Ch. 19 Nursing care for the family during the postpartum period

Question 1

Under the newborns and mothers act, health plans are required to allow new mothers (following an uncomplicated vaginal birth) to stay in hospital for

Answer 1

48hrs

Question 2

Under the newborns and mothers act, health plans are required to allow new mothers (following an c-section) to stay in hospital for

Answer 2

96hrs

Question 3

What is the most frequent cause of excessive bleeding after childbirth

Answer 3

Uterine atony

Question 4

What are the two important interventions for preventing excessive bleeding

Answer 4

Maintaining good uterine tone and preventing bladder distention

Question 5

What happens when uterine atony occurs

Answer 5

The relaxed uterus descends with blood clots, blood vessels in the placental site are not clamped off, and excessive bleeding results

Question 6

Excessive blood loss occurs with a firmly contracted uterus due to

Answer 6

Vaginal or vulgar hematomas or unprepared lacerations

Question 7

T/F A perineal pad saturated in 15min or less or pooling of blood under buttocks is an indication of excessive blood loss requiring immediate assessment

Answer 7

True

Question 8

What are the signs and symptoms of hypovolemic shock

Answer 8

Persistent bleeding- soaked w/in 15min
Weak, light-headed, anxious
Skin is grayish, cool, clammy
Pulse increases
BP decreases

Question 9

What interventions should be done when the women is in hypovolemic shock

Answer 9

Call Dr
Message fudus
Admin oxytocin
Give oxygen
Tilt on side (elevate right hip)
Iv LR
Admin blood

Question 10

Promotion of early ambulation is encouraged to reduce risk of

Answer 10

VTE

And promote return of strength

Question 11

How much longer are the prenatal vitamins and iron used after birth

Answer 11

6wk

Question 12

What is the recommended calorie intake for a nonlactating women postpartum

Answer 12

1800-2200kcal/day

Question 13

What is the recommended calorie intake for lactating women postpartum

Answer 13

2700kcal/day for the 1st 6months

Question 14

When is the ideal time to initiate the initial breastfeeding

Answer 14

1-2hrs after birth

Question 15

Which vaccines are recommended that the mother receive (if she hasn’t already) before discharge

Answer 15

Rubella, Varicella, Tdap

Question 16

After birth Rh immune globulin is administered to

Answer 16

All Rh-negative women who gave birth to Rh-positive infants

Question 17

Why might a women need to get another dose of the vaccine after receiving Rh immunoglobulin and a live vaccine at the same time

Answer 17

Rh suppresses the immune response, women must be tested in 3months to see if she has developed immunity, if not she will need another dose

Question 18

A rubella vaccine is indicated for mothers who

Answer 18

Are not immune

Tiger 1:8 less than .8

Question 19

What is homans sign

Answer 19

Discomfort in the calf with sharo dorsiflexion of the foot may indicate dvt

Question 20

In couplet care the mothers shared the infant care with

Answer 20

The nurse

Question 21

T/F discomfort of afterpains are more acute for multiparas

Answer 21

True, because repeated stretching of muscle fibers leads to loss of uterine muscle tone

Question 22

Postnatal overdistension of bladder and urinary retention can lead to

Answer 22

Postpartum hemorrhage and UTI

Question 23

Rh immune globulin will be ordered if

Answer 23

Mother is rh- and gives birth to Rh + baby

Question 24

T/F

Urinary retention may cause overdistention of the urinary bladder, which lifts and displaces the uterus

Answer 24

True

Question 25

What is the best measure to prevent abdominal distention after a ceasarean birth

Answer 25

Early and frequent ambulation

Question 26

Breast engorgement is caused by

Answer 26

Congestion of veins and lymphatics

Question 27

T/F uterine atony and excessive bleeding after birth can result in bladder distention

Answer 27

True

Question 28

T/F a full bladder causes the uterus to be displaced above the umbilicus and well to one side of the midline in the abdomen

Answer 28

True

Question 29

Sore nipples in breastfeeding mothers are most likely related to

Answer 29

Ineffective technique

Question 30

Discomfort associated with engorged breast may be reduced by

Answer 30

Applying ice-packs, cabbage leaves, well fitted bra