Chapter 14: High-Risk Postpartum Nursing Care
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Chapter 14: High-Risk Postpartum Nursing Care

Maternal Newborn Nursing The Critical Components Of Nursing Care 2nd Edition by Roberta Durham

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Chapter 14: High-Risk Postpartum Nursing Care

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

Multiple Choice

 

 

 

  1. A postpartum woman has been diagnosed with postpartum psychosis. Which of the following actions should the nurse perform?
  2. Supervise all infant care.
  3. Maintain client on strict bed rest.
  4. Restrict visitation to her partner.
  5. Carefully monitor toileting.

 

ANS: a

  Feedback
a. It is essential that a client diagnosed with postpartum (PP) psychosis not be left alone with her infant.
b. There is no need for a client with PP psychosis to be on strict bed rest.
c. Visitation is not usually restricted to the woman’s partner.
d. There is no need to monitor the client’s toileting.

 

KEY: Integrated Process: Nursing Process: Implementation | Cognitive Level: Application | Content Area: Postpartum Care; Psychopathology | Client Need: Health Promotion and Maintenance; Psychosocial Integrity | Difficulty Level: Difficult

 

 

 

  1. Which of the following sites is priority for the nurse to assess when caring for a breastfeeding client, G8 P5, who is 1 hour postdelivery?
  2. Nipples
  3. Fundus
  4. Lungs
  5. Rectum

 

ANS: b

  Feedback
a. Her nipples should be assessed, but this is not the priority assessment.
b. This client is a grand multipara. She is high risk for uterine atony and postpartum hemorrhage. The nurse should monitor her fundus very carefully.
c. Her lungs should be assessed bilaterally, but this is not the priority assessment.
d. Her rectum should be assessed for hemorrhoids, but this is not the priority assessment.

 

KEY: Integrated Process: Nursing Process: Assessment | Cognitive Level: Application | Content Area: Postpartum Care | Client Need: Health Promotion and Maintenance | Difficulty Level: Moderate

 

 

 

  1. A client is 1 hour postpartum from a vacuum delivery over a midline episiotomy of a 4500-gram neonate. Which of the following nursing diagnoses is appropriate for this mother?
  2. Risk for altered parenting
  3. Risk for imbalanced nutrition: less than body requirements
  4. Risk for ineffective individual coping
  5. Risk for fluid volume deficit

 

ANS: d

  Feedback
a. Although the baby is macrosomic, there is no evidence that this mother is high risk for altered parenting.
b. This woman’s baby is macrosomic—there is no indication that this woman is consuming a diet that is less than body requirements.
c. There is no evidence that this mother is high risk for altered coping.
d. This client is high risk for fluid volume deficit. Women who deliver macrosomic babies are high risk for uterine atony, which can lead to heavy flow of lochia.

 

KEY: Integrated Process: Nursing Process: Analysis | Cognitive Level: Application | Content Area: Physiological Adaptation: Fluid and Electrolyte Imbalances; Postpartum Care; Reduction of Risk Potential: Potential for Alterations in Body Systems | Client Need: Health Promotion and Maintenance; Physiological Adaptation; Physiological Integrity: Reduction of Risk Potential | Difficulty Level: Difficult

 

 

 

  1. The perinatal nurse accurately defines postpartum hemorrhage by including a decrease in hematocrit levels from pre- to postbirth by:
  2. 5%
  3. 8%
  4. 10%
  5. 15%

 

ANS: c

Historically, practitioners have defined postpartum hemorrhage as a blood loss greater than 500 mL following a vaginal birth and 1000 mL or more following a cesarean birth. Hematocrit levels that decrease 10% from pre- to postbirth measurements are also included in the definition.

 

KEY: Integrated Process: Clinical Problem Solving | Cognitive Level: Knowledge | Content Area: Maternity | Client Need: Safe and Effective Care Environment | Difficulty Level: Easy

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