ATI RN
Postpartum Body Changes Questions
Question 1 of 5
A nurse on the postpartum unit is caring for two postoperative cesarean clients. One client had spinal anesthesia for the delivery and the other client had an epidural. Which of the following complications will the nurse monitor the spinal client for that the epidural client is much less high risk for?
Correct Answer: C
Rationale: The correct answer is C) Postural headache. In this scenario, the nurse will need to monitor the client who had spinal anesthesia for the development of a postural headache, a common complication associated with spinal anesthesia. This headache typically occurs due to a decrease in cerebrospinal fluid pressure after the procedure. Option A) Pruritus is a common side effect of both spinal and epidural anesthesia and is not specific to spinal anesthesia. Option B) Nausea can occur after both spinal and epidural anesthesia and is not a distinguishing factor between the two types of anesthesia. Option D) Respiratory depression is a serious complication associated with opioids used in both spinal and epidural anesthesia, so both clients are at risk for this complication irrespective of the type of anesthesia used. Educationally, understanding the differences in complications associated with spinal and epidural anesthesia is crucial for nurses caring for postoperative cesarean clients. By knowing the specific risks of each type of anesthesia, nurses can provide targeted monitoring and interventions to ensure optimal patient outcomes.
Question 2 of 5
A client's vital signs and reflexes were normal throughout pregnancy, labor, and delivery. Four hours after delivery the client's vitals are 98.6°F, P 72, R 20, BP 150/100, and her reflexes are 4+. She has an intravenous infusion running with 20 units of Pitocin (oxytocin) added. Which of the following actions by the nurse is appropriate?
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.
Question 3 of 5
The nurse is caring for a couple who are in the labor/delivery room immediately after the delivery of a dead baby who exhibited visible birth defects. Which of the following actions by the nurse is appropriate?
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.
Question 4 of 5
Cloxacillin 500 mg by mouth four times per day for 10 days has been ordered for a client with a breast abscess. The client states that she is unable to swallow pills. The oral solution is available as 125 mg/5 mL. How many mL of medicine should the woman take per dose? (Calculate to the nearest whole.)
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.
Question 5 of 5
The home health nurse is visiting a client with HIV who is 6 weeks postdelivery. Which of the following findings would indicate that patient teaching by the nurse in the hospital was successful?
Correct Answer: D
Rationale: In this scenario, option D, "The client is seeking care for a recent weight loss," indicates successful patient teaching. Weight loss in the postpartum period can be a concerning sign, especially for a client with HIV, as it may indicate underlying health issues that need prompt attention. By seeking care for this symptom, the client demonstrates an understanding of the importance of monitoring her health post-delivery and taking action when necessary. Option A, "The client is breastfeeding her baby every two hours," is a common and beneficial postpartum practice but does not directly relate to the effectiveness of patient teaching regarding postpartum body changes in a client with HIV. Option B, "The client is using a diaphragm for family planning," and option C, "The client is taking her temperature every morning," are not specific to postpartum body changes or indicative of successful patient teaching related to postpartum care for a client with HIV. Educationally, this question highlights the importance of assessing clients holistically in the postpartum period, especially those with underlying health conditions like HIV. It emphasizes the need for ongoing education and support for clients to recognize and act upon concerning symptoms post-delivery. By understanding these concepts, nurses can provide comprehensive care to support the health and well-being of postpartum clients.