ATI RN
Postpartum Body Changes Questions
Question 1 of 5
The nurse assesses a 2-day postpartum, breastfeeding client. The nurse notes blood on the mother's breast pad and a crack on the mother's nipple. Which of the following actions should the nurse perform at this time?
Correct Answer: B
Rationale: In this scenario, the correct action for the nurse to take is to provide the woman with a tube of topical lanolin (Option B). This is because the presence of blood on the breast pad and a crack on the nipple indicate a common issue known as nipple trauma, often associated with breastfeeding. Topical lanolin can help soothe and protect the cracked nipple, promoting healing and providing relief to the mother. Option A is incorrect because washing with soap can further irritate the already sensitive area and potentially worsen the condition. Option C is incorrect as it can cause unnecessary worry and stress to the mother; ingesting a small amount of blood is generally not harmful to the baby. Option D is not the best course of action as a topical anesthetic may not address the underlying issue of nipple trauma and could potentially be harmful to the newborn if transferred during breastfeeding. Educationally, it is crucial for nurses to be knowledgeable about postpartum body changes and common breastfeeding issues to provide effective care and support to new mothers. Understanding the appropriate interventions for nipple trauma can help prevent complications and promote successful breastfeeding experiences for both the mother and baby.
Question 2 of 5
A client is 1 day post-cesarean section with spinal anesthesia. Even though the nurse advised against it, the client has had the head of her bed in high Fowler's position since delivery. Which of the following complications would the nurse expect to see in relation to the client's action?
Correct Answer: B
Rationale: In this scenario, the correct answer is B) Severe postural headache. When a client undergoes a cesarean section with spinal anesthesia, maintaining the head of the bed elevated can lead to a postural headache due to leakage of cerebrospinal fluid from the dural puncture site, exacerbated by the high Fowler's position. This positional headache is a common complication post-spinal anesthesia and can be severe. Option A) Postpartum hemorrhage is incorrect as it is not directly related to the client's position in bed. Postpartum hemorrhage usually occurs due to issues like uterine atony or retained placental fragments. Option C) Pruritic skin rash is also unrelated to the client's bed position and is more commonly associated with allergic reactions or dermatological conditions. Option D) Paralytic ileus is not typically caused by the client's bed position but rather by factors like decreased peristalsis following abdominal surgery. Educationally, this scenario highlights the importance of understanding the potential complications of specific postpartum interventions, like maintaining proper positioning post-cesarean section with spinal anesthesia to prevent avoidable issues such as postural headaches. It also emphasizes the need for clear patient education and compliance with healthcare provider instructions to ensure optimal recovery and outcomes.
Question 3 of 5
A client, who had no prenatal care, delivers a 10-lb 10-oz baby boy whose serum glucose result 1 hour after delivery was 20 mg/dL. Based on these data, which of the following tests should the mother have at her 6-week postpartum checkup?
Correct Answer: A
Rationale: The correct answer is A) Glucose tolerance test. In this scenario, the mother's baby had a high birth weight and low serum glucose level, indicating a risk for gestational diabetes. Without prenatal care, there was no monitoring of the mother's blood glucose levels during pregnancy. Therefore, a glucose tolerance test at the 6-week postpartum checkup is crucial to assess the mother's glucose metabolism and screen for diabetes. Option B) Indirect Coombs' test is used to detect antibodies in the mother's blood that could attack the baby's red blood cells, which is unrelated to the presented scenario of glucose monitoring. Option C) Blood urea nitrogen (BUN) measures kidney function and is not directly related to the mother's risk of developing gestational diabetes. Option D) Complete blood count (CBC) assesses levels of different blood components and is not specific to monitoring glucose levels postpartum. Educationally, understanding the importance of postpartum monitoring for women who had high-risk pregnancies, like in this case with a large baby and low serum glucose levels, highlights the necessity of comprehensive care for both the mother and baby. Regular follow-up and appropriate tests are essential for early detection and management of potential health issues postpartum.
Question 4 of 5
A nurse is caring for the following four laboring patients. Which client should the nurse be prepared to monitor closely for signs of postpartum hemorrhage (PPH)? Select one that doesn't apply
Correct Answer: D
Rationale: In this scenario, option D is the correct answer. The nurse should be prepared to monitor client D closely for signs of postpartum hemorrhage (PPH) due to the risk factors associated with delivering a large-for-gestational-age baby at 42 weeks. Postpartum hemorrhage is more common in women who have delivered larger babies due to potential uterine atony or inability of the uterus to contract effectively after delivery. Additionally, the prolonged gestation increases the risk of uterine atony and subsequent PPH. Option A can be eliminated because delivering a fetal demise at 29 weeks does not typically increase the risk of PPH. Option B, a prolonged first stage of labor, may lead to exhaustion but is not a direct risk factor for PPH. Option C, a cesarean section for failure to progress, does not inherently increase the risk of PPH unless there are complications during or after the surgery. Educationally, understanding the risk factors for postpartum hemorrhage is crucial for nurses caring for laboring patients. By recognizing the factors that can contribute to PPH, nurses can provide appropriate monitoring, interventions, and support to prevent or manage this potentially life-threatening complication effectively.
Question 5 of 5
A home care nurse is visiting a breastfeeding client who is 2 weeks postdelivery of a 7-lb baby girl over a midline episiotomy. Which of the following findings should take priority?
Correct Answer: D
Rationale: In this scenario, the priority finding is option D) Client yells at the baby for crying. This behavior raises concerns about the client's mental and emotional well-being, as well as the potential for postpartum depression or other mental health issues. As a home care nurse, ensuring the safety and well-being of both the mother and baby is crucial. Option A) Lochia is serosa, while important, does not pose an immediate threat to the client or her baby's safety. Option B) Client cries throughout the visit may indicate emotional distress, but it is not as urgent as the potential risk of harm to the baby from the client yelling. Option C) Nipples are cracked is a common issue in breastfeeding mothers but does not take precedence over the safety of the baby in this situation. Educationally, this scenario highlights the importance of assessing not only physical but also mental health status in postpartum clients. It underscores the need for healthcare providers to be vigilant for signs of postpartum depression or other mental health concerns, as early intervention is key to ensuring the well-being of both the mother and baby. It also emphasizes the critical role of the nurse in providing holistic and comprehensive care to postpartum clients.