ATI RN
Complication Postpartum Questions
Question 1 of 5
A woman is receiving patient-controlled analgesia (PCA) post -cesarean section. Which of the following must be included in the patient teaching?
Correct Answer: B
Rationale: In the context of postpartum care following a cesarean section, it is crucial to educate the patient on the proper use of patient-controlled analgesia (PCA). Option B, which states that the client should report any feelings of nausea or itching to the nurse, is the correct answer. This is important because nausea and itching can be side effects of the pain medication administered through PCA, and timely reporting can help prevent complications or the need for additional interventions. Option A is incorrect because monitoring how often the button is pressed is not as critical as recognizing and reporting side effects. Option C is incorrect as only the patient should control the PCA administration to ensure safe dosing. Option D is incorrect because it is the responsibility of the patient, not the family, to communicate any changes in symptoms or condition to the healthcare team. Educationally, this question highlights the importance of patient education in managing postoperative pain and the role of the healthcare team in supporting patients through effective communication and monitoring for potential complications in the postpartum period.
Question 2 of 5
A client is receiving an epidural infusion of a narcotic for pain relief after a cesarean section. The nurse would report to the anesthesiologist if which of the following were assessed?
Correct Answer: A
Rationale: In this scenario, the correct answer is option A) Respiratory rate 8 rpm. This is the most critical assessment finding that would require immediate reporting to the anesthesiologist. The administration of a narcotic via epidural infusion can lead to respiratory depression as a side effect, especially when higher doses are used. A respiratory rate of 8 rpm is dangerously low and could indicate impending respiratory failure, a potentially life-threatening complication that requires immediate intervention. Complaint of thirst (option B) is a common side effect of narcotic medications but is not as urgent or concerning as respiratory depression. Urinary output of 250 mL/hr (option C) is within normal limits and not directly related to the administration of a narcotic. Numbness of feet and ankles (option D) is a common side effect of epidural anesthesia and does not indicate a critical issue requiring immediate attention. Educationally, this question highlights the importance of monitoring patients receiving epidural narcotic infusions postpartum for potential complications, particularly respiratory depression. Nurses must be vigilant in assessing vital signs and responding promptly to any signs of respiratory distress to ensure patient safety.
Question 3 of 5
A post -cesarean section, breastfeeding client, whose subjective pain level is 2/5, requests her as needed (prn) narcotic analgesics every 3 hours. She states, 'I have decided to make sure that I feel as little pain from this experience as possible. ' Which of the following should the nurse conclude in relation to this woman 's behavior?
Correct Answer: C
Rationale: The correct answer is C) The woman's breast milk volume may drop while taking the medicine. This is the correct answer because narcotic analgesics can pass into breast milk and affect the infant. Opioids, like narcotics, can lead to decreased milk production and potentially drowsiness or breathing difficulties in the newborn. It is essential for the nurse to educate the mother about the potential risks associated with taking narcotics while breastfeeding. Option A is incorrect because increasing the strength of the narcotic is not necessary and may increase the risk of adverse effects for both the mother and the baby. Option B is incorrect because while constipation is a potential side effect of narcotic analgesics, it is not the most immediate concern in this scenario. Option D is incorrect because while newborns can experience withdrawal symptoms if the mother is taking narcotics consistently, the primary concern in this situation is the potential impact on breastfeeding due to the medication. Educationally, it is vital for healthcare professionals to understand the implications of prescribing medications to breastfeeding mothers and to provide thorough patient education to ensure the safety and well-being of both the mother and the newborn.
Question 4 of 5
The nurse is assessing the midline episiotomy on a postpartum client. Which of the following findings should the nurse expect to see?
Correct Answer: B
Rationale: In assessing a midline episiotomy on a postpartum client, the nurse should expect to see well-approximated edges (Option B). This indicates proper healing and closure of the incision site. Well-approximated edges suggest that the incision is healing as expected and reduces the risk of infection and other complications. Option A, moderate serosanguinous drainage, may be expected in the immediate postpartum period, but it is not a specific finding related to the assessment of the episiotomy incision site. Option C, an ecchymotic area distal to the episiotomy, suggests bruising, which is not a typical finding in a well-healing incision. Option D, an area of redness adjacent to the incision, could indicate inflammation or infection, which would be concerning and not expected in a healing episiotomy. Educationally, understanding the expected findings in assessing a postpartum episiotomy is crucial for nurses to provide appropriate care, monitor for complications, and intervene promptly if needed to promote optimal healing and recovery for postpartum clients.
Question 5 of 5
The nurse is developing a standard care plan for postpartum clients who have had midline episiotomies. Which of the following interventions should be included in the plan?
Correct Answer: C
Rationale: In developing a standard care plan for postpartum clients with midline episiotomies, including the intervention to teach the client to contract her buttocks before sitting (option C) is crucial. This intervention helps reduce tension and pressure on the episiotomy site, promoting healing and preventing complications such as wound dehiscence and infection. Option A is incorrect as removing stitches on the third postpartum day is premature and can disrupt the healing process. Option B may be necessary for pain management but does not directly address care specific to the episiotomy site. Option D is not recommended as routine irrigation with antibiotic solution can disrupt the natural healing process and increase the risk of developing antibiotic-resistant strains of bacteria. Educationally, this rationale highlights the importance of tailored care plans for specific postpartum complications, emphasizing the significance of interventions that promote healing and prevent complications in line with evidence-based practice.