Chapter 31 Contemporary Maternal Newborn Nursing Care Maternal Newborn Nursing Care Nurse, Family, 8th Edition

Chapter 31 Contemporary Maternal Newborn Nursing Care Maternal Newborn Nursing Care Nurse, Family, 8th Edition

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

Question 1

Type: MCSA

The nurse had completed a postpartum assessment on a patient who gave birth to her first child 12 hours ago. She is nauseated, but has not vomited in the last 2 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 patient?

1. Acute pain related to perineal trauma
2. Risk for deficient fluid volume related to uterine bleeding and nausea
3. Readiness for enhanced family coping
4. Knowledge deficit related to newborn care

Correct Answer: 2

Rationale 1: Although this nursing diagnosis is applicable, pain is a lower priority than is risk for fluid volume deficit.

Rationale 2: Adequate fluid volume is a critical Physiological need; therefore, this is the highest-priority nursing diagnosis.

Rationale 3: Although this nursing diagnosis may be applicable, family coping is a lower priority than is risk for fluid volume deficit.

Rationale 4: Although this nursing diagnosis may be applicable, a knowledge deficit is a psychosocial issue, and therefore a lower priority than is the Physiological need for adequate fluid volume.

Global Rationale:

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Diagnosis

Learning Outcome: LO01: Formulate nursing diagnoses and nursing care based on the findings of the “normal” postpartum assessment.

Question 2

Type: MCSA

During a home care visit, the new mother complains of breast engorgement. Which intervention is most appropriate for recommendation by the home care nurse?

1. “Apply an ice compress to your breast before nursing.”
2. “Encourage your baby to suckle for an average of 5 minutes per feeding.”
3. “Apply warm compresses to your breast after you finish feeding your baby.”
4. “When you aren’t nursing, wear a well-fitted nursing bra at all times, even when you sleep.”

Correct Answer: 4

Rationale 1: Warm compresses before nursing stimulate let-down and soften the breast so that the infant can grasp the areola more easily. Cool compresses after nursing can help slow refilling of the breasts and provide comfort to the mother.

Rationale 2: For women with breast engorgement, the infant should suckle for an average of 15 minutes per feeding and should feed at least 8 to 12 times in 24 hours.

Rationale 3: Warm compresses before nursing stimulate let-down and soften the breast so that the infant can grasp the areola more easily. Cool compresses after nursing can help slow refilling of the breasts and provide comfort to the mother.

Rationale 4: The mother should wear a well-fitted nursing bra 24 hours a day to support the breasts and prevent discomfort from tension.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: LO11: Delineate interventions to address the common concerns of breastfeeding mothers following discharge.

Question 3

Type: MCSA

The postpartum patient delivered 4 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 patient 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 patient is experiencing moderately severe pain with inflammation. Ibuprofen is a nonsteroidal anti-inflammatory drug that both reduces inflammation and provides pain relief.

Rationale 2: This medication is contraindicated because of the patient’s allergic reaction to acetaminophen.

Rationale 3: Topical anesthetic sprays can be a helpful adjunct in pain relief, but are not sufficient when a patient has moderately severe pain.

Rationale 4: Ice packs would be better at this stage, because they will cause vasoconstriction to reduce edema and pain relief.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: LO02: Discuss nursing interventions to promote postpartum maternal comfort, rest, and well-being.

Question 4

Type: MCSA

On the second day postpartum, the patient experiences engorgement. To relieve her discomfort, the nurse should encourage the patient to:

1. Remove her bra.
2. Apply heat to her breasts.
3. Apply ice packs to her breasts.
4. Limit breastfeeding to twice daily.

Correct Answer: 3

Rationale 1: Removing her bra will only serve to increase breast milk production.

Rationale 2: Applying heat will promote breast milk production.

Rationale 3: Applying ice packs to the breasts relieves discomfort through the numbing effect of ice.

Rationale 4: Limiting breastfeeding to b.i.d. actually would decrease the flow of breast milk eventually, and would not serve to decrease the discomfort of mother or infant.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: LO02: Discuss nursing interventions to promote postpartum maternal comfort, rest, and well-being.