Chapter 35 Home Care of the Postpartum Family

Chapter 35   Home Care of the Postpartum Family

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

1) The nurse is speaking to a community group about the controversy regarding the length of the hospital stay for postpartum clients. Which statement indicates that a participant needs additional information?

1. “As of 1998, there’s a law that requires insurance to pay for a 48-hour stay after an uncomplicated birth.”
2. “The length of stay was shortened by insurance companies to decrease healthcare costs.”
3. “Early discharge became more popular in the 1980s as an alternative to having a home birth.”
4. “With current length-of-stay laws, newborns have no problems at home, and get recommended follow-up care.”

Answer:  4

Explanation:  4. Even with the current length-of-stay laws, many newborns do not always receive the recommended follow-up care when they go home early. The health and stability of the mother and baby, the mother’s ability and confidence regarding self and newborn care, support systems available, and access to follow-up care should form the basis of the decision.

Page Ref: 914

Cognitive Level:  Applying

Client Need/Sub:  Safe and Effective Care Environment: Management of Care

Standards:  QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Essentials Competencies: IX. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome:  1 Explain the history of the controversy surrounding length of stay (LOS).

MNL LO:  5.4.1 Develop a discharge teaching plan for the postpartum patient.

 

2) A nurse is performing a postpartum assessment during the first home visit to a client 3 days postdelivery. Which actions will the nurse perform?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. Palpate the breasts.
2. Auscultate the carotid.
3. Check vaginal discharge.
4. Assess the extremities.
5. Inspect the perineum.

Answer:  1, 3, 4, 5

Explanation:  1. The nurse needs to assess for fullness and engorgement.

3. The nurse should check vaginal discharge for amount and color.
4. The extremities should be checked for any redness, edema, and tenderness.
5. The perineum needs to be checked for healing.

Page Ref: 929

Cognitive Level:  Analyzing

Client Need/Sub:  Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards:  QSEN Competencies: V. B. 1. Demonstrate effective use of technology and standardized practices that support safety and quality. | AACN Essentials Competencies: IX. 8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan. | NLN Competencies: Relationship-Centered Care: Factors that contribute to or threaten health. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome:  2 Discuss the components of postpartum home care.

MNL LO:  5.4.2 Explain the purpose and components of the postpartum home visit.

 

 

3) A mother and her newborn have been discharged after a hospital stay of less than 48 hours. What are essential components the nurse must include in the first postpartum home visit?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. Assessment of color
2. Measurement of weight
3. Measurement of height
4. Assessment of mother-newborn interaction
5. Reinforcement of information about feeding and sleep patterns

Answer:  1, 2, 4, 5

Explanation:  1. The nurse should assess the newborn’s general health, hydration, and degree of jaundice.

2. The nurse should weigh the infant.
3. This is an opportune time to assess the quality of mother-newborn interaction and details of newborn behavior.
4. Parents frequently need further clarification and reinforcement of maternal or family education in neonatal care, particularly feeding and sleep position.

Page Ref: 915

Cognitive Level:  Applying

Client Need/Sub:  Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards:  QSEN Competencies: V. B. 1. Demonstrate effective use of technology and standardized practices that support safety and quality. | AACN Essentials Competencies: IX. 8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan. | NLN Competencies: Relationship-Centered Care: Factors that contribute to or threaten health. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome:  2 Discuss the components of postpartum home care.

MNL LO:  5.4.2 Explain the purpose and components of the postpartum home visit.

 

4) A new mother is concerned about spoiling her newborn. The home care nurse teaches the mother which of the following?

1. Newborns can be manipulative, so caution is advised.
2. Meeting the infant’s needs develops a trusting relationship.
3. An infant who is rocked to sleep every night is being spoiled.
4. Crying is good for babies, and letting them cry it out is advised.

Answer:  2

Explanation:  2. Picking babies up when they cry teaches them that adults are responsive to their needs. This helps build a sense of trust and security.

Page Ref: 927

Cognitive Level:  Applying

Client Need/Sub:  Psychosocial Integrity: Coping Mechanisms

Standards:  QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Essentials Competencies: IX. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome:  6 Describe assessment, care of the newborn, and reinforcement of parent teaching in the home.

MNL LO:  5.4.4 Recognize the assessment, care, and teaching required for the postpartum woman during a home visit.

 

5) The homecare nurse is visiting a newborn-and-mother couplet. Which nursing action has the highest priority?

1. Establish rapport with the family members.
2. Review the hospital medical records.
3. Determine the newborn’s sleeping arrangements.
4. Examine the umbilical cord stump.

Answer:  1

Explanation:  1. It is critical to establish rapport with family members prior to beginning any assessments. The nurse can rely on the same characteristics of a caring relationship that have been integral to hospital-based practice–regard for patients, genuineness, empathy, and establishment of trust and rapport.

Page Ref: 916

Cognitive Level:  Applying

Client Need/Sub:  Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards:  QSEN Competencies: V. B. 2. Demonstrate effective use of strategies to reduce risk of harm to self or others. | AACN Essentials Competencies: IX. 8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan. | NLN Competencies: Quality and Safety: Communicate potential risk factors and actual errors. | Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome:  5 Delineate aspects of fostering a caring relationship in the home.

MNL LO:  5.4.2 Explain the purpose and components of the postpartum home visit.