Chapter 30 The Postpartum Family at Risk

Chapter 30   The Postpartum Family at Risk

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

1) The nurse is preparing a community education class on healthy pregnancy. Which statements should be included? Select all that apply.

1. Eating a well-balanced diet helps prevent pregnancy complications.
2. Stress management and support systems are important in pregnancy.
3. Prenatal care can be obtained at any point in the pregnancy.
4. Complications during a prior pregnancy do not recur.
5. Exercising regularly facilitates feeling better in pregnancy.

Answer:  1, 2, 5

Explanation:  1. Good overall nutrition helps reduce the incidence of many pregnancy complications, including anemia, preterm labor, and delivery complications such as shoulder dystocia.

2. Clients with high-stress levels and poor support systems are more likely to develop postpartum depression and have problems parenting.
3. Early and regular prenatal care is important to provide education that can help prevent complications, and to detect complications as they develop.
4. Many complications of pregnancy have a tendency to recur, including postpartum hemorrhage, postpartum depression, preterm labor, and premature rupture of membranes.
5. Regular exercise during pregnancy helps prevent hypertension and gestational diabetes, helps reduce length of labor, and helps patients feel good.

Page Ref: 691-692

Cognitive Level:  Application

Client Need&Sub:  Health Promotion and Maintenance

Standards:  QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Planning/Health teaching and health promotion

Learning Outcome:  LO 30.5-Identify the nurse’s impact in both the hospital and community-based settings in assessing predisposing factors of postpartum complications, implementing preventive care, and teaching for self-help.

MNL LO:  Implement strategies to promote health maintenance throughout pregnancy.

 

2) A client is 3 days postop from a cesarean birth. She has tenderness, localized heat, and redness of the left leg. She is afebrile. As a result of these symptoms, she most likely will be:

1. Encouraged to ambulate freely.
2. Given aspirin 650 mg by mouth.
3. Given Methergine IM.
4. Placed on bed rest.

Answer:  4

Explanation:  1. That would increase the inflammation.

2. Aspirin 650 mg by mouth has anticoagulant properties, but usually is not necessary unless complications occur.
3. Methergine is given only for postpartum hemorrhage, and would only cause vasoconstriction of an already inflamed vessel.
4. These symptoms indicate the presence of superficial thrombophlebitis. The treatment involves bed rest and elevation of the affected limb, analgesics, and use of elastic support hose.

Page Ref: 702

Cognitive Level:  Application

Client Need&Sub:  Health Promotion and Maintenance

Standards:  QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Diagnosis/Coordination of care

Learning Outcome:  LO 30.5-Identify the nurse’s impact in both the hospital and community-based settings in assessing predisposing factors of postpartum complications, implementing preventive care, and teaching for self-help.

MNL LO:  Determine the nursing care specific to a woman who has undergone a cesarean birth.

 

3) The nurse is assisting a multiparous woman to the bathroom for the first time since her delivery 3 hours ago. When the client stands up, blood runs down her legs and pools on the floor. The client turns pale and feels weak. The first action of the nurse is to:

1. Assist the client to empty her bladder.
2. Help the client back to bed to check her fundus.
3. Assess her blood pressure and pulse.
4. Begin an IV of Lactated Ringer’s infusion.

Answer:  2

Explanation:  1. The client might be experiencing a postpartum hemorrhage. Her fundus is not contracting well. Although this might be due to a full bladder, the best first step is to massage the fundus.

2. Massaging the fundus is the top priority because of the excessive blood loss. If the fundus is boggy, fundal massage may stimulate toning of the uterus and prevent further blood loss.
3. Massaging the fundus is the top priority because of the excessive blood loss. Blood pressure and pulse do not change until 1000 to 2000 mL of blood has been lost. Massaging the fundus will prevent further blood loss.
4. Massaging the fundus is the top priority because of the excessive blood loss. An IV might need to be started if the client becomes symptomatic.

Page Ref: 689-690

Cognitive Level:  Application

Client Need&Sub:  Health Promotion and Maintenance

Standards:  QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Implementation/Coordination of care

Learning Outcome:  LO 30.1-Identify the causes, contributing factors, signs and symptoms, clinical therapy, and nursing interventions for early and late postpartum hemorrhage.

MNL LO:  Compare the various etiologies and management of postpartum hemorrhage.

 

 

4) A client is experiencing excessive bleeding immediately after the birth of her newborn. After speeding up the IV fluids containing oxytocin, with no decrease in the bleeding, the nurse should anticipate the physician requesting which medications? Select all that apply.

1. Methergine
2. Stadol
3. Misoprostol
4. Betamethasone

Answer:  1, 3

Explanation:  1. Methergine is a drug of choice for postpartum hemorrhage.

2. Stadol is an analgesic, and is not used for postpartum hemorrhage.
3. Misoprostol is commonly administered rectally for postpartum hemorrhage.
4. Betamethasone is a glucocorticoid used for preterm labor in an attempt to decrease respiratory distress in the preterm infant.

Page Ref: 690

Cognitive Level:  Application

Client Need&Sub:  Health Promotion and Maintenance

Standards:  QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Implementation/Coordination of care

Learning Outcome:  LO 30.1-Identify the causes, contributing factors, signs and symptoms, clinical therapy, and nursing interventions for early and late postpartum hemorrhage.

MNL LO:  Compare the various etiologies and management of postpartum hemorrhage.