Why does the nurse encourage ambulation in a patient who has experienced a cesarean birth?

Correct Answer: B

Rationale: The correct answer is A) Ambulation helps to prevent DVT (Deep Vein Thrombosis) in a patient who has experienced a cesarean birth. After a cesarean birth, there is an increased risk of developing blood clots due to immobility and changes in blood flow. Ambulation promotes blood circulation, preventing stasis in the veins, which reduces the risk of DVT formation. This is crucial in postpartum care to ensure the mother's well-being and prevent potentially life-threatening complications. Option B) Ambulation causes the person to lose weight in the hospital is incorrect as the primary reason for encouraging ambulation post-cesarean birth is to prevent complications like DVT, not weight loss. Option C) Ambulation helps with breastfeeding is incorrect as while ambulation can indirectly support breastfeeding by improving overall well-being, the primary reason in this context is to prevent DVT. Option D) Ambulation decreases peristalsis is incorrect because ambulation actually helps to stimulate peristalsis, promoting gastrointestinal motility, which can prevent issues like constipation that often occur postoperatively. In pharmacology, understanding the rationale behind postpartum care interventions, such as encouraging ambulation, is crucial for nurses to provide safe and effective patient care. By promoting ambulation, nurses can significantly contribute to preventing postoperative complications and promoting maternal health during the postpartum period.

Correct Answer: B

Rationale: In addressing Postpartum Depression (PPD), the correct intervention by the nurse is option B: encouraging the family to have support available for the person and partner. This intervention is crucial as PPD is a serious condition that affects not only the person but also their partner and family. Having a strong support system can provide emotional, physical, and practical assistance, which is vital in helping the individual cope with PPD. Option A is incorrect because while it is important for the postpartum person to learn self-care, PPD requires more comprehensive support than just self-care. Option C is incorrect because breastfeeding can still be possible while taking antidepressants, and it is essential to consult with healthcare providers to make informed decisions. Option D is also incorrect as keeping the newborn in the nursery most of the time can worsen feelings of isolation and detachment, contributing to PPD. Educationally, it is important for nurses to understand the multifaceted nature of PPD and the significance of a robust support system in managing this condition effectively. Nurses play a critical role in advocating for proper support structures and providing evidence-based care to individuals experiencing PPD. By educating families about the importance of support and involvement in the care of the affected individual, nurses can help improve outcomes and promote holistic well-being during the postpartum period.

Correct Answer: B

Rationale: In this scenario, the correct answer is option B: Ask the person if they are feeling depressed, hopeless, afraid, or overwhelmed. This response is appropriate because the nurse should assess the postpartum person's mental and emotional well-being, as their refusal to hold the newborn may indicate underlying issues such as postpartum depression or anxiety. By addressing these feelings directly, the nurse can provide necessary support and intervention. Option A, calling CPS for risk of child abuse, is not the initial action to take in this situation as it can escalate the issue without addressing the root cause of the postpartum person's behavior. This option lacks sensitivity and understanding towards the complexities of postpartum complications. Option C, asking the healthcare provider to order an antidepressant, is premature without a comprehensive assessment of the postpartum person's mental health status. Medication should not be the first-line intervention without exploring other factors contributing to their behavior. Option D, discussing how good parents hold and talk to their newborns, does not address the immediate concern of the postpartum person's refusal to hold the newborn. This option overlooks the importance of assessing the individual's emotional state and providing appropriate support. In an educational context, it is crucial for healthcare providers, especially nurses, to be adept at recognizing signs of postpartum complications and providing holistic care that includes mental health assessment and support. Understanding the complexities of postpartum mental health is essential for delivering patient-centered care and promoting positive health outcomes for both the postpartum person and the newborn.

Correct Answer: B

Rationale: In this scenario, the correct nursing action is option B: assess the fundus and massage the uterus to determine uterine tone and location. This is the priority because heavy bleeding postpartum could indicate uterine atony, which is a common cause of postpartum hemorrhage. By assessing the fundus, the nurse can determine if the uterus is firm (indicating good tone) or boggy (indicating poor tone), which will guide further interventions like massage to stimulate contractions and reduce bleeding. Option A is incorrect because while assessing for lacerations is important, addressing uterine atony takes precedence in this situation. Option C is also incorrect as catheterization is not the immediate priority unless there are signs of bladder distension impacting uterine contraction. Option D is incorrect because while assessing for clots is necessary, addressing uterine tone is the priority over determining normal bleeding amounts at this point. In an educational context, understanding the importance of prompt assessment and management of postpartum hemorrhage is critical for nurses caring for postpartum women. Recognizing the signs of uterine atony and knowing how to address it effectively can prevent serious complications and save lives in the postpartum period. This scenario highlights the significance of quick and accurate nursing interventions in managing postpartum complications.

Correct Answer: A

Rationale: In this scenario, option A is the most appropriate intervention for the patient based on the hemorrhage risk. The patient's history of a previous vaginal delivery and the presence of a uterine fibroid increase her risk of hemorrhage during the current labor and delivery process. Ordering a type and screen allows for the preparation of blood products in case of significant hemorrhage, ensuring timely access to necessary interventions. Option B is incorrect because ordering 4 units of packed red blood cells without prior assessment or indication of active hemorrhage is not in line with evidence-based practice and may expose the patient to unnecessary risks. Option C is also incorrect as drawing a hold tube alone does not adequately address the hemorrhage risk in this high-risk patient population. It is essential to proactively assess and prepare for potential complications. Option D is not the best course of action as it neglects the patient's moderate hemorrhage risk based on her history and current clinical presentation. It is crucial to be proactive in managing potential complications in obstetric patients to ensure optimal outcomes. Educationally, this question highlights the importance of risk assessment and appropriate interventions in the management of postpartum complications. Understanding the individualized risk factors for each patient is essential in providing safe and effective care during the peripartum period. By choosing the correct intervention based on the patient's risk profile, healthcare providers can optimize outcomes and ensure timely management of potential complications.