If a woman complains of persistent constipation in the postpartal period, the best treatment approach is usually a(n)

Correct Answer: B

Rationale: In the postpartum period, many women experience constipation due to factors such as hormonal changes, decreased physical activity, and fear of pain during bowel movements. The best treatment approach for persistent constipation in this period is a high fiber diet (Option B). A high fiber diet helps to add bulk to the stool, making it easier to pass through the intestines. Fiber also promotes regular bowel movements and helps prevent constipation. Increasing fluid intake (Option A) is important to prevent dehydration and can aid in softening the stool, but without an adequate fiber intake, it may not fully address constipation. Using a stool softener (Option C) may provide temporary relief, but it does not address the root cause of constipation. It is important to focus on dietary changes to promote long-term bowel health. Educationally, understanding the physiological changes that occur in the postpartum period and their impact on bowel function is crucial for healthcare professionals to provide holistic care to women during this time. Teaching patients about the importance of a high fiber diet can empower them to manage constipation effectively and promote overall well-being postpartum.

Correct Answer: B

Rationale: In the postpartum period, the correct answer to this question is B) bladder distension. When the nurse palpates the uterus and finds the fundus displaced superior to the umbilicus and to the right, it suggests that the bladder is full and pushing the uterus upwards and to the right. Bladder distension is common after childbirth due to the pressure exerted by the uterus on the bladder, especially if the mother has difficulty emptying her bladder completely. Option A) uterine atony is incorrect because uterine atony would typically present as a boggy uterus that is enlarged and displaced, not shifted to a specific direction like in this scenario. Option C) uterine hemorrhage would not cause the fundus to be displaced in a specific direction; instead, it would result in excessive bleeding. Educationally, understanding the postpartum assessment is crucial for nurses caring for postpartum women. Recognizing the signs of bladder distension is important to prevent complications such as uterine displacement, urinary retention, and potential infection. Proper education on postpartum assessment helps nurses provide optimal care to new mothers during a critical period of recovery.

Correct Answer: B

Rationale: In the context of a woman who has taken methadone during pregnancy and wishes to breastfeed, the correct answer is B) continue the same dose of methadone. This is because abrupt cessation of methadone can lead to withdrawal symptoms in both the mother and the infant, which can be harmful. By continuing the same dose, the woman can safely breastfeed while managing her opioid dependence. Option A) take the lowest dose of methadone is incorrect because sudden dose reduction can also trigger withdrawal symptoms. Option C) stop taking methadone is not recommended as it can lead to relapse and harm the mother's and infant's well-being. Educationally, it is crucial to understand the principles of medication management during pregnancy and lactation. Methadone maintenance therapy is a common approach for pregnant women with opioid use disorder to prevent withdrawal and reduce the risk of relapse. Continuation of a stable methadone dose under medical supervision is generally considered safe for breastfeeding, as the benefits often outweigh the risks. It is essential for healthcare providers to support and educate women on the best practices for managing opioid dependence while breastfeeding to ensure the health and well-being of both the mother and the infant.

Correct Answer: A

Rationale: In the context of normal anatomy and physiology of the female pelvis, it's important to understand the typical postpartum changes that occur. In this scenario, the correct answer is A) normal postpartal elevation. After delivery, it is common for a woman's white blood cell count to increase as a normal physiological response to the stress of childbirth. The count can reach up to 30,000-40,000 cells/mm3 without indicating infection. By the second day postpartum, a count of 40,000 is within the expected range for this normal postpartal elevation. Option B) acute infection is incorrect because in cases of infection, the white blood cell count would typically be much higher than 40,000, indicating a more severe immune response. Option C) chronic infection is also incorrect as chronic infections usually present with more subtle changes in white blood cell count over a longer period of time, rather than the rapid increase seen in this case. Understanding these normal physiological changes is crucial for healthcare providers working in obstetrics and gynecology to differentiate between expected postpartum elevations and signs of infection, ensuring appropriate care for postpartum women.

Correct Answer: B

Rationale: In the context of breastfeeding, the football hold is the most effective position for relieving plugged milk ducts and engorged breasts. This position allows for better drainage of the affected area due to the baby's chin and nose being positioned towards the blockage. This helps to apply more pressure to the affected duct, facilitating better milk flow and relieving discomfort. The cradle hold, though a common breastfeeding position, may not provide the same level of targeted pressure needed to alleviate plugged ducts. Similarly, the side-lying hold is more suitable for relaxation during feeding and may not offer the necessary pressure to address engorgement effectively. Educationally, understanding the optimal breastfeeding positions not only promotes successful breastfeeding but also aids in managing common issues like plugged ducts and engorgement. Encouraging mothers to utilize the football hold when experiencing these challenges can help prevent more serious issues such as mastitis. It is essential for healthcare providers and educators to equip breastfeeding individuals with this knowledge to ensure a positive breastfeeding experience.