Nursing Management of the Postpartum Woman

Nursing Management of the Postpartum Woman 1. Which recommendation should be given to a client with mastitis who is concerned about breastfeeding her neonate? a. She should stop breastfeeding until completing the antibiotic. b. She should continue to breastfeed; mastitis will not infect the neonate. c. She should supplement feeding with formula until the infection resolves. d. She should not use analgesics because they are not compatible with breastfeeding. 2. The nurse is assessing a client who is 14 hours postpartum and notes very heavy lochia flow with large clots. Which action should the nurse prioritize? a. Assess her blood pressure. b. Palpate her fundus. c. Have her turn to her left side. d. Assess her perineum. 3. A client has had a cesarean birth. Which amount of blood loss would the nurse document as a postpartum hemorrhage in this client? a. 1000 ml b. 750 ml c. 250 ml d. 500 ml 4. Six hours after birth, a client’s first void is 70 ml. What is the nurse’s next action? a. Assess for residual urine. b. Assess for perineal hematoma. c. Assess for dehydration. d. Assess for a urinary tract infection. 5. What postpartum client should the nurse monitor most closely for signs of a postpartum infection? a. a client who had an 8-hour labor b. a client who had a nonelective cesarean birth c. a client who conceived following fertility treatments d. a primiparous client who had a vaginal birth 1 6. The nurse is caring for several women in the postpartum clinic setting. Which statement(s), when made by one of the clients, would alert the nurse to further assess that client for postpartum psychosis? Select all that apply. a. "I believe my newborn is losing weight because I will not feed him because my milk was poisoned by the health care provider." b. "Sometimes I get tired of being with only the newborn, so I call my mom and sister to come visit." c. "I am sad because I am not spending as much time with my toddler now that my newborn is here." d. "When the newborn is sleeping, I can see his thoughts projected on my phone and I do not like the thoughts." e. "The newborn is not really mine emotionally, since I was never pregnant and do not have children." 7. A client presents to the clinic with a 3-week-old infant reporting general flu-like symptoms and a painful right breast. Assessment reveals temperature 101.8°F (38.8°C) and the right breast nipple with a movable mass that is red and warm. The client is diagnosed with mastitis. Which instruction should the nurse prioritize for this client? a. Complete the full course of antibiotic prescribed, even if you begin to feel better. b. Breastfeed or otherwise empty your breasts at least every 3 hours. c. Increase your fluid intake to ensure that you will continue to produce adequate milk. d. Use NSAIDs, warm showers, and warm compresses to relieve discomfort. 8. A nurse is caring for a client in the postpartum period. When observing the client’s condition, the nurse notices that the client tends to speak incoherently. The client’s thought process is disoriented, and they frequently indulge in obsessive concerns. The nurse notes that the client has difficulty in relaxing and sleeping. The nurse interprets these findings as suggesting which condition? a. postpartum psychosis b. postpartum depression c. postpartum blues d. postpartum panic disorder 9. The nurse is assessing the breast of a woman who is 1 month postpartum. The woman reports a painful area on one breast with a red area. The nurse notes a local area on one breast to be red and warm to touch. What should the nurse consider as the potential diagnosis? a. breast yeast b. plugged milk duct c. mastitis d. engorgement 2 10. The nurse is teaching a client about mastitis. Which statement should the nurse include in her teaching? a. Mastitis usually develops in both breasts of a breastfeeding client. b. The most common pathogen is group A streptococcus (GAS). c. Symptoms include fever, chills, malaise, and localized breast tenderness. d. A breast abscess is a common complication of mastitis. 3