen minutes is not the most appropriate action when there are signs of potential postpartum preeclampsia present. Immediate notification of the obstetrician is necessary for timely intervention. Educationally, understanding the significance of postpartum preeclampsia and recognizing the signs and symptoms is crucial for nurses caring for postpartum clients. Prompt identification and intervention can prevent serious complications for the mother. Regular education and training on postpartum complications are essential to ensure optimal care and outcomes for postpartum clients.

Correct Answer: D

Rationale: In this scenario, option D is the most appropriate action for the nurse to take. Giving the parents a lock of the baby's hair and a copy of the footprint sheet allows them to have tangible keepsakes to remember their baby by. This gesture acknowledges the significance of the baby's existence and helps the parents in their grieving process. Option A is incorrect because discouraging the parents from naming the baby could invalidate their feelings and hinder their ability to properly mourn their loss. Option B is inappropriate as it undermines the parents' autonomy and their right to make decisions about their own emotional well-being. Option C is not the best choice as it may rush the parents through the grieving process by removing the baby too quickly without allowing them time for closure and saying their goodbyes. In an educational context, it is crucial for healthcare professionals to understand the importance of supporting families during difficult times like the loss of a baby. Providing compassionate care and respecting the parents' wishes in how they choose to grieve can positively impact their emotional healing process. Empathy, sensitivity, and personalized care are essential components of nursing care in such delicate situations.

Correct Answer: A

Rationale: In this scenario, the correct answer is option A) 20 mL. To calculate this, we first need to determine the total daily dose required, which is 2,000 mg (500 mg x 4 doses). Next, we divide the total daily dose by the concentration of the oral solution to find out how many mL to administer per dose. There are a few key points to consider when analyzing the answer choices: - Option A (20 mL) is correct because it aligns with the calculated dosage needed for the client based on the concentration of the oral solution. - Options B, C, and D are marked as "NA," indicating they are not applicable. This is because these options do not provide a numerical value for the amount of medication the client should take per dose. Educationally, this question is essential for healthcare professionals working with postpartum clients to understand how to calculate and administer medication dosages accurately, especially when dealing with specific patient preferences or needs, such as difficulty swallowing pills. It reinforces the importance of dosage calculations, understanding medication concentrations, and ensuring safe and effective administration to provide optimal care for clients with postpartum complications like breast abscesses.