ATI RN
Complication Postpartum Questions
Question 1 of 5
A woman has an 8-lb, 9-oz baby after an 18-hour labor that required a vacuum extraction. Her membranes have been ruptured for 15 hours. Based on these facts, client teaching should emphasize:
Correct Answer: A
Rationale: In this scenario, the correct answer is A) Reporting foul-smelling lochia and fever. This is crucial because the clinical presentation indicates a potential postpartum infection, most likely endometritis due to prolonged rupture of membranes and instrument-assisted delivery. Teaching this client to recognize signs of infection is vital for early intervention and prevention of complications. Option B) Delaying intercourse for at least 6 weeks is a standard recommendation postpartum but is not the priority in this case where infection signs are more critical to address promptly. Option C) Eating a diet high in iron and vitamin C is important for postpartum recovery but is not the priority when signs of infection are present, as addressing infection takes precedence. Option D) Losing weight over at least a 6-month period is not relevant to the immediate postpartum period and does not address the current clinical concern of potential infection. Educationally, this question highlights the importance of client education in recognizing and reporting postpartum complications, emphasizing the significance of early detection and intervention in improving outcomes for postpartum women. It underscores the need for healthcare providers to educate clients on signs and symptoms to watch for after childbirth, promoting their active participation in their own postpartum care.
Question 2 of 5
A woman tells you she has been teary for most of the 2 weeks since the birth of her baby. Although the infant appears to be cared for appropriately, the mother states that she feels too tired to spend as much time with him as she should. She has lost her appetite and cannot sleep at night. She has been too ashamed to tell anyone before now. The nurse's best response is to:
Correct Answer: C
Rationale: The correct response, option C, is to listen to the woman's feelings carefully and acknowledge that something is wrong. This is the best approach because the woman is exhibiting symptoms of postpartum depression, a serious condition that requires professional intervention. By actively listening and acknowledging her feelings, the nurse can provide support and encourage the woman to seek help from a healthcare provider. Option A is incorrect because dismissing her symptoms as "normal postpartum blues" minimizes the severity of her condition and may prevent her from seeking necessary help. Option B is also incorrect as simply suggesting more rest oversimplifies the complex nature of postpartum depression and does not address the underlying issue. Option D is not appropriate as separating the woman from her baby may exacerbate feelings of guilt and worsen her condition. In an educational context, it is crucial for healthcare providers, especially nurses, to be able to recognize the signs of postpartum depression and provide appropriate support and guidance to women experiencing it. By addressing mental health issues in the postpartum period, healthcare professionals can help prevent long-term consequences for both the mother and the baby.
Question 3 of 5
What physiologic postpartum change occurs because the uterus shrinks in size, resulting in an increase in blood flow?
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.
Question 4 of 5
The nurse assesses the fundus and finds it to be boggy, elevated >2 fingerbreadths above the umbilicus, and deviated to one side. What is the common cause of this finding?
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.
Question 5 of 5
The nurse screens for risk factors such as an infant in the neonatal intensive care unit (NICU), difficulty in role transition, birth complications, unmet social and physical needs, and lack of partner support for what complication?
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.