Chapter 31 Contemporary Maternal Newborn Nursing 7th Edition by Patricia W. Ladewig

Chapter 31 Contemporary Maternal Newborn Nursing 7th Edition by Patricia W. Ladewig

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

Chapter 31_LO01_Q01

The nurse had completed a postpartum assessment on a client who gave birth to her first child 12 hours ago. She is nauseated, but has not vomited in the last two hours. Her fundus was boggy, and firmed with massage to 1 FB ↓ U, moderately heavy lochia rubra, perineum ecchymotic and edematous, and pain rating 6 on scale of 1–10. Her partner is present and supportive. Breastfeeding has been successful three times. Which nursing diagnosis has the highest priority for this client?

1. Pain [acute] related to perineal trauma
2. Fluid Volume, risk for deficit secondary to boggy fundus and nausea
3. Family Coping, readiness for enhanced related to partner involvement
4. Knowledge, deficit related to birth of first child

Correct Answer: 2

Rationale:

1. Although this nursing diagnosis fits, pain is a lower priority than risk for fluid volume deficit.
2. Fluid volume is a critical physical issue; therefore, this is the highest-priority nursing diagnosis.
3. Although this nursing diagnosis fits, family coping is a lower priority than risk for fluid volume deficit.
4. Although this nursing diagnosis fits, a knowledge deficit is a psychosocial issue, and therefore a much lower priority than the critical physical diagnosis risk for fluid volume deficit.

Cognitive level: Application

Category of Client Need: Health Promotion and Maintenance

Nursing Process: Diagnosis

Learning Outcome: 31.1 Formulate nursing diagnoses and nursing care based on the findings of the “normal” postpartum assessment.

Chapter 31_LO02 _Q02

The nurse is providing education to the new family. Which question is best?

1. “Do you know how to give the baby a bath?”
2. “You have diapers and supplies at home, right?”
3. “How have your breastfeedings been going?”
4. “How much formal education do you have?”

Correct Answer: 3

Rationale:

1. This is a closed question. Closed questions should be avoided. And bathing is a lower priority need than is feeding.
2. This is a leading question. Leading questions should be avoided.
3. This is an open-ended question about an important physiologic issue. This is the best question.
4. Although the family members’ level of educational attainment helps when choosing written materials and words, it is rude to ask outright what education they have had. The nurse has the responsibility to provide adequate teaching for all clients, regardless of their educational level.

Cognitive level: Application

Category of Client Need: Health Promotion and Maintenance

Nursing Process: Implementation

Learning Outcome: 31.2 Delineate strategies for promoting family learning during the early postpartal period.

Chapter 31_LO03 _Q03

The postpartum client delivered four hours ago. She has a mediolateral episiotomy and large hemorrhoids. She is rating her pain at 7 on a scale of 1–10. She has a history of anaphylactic reaction to Tylenol (acetaminophen). Which nursing action would be best?

1. Offer the client 800 mg Advil (ibuprofen) orally with food.
2. Provide two Percocet (oxycodone with acetaminophen) by mouth.
3. Encourage use of Dermoplast topical anesthetic spray.
4. Run very warm water into the tub and assist her into the bath.

Correct Answer: 1

Rationale:

1. This is the best option, because the client is experiencing moderately severe pain with inflammation. Ibuprofen is a non-steroidal anti-inflammatory drug that both reduces inflammation and provides pain relief.
2. This medication is contraindicated because of the client’s allergic reaction to acetaminophen.
3. Topical anesthetic sprays can be a helpful adjunct in pain relief, but are not sufficient when a client has moderately severe pain.
4. Ice packs would be better at this stage, because they will cause vasoconstriction to reduce edema and pain relief.

Cognitive level: Application

Category of Client Need: Health Promotion and Maintenance

Nursing Process: Planning

Learning Outcome: 31.3 Formulate nursing interventions and client teaching that promote postpartum maternal comfort and well-being.