Mention to the mother how it is common to feel "left out" when all of the attention shifts from the pregnant mother to the newborn
Many mothers, if given the opportunity, admit to feeling abandoned and less important after giving birth than they did during pregnancy or labor. Only hours before, after all, they were the center of attention, with everyone asking about their health and well-being. Now, suddenly, the baby is everyone's chief interest. You can help a woman move past these feelings by verbalizing the problem: "How things have changed! Everyone's asking about the baby today and not about you, aren't they?" These are reassuring words for a woman and help her realize, although uncomfortable, the feeling she is experiencing is normal. Commenting on a newborn's good points would be more appropriate if the mother is experiencing disappointment with the child. An explanation of how hormonal changes contribute to overwhelming sadness would be more appropriate in the case of postpartal blues. Referral to a psychologist would be more appropriate for a case of postpartal depression.
Upgrade to remove ads
Only SGD 41.99/year
-
Flashcards
-
Learn
-
Test
-
Match
-
Flashcards
-
Learn
-
Test
-
Match
Butler County Community College Nursing 102 Spring 2020
Terms in this set [23]
A nurse is making an initial call on a new mother who gave birth to her third baby 5 days ago. The woman says,"I just feel so down this time. Not at all like when I had my other babies. And this one just doesn't sleep. I feel so inadequate." What is the best response to this new mother?
a. "It sounds like you have the 'baby blues.' They are common after having a baby when you are not getting enough sleep, are busy with your other children, and are still a bit uncomfortable from the birth. They will most likely go away in a day or two."
b. "Tell me, are you seeing things that aren't there, or hearing voices?"
c. "It sounds like you need to make an appointment with a counselor. You may have postpartum
depression."
d. "Every baby is different with their own temperament. Maybe this one just isn't ready to sleep when you want him to."
a. "It sounds like you have the 'baby blues.' They are common after having a baby when you are not getting enough sleep, are busy with your other children, and are still a bit uncomfortable from the birth. They will most likely go away in a day or two."
Explanation:
A combination of factors likely contributes to
the baby blues. Psychological adjustment along with a physiologic decrease in estrogen and progesterone appear to be the greatest contributors. Additional contributing factors include too much activity, fatigue, disturbed sleep patterns, and discomfort.
The nurse is used to working on the postpartum floor taking care of women who have had normal vaginal births. Today, however, the nurse has been assigned to help care for women who are less than 24 hours post cesarean birth. The nurse realizes that some areas will not be assessed. What would the nurse leave out of the client assessments?
a. breasts
b. lower extremities
c. perineum
d. respiratory status
Perineum
Explanation:
Usually a woman who experiences cesarean birth does not have an episiotomy, although rarely this may be the case.
Which action would most make the nurse believe that a postpartum woman is accepting a child well?
a. She asks the nurse to use her camera to take a photo of the child.
b. She states she has named the child after a well-loved friend.
c. She turns her face to meet the infant's eyes when she holds her.
d. She comments that her baby has the most hair of any in the nursery.
She turns her face to meet the infant's eyes when she holds her.
Explanation:
An "enface" position is a mark of a
woman who is interacting warmly with a newborn.
A postpartum client reports urinary frequency and burning. What cause would the nurse suspect?
a. subinvolution
b. uterine atony
c. stress incontinence
d. urinary tract infection
urinary tract infection
Explanation:
Urinary frequency and burning suggest a urinary tract infection. Uterine atony and subinvolution could cause increased blood loss
and prolonged lochia. Loss of pelvic muscle tone causes stress incontinence, which results in an inability to hold urine.
When caring for a postpartum client who has given birth vaginally, the nurse assesses the client's respiratory status, noting that it has quickly returned to normal. The nurse understands that which factor is responsible for this change?
a. decreased intra-abdominal pressure
b. decreased bladder pressure
c. increased
progesterone levels
d. use of anesthesia during birth
decreased intra-abdominal pressure
Explanation:
The nurse should identify decreased intra-abdominal pressure as the cause of the respiratory system functioning normally. Progesterone levels do not influence the respiratory system. Decreased bladder pressure does not affect breathing. Anesthesia used during birth causes the respiratory system to take a longer time to return to
normal.
A nurse is caring for a breastfeeding client who reports engorgement. The nurse identifies that the client's condition is due to not fully emptying her breasts at each feeding. Which suggestion should the nurse make to help her prevent engorgement?
a. Provide the infant oral nystatin.
b. Dry the nipples following feedings.
c. Apply cold compresses to the breasts.
d. Feed the baby at least every two or three hours.
Feed the baby at least every two or three hours.
Explanation:
The nurse should suggest the client feed the baby every two or three hours to help her reduce and prevent further engorgement. Application of cold compresses to the breasts is suggested to reduce engorgement for nonbreastfeeding clients. If the mother has developed a candidal infection on the nipples, the treatment involves application of an antifungal cream to the nipples following feedings and
providing the infant with oral nystatin. The nurse can suggest drying the nipples following feedings if the client experiences nipple pain.
A nurse is caring for a nonbreast-feeding client in the postpartum period. The client reports engorgement. What suggestion should the nurse provide to alleviate breast discomfort?
a. Apply warm compresses.
b. Wear a well-fitting bra.
c. Express milk frequently.
d. Apply hydrogel dressing.
Wear a well-fitting bra.
Explanation:
The nurse should suggest the client wear a well-fitting bra to provide support and help alleviate breast discomfort. Application of warm compresses and expressing milk frequently is suggested to alleviate breast engorgement in breastfeeding clients. Hydrogel dressings are used prophylactically in treating nipple pain.
A nurse is caring for a client who is nursing her baby boy. The client reports afterpains. Secretion of which substance would the nurse identify as the cause of afterpains?
a. estrogen
b. progesterone
c. oxytocin
d. prolactin
oxytocin
Explanation:
Secretion of oxytocin stimulates uterine contraction and causes the woman to experience afterpains. Decrease in progesterone and estrogen after placental delivery stimulates the anterior pituitary to secrete prolactin which causes
lactation.
A client in her sixth week postpartum reports general weakness. The client has stopped taking iron supplements that were prescribed to her during pregnancy. The nurse would assess the client for which condition?
a. hypovolemia
b. hyperglycemia
c. hypothyroidism
d. hypertension
hypovolemia
Explanation:
The nurse should assess the client for hypovolemia as the client must have had hemorrhage during
birth and puerperium. Additionally, the client also has discontinued iron supplements. Hyperglycemia can be considered if the client has a history of diabetes. Hypertension and hyperthyroidism are not related to discontinuation of iron supplements.
A nurse is making a home visit to a new mother who gave birth vaginally five days ago. The woman tells the nurse that she has lost some weight but still feels as if she has a long way to go to return to her prepregnancy weight. The woman asks what the average weight loss at 5 days into the postpartal period is. Which information would the nurse incorporate into the response?
a. 9 lb
b. 14 lb
c. 19 lb
d. 24 lb
19 lb
Explanation:
The rapid diuresis and diaphoresis during the second to fifth days after birth usually result in a weight loss of 5 lb [2 to 4 kg], in addition to the approximately 12 lb [5.8 kg] lost at birth. Lochia flow
causes an additional 2- to 3-lb [1-kg] loss, for a total weight loss of about 19 lb.
A nurse is monitoring the vital signs of a client 24 hours after birth. She notes that the client's blood pressure is 100/60 mm Hg. Which postpartum complication should the nurse mostsuspect in this client, based on this finding?
a. infection
b. postpartal gestational hypertension
c. diabetes
d. bleeding
bleeding
Explanation:
Blood pressure should also be monitored carefully during the postpartal period because a decrease in this can also indicate bleeding. In contrast, an elevation above 140 mm Hg systolic or 90 mm Hg diastolic may indicate the development of postpartal gestational hypertension, an unusual but serious complication of the puerperium. An infection would best be indicated by an elevated oral temperature. Diabetes would be indicated by an elevated blood glucose level.
A nurse is performing an assessment on a female client who gave birth 24 hours ago. On assessment, the nurse finds that the fundus is 2 cm above the umbilicus and boggy. Which intervention is a priority?
a. Have the client void, and then massage the fundus until it is firm.
b. Check and inspect the lochia, and document all findings.
c. Assess a full set of vital signs.
d. Notify the primary care provider, and document the findings.
Have the client void, and then massage the fundus until it is firm.
Explanation:
The fundus in a postpartum client should decrease 1 cm below the umbilicus each day. The fundus should also be firm to decrease the risk of postpartum hemorrhage. All of the listed interventions are appropriate, but a firm fundus is the priority.
A client reports pain in the lower back, hips, and joints 10 days after the birth of her baby. What instruction should the nurse give the client after birth to prevent low back pain and injury to the joints?
a. Soak in a warm bath several times a day.
b. Apply ice to the sore joints.
c. Maintain correct posture and positioning.
d. Try to avoid carrying the baby for a few days.
Maintain correct posture and positioning.
Explanation:
The nurse should recommend that clients maintain correct position and good body mechanics to prevent
pain in the lower back, hips, and joints. Avoiding carrying her baby and soaking several times per day is unrealistic. Application of ice is suggested to help relieve breast engorgement in nonbreastfeeding clients.
A client has come to the office for her first postpartum visit. On evaluating her blood work, the nurse would be concerned if the hematocrit is noted to have:
a. slightly increased.
b. slightly decreased.
c. acutely
decreased.
d. acutely increased.
acutely decreased.
Explanation:
Despite the decrease in blood volume, the hematocrit remains relatively stable and may even increase, reflecting the predominant loss of plasma. An acute decrease in hematocrit is not an expected finding and may indicate hemorrhage.
A woman comes to the clinic. She gave birth about 2 months ago to a healthy term male newborn. During the visit, the woman tells the nurse, "I've noticed that I'm a bit uncomfortable now when we have sexual intercourse. Is there anything that I can do?" The woman's menstrual period has not yet resumed. Which suggestion by the nurse would be most appropriate?
a. "Try doing Kegel exercises to get your pelvic muscles back in shape."
b. "This is entirely normal, and many women go through it. It just takes time."
c. "It takes a while to get your body back to its normal function after having a
baby."
d. "You might try using a water-soluble lubricant to ease the discomfort."
"You might try using a water-soluble lubricant to ease the discomfort."
Explanation:
Coital discomfort and localized dryness usually plague most postpartum women until menstruation returns. Water-soluble lubricants can reduce discomfort during intercourse. Although it may take some time for the woman's body to return to its prepregnant state, telling the woman this
does not address her concern. Telling her that dyspareunia is normal and that it takes time to resolve also ignores her concern. Kegel exercises are helpful for improving pelvic floor tone but would have no effect on vaginal dryness.
While providing care to a postpartum client on her first day at home, the nurse observes which behavior that would indicate the new mother is in the taking-hold phase?
a. Showing increased confidence when caring for
the newborn
b. Having feelings of grief or guilt
c. Talking about her labor experience to others around her
d. Pointing out specific features in the newborn
Showing increased confidence when caring for the newborn
Explanation:
Independence with self-care is an important aspect of the taking-hold phase. During the letting-go phase, the woman assumes responsibility and care for the newborn with increased confidence. Recounting her labor
experience is usually part of the taking-in phase. Identifying specific features of the newborn is typical of the taking-in phase. Feelings of grief, guilt, and anxiety are part of the letting-go phase where the mother accepts the infant as it is and lets go of any fantasies.
The nurse is preparing a new mother to be discharged home after an uncomplicated delivery. Which type of lochia pattern should the nurse point out needs to be reported to her primary care provider immediately during the discharge teaching?
a. moderate flow of lochia rubra on day 3 postpartum, changing to serosa on day 5
b. lochia progresses from rubra to serosa to alba within 10 days
c. moderate lochia rubra on day 3, mixed serosa and rubra on day 4, light serosa on day 5
d. moderate lochia serosa on day 4 postpartum, increasing in volume and changing to rubra on day 5
moderate lochia serosa on day 4 postpartum,
increasing in volume and changing to rubra on day 5
Explanation:
Lochia by day 4 should be decreasing in amount, and the color should be changing to pink tinge. Red rubra on day 4 may indicate bleeding, and the health care provider should be notified. A moderate flow of lochia rubra on day 3 postpartum, changing to serosa on day 5, is a normal finding. Lochia progressing from rubra to serosa to alba within 10 days of delivery is a normal finding. Moderate lochia rubra on day 3, mixed
serosa and rubra on day 4, and light serosa on day 5 is a normal finding.
The nurse is observing a set of new parents to ensure that they are bonding with their newborn. What displayed behavior would indicate that the parents bonding is maladaptive?
a. The mother states that she has her father's eyes.
b. The mother is reluctant to touch the newborn for fear of hurting her.
c. The father holds the newborn en face and talks to her.
d. The
parents explore the newborn's extremities, counting fingers and toes.
The mother is reluctant to touch the newborn for fear of hurting her.
Explanation:
New parents are often nervous and unsure of themselves but bonding behaviors normally follow a pattern. Initially, the parents gently touch the newborn with their fingers, and then go to the extremities to inspect them. Making comments about the newborn's similarities in appearance to the parents
is also commonly seen. Holding of the newborn in the en face position, where the parent is directly looking at the newborn is seen in most families. A reluctance to touch the newborn is counter-productive for bonding since bonding relies on the interaction between the parent and the child.
A new mother tells the postpartum nurse that she thinks her baby does not like her since it cries often when she holds it. How should the nurse respond to this statement?
a. Recommend rooming-in to foster attachment and confidence by the mother.
b. Dismiss the mother's concerns by telling her that you are sure she doesn't really mean it.
c. Tell the mother that it is natural to have feelings of uncertainty when adjusting to a new baby.
d. Recommend that she talk to the unit social worker to get the mother some counseling prior to discharge.
Tell the mother that it is natural to have feelings of
uncertainty when adjusting to a new baby.
Explanation:
Negative comments are often made by mothers who lack confidence in their mothering abilities and are experiencing hormonal fluctuations. The best response by the nurse is to acknowledge the mother's concerns and be accepting and supportive to her. Trying to force attachment will only make the situation worse. The mother does not need psychological counseling nor should the nurse dismiss the mother's concerns.
The nurse is caring for a client is who 24-hours post delivery of an infant. Which assessment does the nurse predict the health care provider will prioritize for the mother at this time?
a. hemoglobin and hematocrit
b. blood type
c. iron level
d. folic acid level
hemoglobin and hematocrit
Explanation:
The health care provider will order a hemoglobin and hematocrit [H&H] levels to assess the woman for
potential anemia. A decreased result may indicate the woman has suffered post-delivery hemorrhage and is also common with cesarean deliveries. The maternal blood type will be determined before the delivery. The H&H may be ordered as part of the complete blood count or may be ordered separately. The complete blood count may be order to evaluate for infection if the client has a fever. The iron level may be ordered at a later date if the H&H continues to remain low after a few days, but is
not a priority within the first 24 hours after delivery.
A woman is bottle-feeding her baby. When the nurse comes into the room the woman says that her breasts are painful and engorged. Which nursing intervention is appropriate?
a. Ask if she wants a breast pump to empty her breasts.
b. Assist the woman in placing ice packs on her breasts.
c. Assist the woman into the shower, and have her run cold water over her breasts.
d. Explain to
the woman that she should breastfeed because she is producing so much milk.
...
A nurse is caring for a client with postpartum hemorrhage. What should the nurse identify as the significant cause of postpartum hemorrhage?
a. hemorrhoid
b. diuresis
c. iron deficiency
d. uterine atony
...
A client gave birth to a healthy boy 2 days ago. Both mother and baby have had a smooth recovery. The nurse enters the room and tells the client that she and her baby will be discharged home today. The client states, "I do not want to go home." What is the nurse's most appropriate response?
a. Ask the client if she has any support in the home.
b. Ask the client why she does not want to go home.
c. Tell the client that she must go home as per hospital policy.
d. Inform the primary care provider that the client
does not want to go home.
...
Sets found in the same folderPeds PrepU: Chapter 18
89 terms
navybluescrubz4u
Chapter 17: Nursing Care of the Child With an Alte…
43 terms
Julia31615
Peds - Chapter 07: Growth and Development of the A…
84 terms
student3392
PEDS: Chapter 25 - Newborn/Infant
30 terms
meredithauge4
Other sets by this creatorLeadership Case: Evidence-Based Practice and Quali…
4 terms
ruth_ann_bradfordPLUS
HSEI Practice Exam 3
126 terms
ruth_ann_bradfordPLUS
HSEI One Comprehensive Exam
125 terms
ruth_ann_bradfordPLUS
Leadership Case: Team Building for Less Stress and…
10 terms
ruth_ann_bradfordPLUS
Other Quizlet setsAnatomy Superficial Back Muscles SPA
34 terms
NFTMFT
Risk and Insurance Ch.16 Exam 3
66 terms
Olivia_Simon9
Consumer Behavior Quiz 2
79 terms
polkapurple101
Econ HW 6
18 terms
danny13695
Related questionsQUESTION
A nurse is preparing to file a safety event report after a client experienced a fall. Which statement is correct regarding the filling of a safety event report?
3 answers
QUESTION
when a prescription for pain medication States 10-20 mg IM q 4-6 hours PRN for pain what will the nurse do when a 10 mg dose has been given and it is not effective
4 answers
QUESTION
What can the nurse aide give the resident who has an order for NPO?
15 answers
QUESTION
The nurse manager calls a meeting of members of the nursing team to resolve problems surrounding patient complaints of slow and sometimes discourteous responses to requests. What role does problem resolution play in this communication?
7 answers