The nurse is caring for a client, G3 P2002, whose infant has been diagnosed with a treatable birth defect. Which of the following is an appropriate statement for the nurse to make?

Correct Answer: D

Rationale: The correct answer is D) It is appropriate for you to cry at a time like this. Rationale: - The correct answer acknowledges and validates the client's emotions, indicating empathy and understanding of the difficult situation the client is facing. It recognizes that crying is a natural response to emotional stress and provides a supportive approach. Why the other options are wrong: - Option A: This response minimizes the client's feelings by comparing the situation to a potentially worse scenario. It does not address the client's current emotional state or offer support. - Option B: This response focuses on the health of the client's other children, which may come across as dismissive of the client's current concerns and emotions. - Option C: This response imposes personal beliefs on the client and may not align with the client's own beliefs or values. It does not address the client's emotional needs or provide support. Educational context: In the postpartum period, mothers may experience a wide range of emotions, especially when faced with challenges such as a newborn with a birth defect. As a nurse, it is crucial to provide compassionate and empathetic care, acknowledging the client's feelings and offering support. Validating the client's emotions and providing a safe space for expression can help promote emotional well-being and facilitate coping during a challenging time.

Correct Answer: C

Rationale: The correct answer is C) Human placental lactogen (hPL). Explanation: Human placental lactogen (hPL) is a hormone produced by the placenta during pregnancy. It plays a role in promoting insulin resistance in the mother, which helps ensure a steady supply of glucose to the fetus. After delivery, hPL levels drop rapidly. This decrease in hPL leads to decreased insulin resistance, allowing glucose levels to normalize. A) Estrogen and B) Progesterone do not directly impact glucose levels in the same way as hPL. Estrogen and progesterone levels also drop postpartum but do not have a significant effect on glucose regulation. D) Human chorionic gonadotropin (hCG) is a hormone produced during pregnancy that is responsible for maintaining the corpus luteum, which in turn produces progesterone to support the pregnancy. However, hCG levels drop quickly after delivery and do not play a significant role in glucose regulation postpartum. Educational Context: Understanding the hormonal changes that occur postpartum is crucial for healthcare providers managing patients with diabetes, especially type 1 diabetes. Recognizing the impact of hPL on glucose levels can help healthcare professionals anticipate and manage blood glucose levels in the postpartum period, ensuring optimal care for both the mother and the newborn.

Correct Answer: C

Rationale: In this scenario, option C, "Encourage the couple to try to get pregnant again in the near future," is not an appropriate nursing action. It is crucial to provide sensitive and empathetic care to a couple who has experienced a fetal demise at 28 weeks. Encouraging them to try to get pregnant again in the near future can be emotionally insensitive and could potentially hinder their grieving process. Option A, "Swaddle the baby in a baby blanket," may provide the couple with the opportunity to hold and say goodbye to their baby, facilitating the grieving process. Option B, "Discuss funeral options for the baby," is important as it allows the couple to make decisions about honoring their baby's memory and provides closure. Option D, "Ask the couple whether they would like to hold the baby," is also appropriate as it gives the couple a chance to bond with their baby and create memories. In an educational context, it is vital for healthcare providers to be well-versed in providing compassionate care to individuals experiencing pregnancy loss. Understanding the emotional complexities involved and knowing how to support individuals through the grieving process is essential in delivering holistic care. By choosing appropriate actions and responses, healthcare providers can help facilitate healing and promote emotional well-being during such challenging times.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Postpartum hemorrhage. Postpartum hemorrhage is a major concern after delivery and is one of the leading causes of maternal mortality worldwide. It can occur due to various reasons, including uterine atony, retained placental tissue, or lacerations. The other options are incorrect because: A) Endometrial ischemia: While important, endometrial ischemia does not present an immediate threat post-delivery compared to postpartum hemorrhage. C) Prolapsed uterus: This is a rare complication that usually occurs later and is not typically associated with the immediate postpartum period. D) Vaginal hematoma: While vaginal hematomas can occur post-delivery, they are not as life-threatening as postpartum hemorrhage. Educational context: It is crucial for nurses and healthcare providers to be vigilant for signs and symptoms of postpartum hemorrhage in the immediate postpartum period. This includes monitoring vital signs, assessing uterine tone, and observing for excessive bleeding. Early recognition and prompt intervention are vital in managing postpartum hemorrhage effectively and preventing adverse outcomes for the mother.

Correct Answer: A

Rationale: In this scenario, the correct answer is A) Uterine atony. Uterine atony is a condition where the uterus fails to contract after childbirth, leading to excessive postpartum bleeding. In the case of a macrosomic baby and a prolonged labor, there is an increased risk of uterine atony due to the prolonged stretching of the uterus and potential exhaustion of uterine muscles. Option B) Hypoprolactinemia is incorrect because it refers to low levels of prolactin, a hormone responsible for milk production. While this can affect breastfeeding, it is not directly related to the scenario of postpartum complications following a macrosomic birth. Option C) Infection is a general risk after any labor and delivery but is not specifically linked to macrosomia or prolonged labor. Option D) Mastitis is an inflammation of the breast tissue commonly associated with breastfeeding. While it can occur postpartum, it is not directly related to the scenario of macrosomia and uterine atony. Educationally, understanding the potential complications following a macrosomic birth is crucial for healthcare providers caring for postpartum women. Monitoring for uterine atony is essential to prevent severe postpartum hemorrhage and ensure the woman's well-being post childbirth. This knowledge helps in providing timely interventions and appropriate care to prevent and manage complications effectively.