The nurse has completed a postpartum assessment on a patient who delivered 1 hour ago. Which amount of lochia consists of a moderate amount?

Correct Answer: B

Rationale: Because estimating the amount of lochia is difficult, nurses frequently record flow by estimating the amount of lochia in 1 hour using the following labels: Scant€”less than 2.5 cm (1-inch) stain on the peripad; Light€”less than a 10 cm (4 inch) stain; Moderate€”less than a 15 cm (6 inch) stain; Heavy€”saturated peripad; Excessive€”saturated peripad in 15 minutes. Determining the time interval that the peripad is in place is also important. Lochia is less for women who have had a cesarean birth because some of the endometrial lining is removed during surgery.

Correct Answer: A

Rationale: Accepting the real infant and relinquishing the fantasy infant occurs during the letting-go phase of maternal adjustment. This phase is crucial for a mother to bond with her baby and establish a healthy relationship. Letting-go allows the mother to embrace the reality of her new role and the needs of her infant, leading to better maternal adjustment and overall well-being for both mother and baby.

Correct Answer: D

Rationale: In the context of pediatric respiratory nursing, understanding the management of subinvolution is crucial. Subinvolution refers to the failure of the uterus to return to its normal size after childbirth. In this scenario, the correct answer is D) oral methylergonovine maleate (Methergine) for 48 hours. Methylergonovine maleate is a medication commonly used to treat uterine atony, which is a common cause of postpartum hemorrhage. In cases of subinvolution, where the uterus fails to contract properly and return to its pre-pregnancy size, Methergine helps by promoting uterine contractions to reduce bleeding and aid in involution. Option A) oral fluids to 3000 mL/day is not directly related to the treatment of subinvolution. While hydration is important postpartum, it does not address the underlying issue of uterine subinvolution. Option B) intravenous fluid and blood replacement may be necessary in cases of postpartum hemorrhage due to subinvolution, but it does not specifically target the uterine contractions needed to address subinvolution. Option C) oxytocin intravenous infusion for 8 hours is commonly used to induce or augment labor contractions, but in cases of subinvolution, Methergine is more appropriate as it directly targets uterine contractions to address the issue. Educationally, this question highlights the importance of understanding pharmacological interventions in managing postpartum complications like subinvolution. Nurses must be able to differentiate between various medications and their specific indications to provide safe and effective care to postpartum patients.

Correct Answer: C

Rationale: Early and frequent feedings prevent milk stasis, engorgement, and mastitis by ensuring proper milk flow and emptying of the breast. Nursing for only 5 minutes may not fully empty the breast, leading to stasis. Tight bras can constrict milk flow, and ice packs before feeding can decrease milk production. Frequent feedings are key to preventing mastitis in breastfeeding patients.

Correct Answer: D

Rationale: The correct answer is D) on the second postpartum day. In the postpartum period, a late postpartum hemorrhage is defined as excessive bleeding occurring between 24 hours and up to 12 weeks post-delivery. In this scenario, since the patient delivered 3 days ago, the hemorrhage occurring on the second postpartum day aligns with this definition. Option A) on the first postpartum day is incorrect because a hemorrhage occurring on the first day would be considered an early postpartum hemorrhage, typically within the first 24 hours post-delivery. Option B) during the recovery phase of labor is incorrect as hemorrhage during labor recovery is not termed as postpartum hemorrhage. Option C) during the third stage of labor is also incorrect as this stage includes the delivery of the placenta, not the postpartum period. Educationally, understanding the timing and definitions of postpartum hemorrhage is crucial for nurses caring for postpartum patients. This knowledge is vital for early recognition, prompt intervention, and ensuring optimal outcomes for both the mother and baby. Nurses must be able to differentiate between early and late postpartum hemorrhage to provide appropriate care and prevent complications.