[Exam 2] Chapter 16 – Nursing Management During the Postpartum Period Flashcards
1
Q
Nursing Assessment Postpartum Period: VS how often during first hour?
A
Every 15 mins
2
Q
Nursing Assessment Postpartum Period: VS how often during second hour?
A
Every 30 mins
3
Q
Nursing Assessment Postpartum Period: VS how often during first 24 hours?
A
Every 4 hours
4
Q
Nursing Assessment Postpartum Period: VS how often after 24 hours?
A
Every 8 hours
5
Q
Nursing Assessment Postpartum Period: Assessments typically include what?
A
VS, Pain Level, Epidural Site, Inspection for Infection, And systematic head-to-toe review
6
Q
Nursing Assessment Postpartum Period: What acronym is used to guide head-to-toe review?
A
BUBBLE-EE
7
Q
Nursing Assessment Postpartum Period: What does BUBBLE-EE stand for?
A
Breast Uterus Bladder Bowels Lochia Episiotomy/Perineum/Epidural Site Extremities Emotional Status
8
Q
Nursing Assessment Postpartum Period - VS and Temp: Mothers temp during first 24 hours postpartum?
A
Within the normal range or a low-grade elevation
9
Q
Nursing Assessment Postpartum Period - VS and Temp: Why might temperature be elevated?
A
Because of dehydration due to fluid loss during labor. Should be normal within 24 hours.
10
Q
Nursing Assessment Postpartum Period - VS and Temp: Temp above 100 at any time after first 24 hours indicates
A
infection. Warrants continued monitoring until infection ruled out. May identify maternal sepsis
11
Q
Nursing Assessment Postpartum Period - VS and Pulse: Normal rate one week after birth?
A
60-80 bpm, called puerperal bradycardia . This is due to the increased CO due to increase IV volume.
12
Q
Nursing Assessment Postpartum Period - VS and Pulse: Tachycardia postpartum suggests what?
A
Anxiety, excitement, fatigue, pain, excessive blood/delayed hemorrhage, infection, or underlying cardiac problems.
13
Q
Nursing Assessment Postpartum Period - VS and Resp.: What range should this be in?
A
12-20.
14
Q
Nursing Assessment Postpartum Period - VS and Resp.: When does this return to normal?
A
After childbirth when diaphragm descends and organs revert to normal positions
15
Q
Nursing Assessment Postpartum Period - VS and Resp.: Abnormal respirations may indicate what?
A
pulmonary edema, atelectasis, or pulmonary embolism
16
Q
Nursing Assessment Postpartum Period - VS and BP: How is it after childbirth?
A
Should remain the same as during labor.
17
Q
Nursing Assessment Postpartum Period - VS and BP: What would an increase in BP indicate?
A
Gestational hypertension
18
Q
Nursing Assessment Postpartum Period - VS and BP: What would an decrease of BP indicate?
A
Shock or orthostatic hypotension or dehydration.
19
Q
Nursing Assessment Postpartum Period - VS and BP: What range should this stay in?
A
140/90 - 85/60
20
Q
Nursing Assessment Postpartum Period - VS and Pain: Nursing care to focus on providing comfort measures should include what?
A
Perineal care, clean gown, mouth care, providing warm blankets, ensuring adequate fluid intake, and enecouraiging rest
21
Q
Nursing Assessment Postpartum Period - VS and Pain: Goal for pain management and their pain scale?
A
Have it be maintained beween 0 to 2 at all times.
22
Q
Nursing Assessment Postpartum Period - Physical Exam and Breasts: Inspect breasts for what?
A
Size, contour, asymmetry, engorgement or erythema
23
Q
Nursing Assessment Postpartum Period - Physical Exam and Breasts: Check nipples for what
A
Cracks, redness, fissures, or bleeding and note whether they are errect, flat, or inverted
24
Q
Nursing Assessment Postpartum Period - Physical Exam and Breasts: What do cracked, blistered, bruised nipples indicate?
A
That baby is positioned improperly
25
Nursing Assessment Postpartum Period - Physical Exam and Breasts: What to know for palpatation?
Palpate lightly to see if they are soft, filling, or engorged.
For those not breast feeding, use gentle touch to avoid breast stimulation
26
Nursing Assessment Postpartum Period - Physical Exam and Breasts: What is Lactogenesis (onset of milk secretion) triggered?
By delivery of placenta, which results in failing amount of estrogen and progesterone.
27
Nursing Assessment Postpartum Period - Physical Exam and Breasts: How do engorged breats feel?
Hard, tender, and taut
28
Nursing Assessment Postpartum Period - Physical Exam and Breasts: How will colostrum and foremilk be described?
Colostrum = creamy yellow
foremilk = bluish white
29
Nursing Assessment Postpartum Period - Physical Exam and Uterus: What should you feel for?
The top of the fundus. Have women empty bladder before assessing the fundus.
30
Nursing Assessment Postpartum Period - Physical Exam and Uterus: Where should the fundus be
Should be midline and should feel firm
31
Nursing Assessment Postpartum Period - Physical Exam and Uterus: What does a boggy/relaxed uterus show?
Uterine atony (loss of muscle tone in the uterus), which can result in bladder distention which displaces uterus upward and to the right
32
Nursing Assessment Postpartum Period - Physical Exam and Uterus: How to determine location of fundus location wise?
Count number of fingerbreadths between fundus and umbilicus.
33
Nursing Assessment Postpartum Period - Physical Exam and Uterus:When should this return to its normal height?
After 14 days
34
Nursing Assessment Postpartum Period - Physical Exam and Uterus: How do you record that the fundus is 1cm below the umbilicus?
Record it as u/1
35
Nursing Assessment Postpartum Period - Physical Exam and Bladder: When does diuresis usually end?
By day 21
36
Nursing Assessment Postpartum Period - Physical Exam and Bladder: Signs of UTI?
Fever, urinary frequency, difficult or painful urination, and tenderness
37
Nursing Assessment Postpartum Period - Physical Exam and Bladder: What Q's should we ask to assess voiding problems?
Have you gone to the bathroom yet?
Any burning??
Difficulty passing urine?
38
Nursing Assessment Postpartum Period - Physical Exam and Bladder: What does bladder distention feel like?
Palpation of a rounded mass. Dull to percussion. Lochia drainage will be more than normal
39
Nursing Assessment Postpartum Period - Physical Exam and Bowels: Bowel movements may not occur for how many days
Not until 1-3 days in. Due to decrease in muscle tone in the intestines because of progesterone levels
40
Nursing Assessment Postpartum Period - Physical Exam and Bowels: How does abdomen usually feel?
Soft, nontender, and nondistended
41
Nursing Assessment Postpartum Period - Physical Exam and Bowels: What question should you ask women here?
If they've had a bowel movement or has passed gas since giving birth.
42
Nursing Assessment Postpartum Period - Physical Exam and Lochia: What should you assess about this?
Amount, color, and odor. Assess how much they are bleeding and how many perineal pads have been used in past 1-2 hours.
43
Nursing Assessment Postpartum Period - Physical Exam and Lochia: What do large clots suggest?
Poor uterine involution
44
Nursing Assessment Postpartum Period - Physical Exam and Lochia: Why does lochia increase while breastfeeding?
Because Oxytocin releases causes uterine contraction
45
Nursing Assessment Postpartum Period - Physical Exam and Lochia: What is Scant?
1-2 inch lochia stain , 10 mL loss
46
Nursing Assessment Postpartum Period - Physical Exam and Lochia: What is light or small?
4 inch stain, or 10-25 mL of loss
47
Nursing Assessment Postpartum Period - Physical Exam and Lochia: What is moderate?
4-6 inch stain, with estimated loss of 25-50 mL
48
Nursing Assessment Postpartum Period - Physical Exam and Lochia: What is large or heavy?
Pad saturated within 1 hour
49
Nursing Assessment Postpartum Period - Physical Exam and Lochia: What would be an abnormal finding?
Heavy, bright-red lochia with large tissue gragments or a foul odor.
50
Nursing Assessment Postpartum Period - Physical Exam and Lochia: What to do if excessive bleeding occurs?
Massage the boggy fundus until it is firm to reduce flow of blood
51
Nursing Assessment Postpartum Period - Physical Exam and Lochia: When should the woman contact the provider for an abnormal finding?
If lochia rubra returns after the serosa and alba transitions. May indicate subinvolution or that women is too active
52
Nursing Assessment Postpartum Period - Physical Exam and Episiotomy/Perineum and Epidural Site: What should be inspected at episiotomy?
For irritation, ecchymosis, tenderness, or hematomas
53
Nursing Assessment Postpartum Period - Physical Exam and Episiotomy/Perineum and Epidural Site: What is a first-degree laceration?
Involves only skin and superficial structures above muscle
54
Nursing Assessment Postpartum Period - Physical Exam and Episiotomy/Perineum and Epidural Site: What is a second-degree laceration?
Extends through perineal muscles
55
Nursing Assessment Postpartum Period - Physical Exam and Episiotomy/Perineum and Epidural Site: What is a third-degree laceration?
Extends through anal sphincter muscle
56
Nursing Assessment Postpartum Period - Physical Exam and Episiotomy/Perineum and Epidural Site: What is a fourth-degree laceration?
Continues through anterior rectal wall
57
Nursing Assessment Postpartum Period - Physical Exam and Episiotomy/Perineum and Epidural Site: How often should this be assessed?
Every 8 hours
58
Nursing Assessment Postpartum Period - Physical Exam and Episiotomy/Perineum and Epidural Site: Large areas of swollen, bluish skin with complaints of severe pain in perineal area indicate what?
Pelvic or vulvar hematomas
59
Nursing Assessment Postpartum Period - Physical Exam and Episiotomy/Perineum and Epidural Site: What does a white line running the length of episiotomy indicate?
An infection
60
Nursing Assessment Postpartum Period - Physical Exam and Episiotomy/Perineum and Epidural Site: How to relieve comfort here?
Ice, sitz baths
61
Nursing Assessment Postpartum Period - Physical Exam and Extremities: What is the most important thing to look out for here?
VTE, which includes pulmonary embolism and deep vein thrombosis.
62
Nursing Assessment Postpartum Period - Physical Exam and Extremities: What three factors predispose women to thromboembolic disorders?
Stasis (compression of large veins bc of gravis uterus)
Altered Coagulation (state of pregnancy)
Localized vascular damage (may occur during birthing process)
63
Nursing Assessment Postpartum Period - Physical Exam and Extremities: RF for deep vein thrombi?
Anemia, Diabetes, Obesity, Preeclampsia, Hypertension
Pregnancy, and Cesarean Birth
64
Nursing Assessment Postpartum Period - Psychosocial Assess and Emotional Status: How do you asssess this?
How they interect with family, level of indepence, energy levels, and eye contact with infant
65
Nursing Assessment Postpartum Period - Psychosocial Assess and Bonding and Attachment: What is bonding?
The close emotional attraction to a newborn by the parents that develops during the first 30-60 mins after birth.
66
Nursing Assessment Postpartum Period - Psychosocial Assess and Bonding and Attachment: What is attachment?
Development of strong affection between an infant and a significant other. Attachment is reciprocal.
67
Nursing Assessment Postpartum Period - Psychosocial Assess and Bonding and Attachment: What is the developmental task the infant works on?
Trust vs mistrust. If they learn that mother will always be there, they will learn to trust the person.
68
Nursing Assessment Postpartum Period - Psychosocial Assess and Bonding and Attachment: According to Mercer, what are the four steps of "becoming" a parent , which may take 4-6 months?
Commitment, attachment during pregnancy
Acquaintance and increasing attachment to infant
Moving toward new routing in first 4 months
Achievement of parenthood role
69
Nursing Assessment Postpartum Period - Psychosocial Assess and Bonding and Attachment: What factors affect attachment?
Parents background (what care did they receive growing up)
Infant (infants temperament and health)
Care practices (the support staff)
70
Nursing Assessment Postpartum Period - Psychosocial Assess and Bonding and Attachment: What factors are associated with the health care facility hinder attachment?
Separation of infant/parent immediately after birth
Policies that discourage exploring infant
Intensive care environment
71
Nursing Assessment Postpartum Period - Psychosocial Assess and Bonding and Attachment: What stages does attachment include?
Proximity, Reciprocity, and commitment
72
Nursing Assessment Postpartum Period - Psychosocial Assess and Bonding and Attachment: What does Proximity refer too?
Physical and psychological experience of parents beign close to their infant. Has three dimensions
73
Nursing Assessment Postpartum Period - Psychosocial Assess and Bonding and Attachment: What are the three dimensions of proximity?
Contact
Emotional State
Individualization
74
Nursing Assessment Postpartum Period - Psychosocial Assess and Attachment: What does contact refer to?
Sensory experiences of touching, holding, and gazing at infant
75
Nursing Assessment Postpartum Period - Psychosocial Assess and Attachment: What does Emotional state refer to?
Emerges from affective experience of the new parents toward their infant and their parental role
76
Nursing Assessment Postpartum Period - Psychosocial Assess and Attachment: what does individualization refer to?
Aware of need to differentiate needs of infant from themselves
77
Nursing Assessment Postpartum Period - Psychosocial Assess and Attachment: What does reciprocity refer to?
Process by which infants abiliteis and behaviors elicit parental response.
78
Nursing Assessment Postpartum Period - Psychosocial Assess and Attachment: What two dimensions are there in reciprocity?
Complementary behavior and sensitivity behavior
79
Nursing Assessment Postpartum Period - Psychosocial Assess and Attachment: What is complementary behavior in reciprocity?
Invovles taking turns and stopping when the other is not interested or becomes tired. Those who are responsive to infants cues promote their growth
80
Nursing Assessment Postpartum Period - Psychosocial Assess and Attachment: What does Commitment refer to?
Enduring nature of relationships. Contains centrality and parent role exploration
81
Nursing Assessment Postpartum Period - Psychosocial Assess and Attachment: What happens in centrality in commitment?
Parents place the infant at the center of their lives. They acknowledge and accept their responsibility to promote infants safety and growth
82
Nursing Assessment Postpartum Period - Psychosocial Assess and Attachment: What is parents role exploration in commitment?
Parents ability to find their own way and integrate the parental identity into themselves
83
Nursing Interventions: Positive behaviors from infant?
Smile is alert, demonsstrates strong grasp, sucks well, feeds easily
84
Nursing Interventions: Negative behaviors from infant?
Feeds pooorly, cries for long periods, show flat affect, rarely smiles even when prompted
85
Nursing Interventions: Positive behaviors from parents?
Makes direct eye contact, assumes en face posiiton, claims infant as famil y members, expresses pride
86
Nursing Interventions: Negative behaviors from parent?
Expresses disappointment
Fails to explore the infant
Avoids caring for the innfant
87
Nursing Interventions - Providing Optimal Cultural Care: Cultural practices that nurses need to be aware of include what?
Dietary restrictions, certain clothes, taboos, activites fro maintaining mental health, and use of silence, prayer, or medication
88
Nursing Interventions - Providing Comfort and Cold: What is used as a first measure after birth to relieve perineal comfort?
An ice pack. Minimizes edema, reduces inflammation, decreased capillary permeability and reduces nerve conduction to the site
89
Nursing Interventions - Providing Comfort and Cold: How long is ice pack applied for?
Intermittently for 20 minutes and removed for 10 minutes.
90
Nursing Interventions - Providing Comfort and Heat: What is a peribottle?
Plastic sqeeze bottle filled with warm tap water that is sprayed oveer the perineal area after each voiding and before applying new pad
91
Nursing Interventions - Providing Comfort and Heat: What may be prescribed after 24 hours?
A sitz bath with room temperature water to reduce local swelling and promote comfort for an episiotomy, perineal trauma, or hemorrhoids
92
Nursing Interventions - Providing Comfort and Heat: How do you avoid accidents when attempting to take a Sitz Bath?
Stay in womans room, ensure that emergency call light is readily available, and being available during early period to ensure safety
93
Nursing Interventions - Topical Preparations: What does Benzocaine Topical do?
Numb the perineal area and are used after cleaning the area with water via the peribottle or sitz bath.
94
Nursing Interventions - Topical Preparations: What can be used to reduce Hemorrhoids?
Ice packs, ice sitz baths, and application of cool witch hazel pads.
95
Nursing Interventions - Topical Preparations: What do witch hazel pads do?
Cool the area , help relieve swelling, and minimize itching
96
Nursing Interventions - Topical Preparations: Pharmacologic methods to reduce hemorrhoid pain?
Local anesthetics (dibucaine) or steroids (hydrocortisone acetate)
97
Nursing Interventions - Topical Preparations: What can be used to treat nipple pain?
Beeswax, glycerin-based products, petrolatum, lanolin, and hydrogel products
98
Nursing Interventions - Analgesics: What may be prescibed to treat pain?
Acetaminophen and NSAIDS like Ibuprofen
For mod-to-severe pain, codeine or oxycodone with aspirin may be prescribed.
99
Nursing Interventions - Assisting with Elimination: How is the bladder in the period after labor?
Edematous, hypotonic, and congested. Bladder distention, incomplete emptying, and inability to void are common.
100
Nursing Interventions - Assisting with Elimination: Why is a full bladder problematic?
Interferes with uterine contractions and may lead to hemorrhage because uterus displaced .
101
Nursing Interventions - Assisting with Elimination: How to help woman if she cannot void?
Pour warm water over perineal area, hearing the sound of running water, blowing bubble through a straw, taking a warm shower, drinking fluids, and providing her with privacy.
102
Nursing Interventions - Assisting with Elimination: When will catheterization be encouraged?
After voiding does not occur within 4-6 hours after givign birth.
103
Nursing Interventions - Assisting with Elimination: What predisposes woman to constipation?
Decrease bowel motility, high iron content in prenatal viamins, postpartum fluid loss, and adverse efects of pain meds
104
Nursing Interventions - Assisting with Elimination: What measures can be taken to assist with BM's?
Ambulating, and increasing fluid/fiber intake. A stool softener may also be prescribed.
105
Nursing Interventions - Assisting with Elimination: Nutritional instructions for BM?
Increasing fruits and vegetables, drinking plenty of fluids to keep stool soft, drinking small amount of prune juice, and eating high-fiber foods
106
Nursing Interventions - Promoting Activity, Rest, and Exercise: What recommendations will you give to get rest?
Nap when infant sleeping.
Reduce participation in outside activites
Determines infant sleep-wake cycles
Ask other family members to provide infant care during the night periodically
107
Nursing Interventions - Promoting Activity, Rest, and Exercise: Benefits of exerccising postpartum?
Lose pregnancy weight, reduce risk of obesity, increased energly level, speeds return to prepregnant size/shape
108
Nursing Interventions - Promoting Activity, Rest, and Exercise: Women who are unable to return to healthy weight by 6 months postpartum are at a increased risk for
chronic diseases like metabolic syndrome, obesity, and cardiovascular disease
109
Nursing Interventions - Promoting Activity, Rest, and Exercise: When can jogging stroller be used?
When infant is 6-12 months (can hold their head up)
110
Nursing Interventions - Promoting Activity, Rest, and Exercise: Exercises should begin with which type?
Pelvic floor exercises on first postpartum day, and progressing to abdominal, buttock, and thigh-toning exercises.
111
Nursing Interventions - Promoting Activity, Rest, and Exercise: Recommended exercises for first few weeks postpartum include?
Abdominal breathing, head lifts, modified sit-ups, and double knee roll
112
Nursing Interventions - Preventing Stress Incontinence: How can this be prevented?
By offering pelvic floor muscle exercises, and prepares the woman for any activity that causes an increase in intra-abdominal pressure
113
Nursing Interventions - Preventing Stress Incontinence: Suggestions to prevent this?
Pelvic floor muscle excersises
Lose weight if necessary
Avoid smoking
Adjust fluid intak e
114
Nursing Interventions - Assisting with Self-Care Measures: What measures can be done for this?
Frequently change perineal pads
Avoid using tamps
Shower once or twice daily using mild soap
Use sitz bath after every BM
Use peribottle filled with warm water.
115
Biggest safety concern postpartum?
Orthostatic Hypotension
116
Nursing Interventions - Ensuring Safety: What safeguards can be made for orthostatic hypotension?
Check BP first before ambulating
Elevate HOB for few mins before ambulating
Have client sit on side of bed
Help client stand up.
ambulate alongside the client
117
Nursing Interventions - Counseling about Sexuality and Contraception: What can sex resume?
Once bright-red bleeding has stopped and perineum is healed from an episiotomy (3-6 weeks after).
118
Nursing Interventions - Counseling about Sexuality and Contraception: What to know about woman and combined hormonal contraceptives?
Don't use during frst 21 days because of high risk for VTE.
During days 21-42, wirhout risk of VTE, can initiate estrogen-containing contraceptives
119
Nursing Interventions - Counseling about Sexuality and Contraception: When can normal combined hormal contraceptives be used?
After 42 days
120
Nursing Interventions - Promoting Maternal Nutrition: Nutrition recommendations include what?
Eat wide variety of foods high in nutrient density
Eat meals that require little or no prep
Avoid high-fat foods
Drink plenty of fludis daily
121
Nursing Interventions - Nutrition for Breast-Feeding Mother: What nutrient should women include in their diet?
Foods that contain iodine. Necessary to produce thyroid hormone, which helps brain development
122
Nursing Interventions - Nutrition for Breast-Feeding Mother: Calorie changes?
+500 calories for first and second 6 months of lactation
123
Nursing Interventions - Nutrition for Breast-Feeding Mother: Protein changes?
+20 g/day, adding 2 cups of skim milk
124
Nursing Interventions - Nutrition for Breast-Feeding Mother: Calcium changes?
+400 mg daily, consumption of four or more servings of milk
125
Nursing Interventions - Nutrition for Breast-Feeding Mother: Iodine changes?
290 mcg daily, dairy products, seafood, iodized salt
126
Nursing Interventions - Nutrition for Breast-Feeding Mother: Fluid changes?
+2 to 3 quarts of fluids daily (milk, juice water), no soda
127
Nursing Interventions - Women Who Should Not Breast-Feed: What drugs would enter breast milk and harm infant?
Antithyroid drugs, antineoplastic drugs, alcohol, herpes infection on breasts or street drugs
128
Nursing Interventions - Providing Assisting with Breast Feeding: What benefits have kangaroo care been reported?
Physiologic (thermoregulation, cardiorespiratory stability)
Behavioral (sleep, breast-feeding duration)
domains (effective way to relieve procedural pain)
129
Nursing Interventions - Providing Assisting with Breast Feeding: What 10 steps should be taken to provide an optimal environment for the promotion, protection, and suport of breast feeding?
Have well written breast feeding policy
Educate all stuff on policy
Inform mom of benefits
Show how to feed
Give no food to newborns
Demonstate to mom how to feed
Breast feed on demand
Allow no pacificers to be given
Establish breast feeding support group
Practice rooming in 24 hours daily
130
Nursing Interventions - Providing Assisting with Breast Feeding: What problem do women who are obese have with hormones?
Problem with prolactin response to sucking, resulting in decrease in milk production
131
Nursing Interventions - Providing Assisting with Breast Feeding: What is the sandwich technique?
Mother is taught to grasp her breast by making a "C" with her thumb or index finger. Thumb stabilzies top of breast while remaining four fingers support breast from below
132
Nursing Interventions - Providing Assisting with Bottle Feeding: What are commercial formulas classified as?
Cow milk-based, soy protein-based, or specialized or therapeutic formulas for those with protein allergies.
133
Nursing Interventions - Providing Assisting with Bottle Feeding: What forms can commercial formulas be used?
Powdered, condensed liquid, ready to use, and prepackaged
134
Nursing Interventions - Providing Assisting with Bottle Feeding: How many calories needed per day?
About 650 cal/day. Means 2-4 oz to feel satisfied at each feeding.
135
Nursing Interventions - Providing Assisting with Bottle Feeding: How many feedings needed per day until age 4 months?
About six feedings per day
136
Nursing Interventions - Providing Assisting with Bottle Feeding: Instructions to give mother about bottle feeding?
Wash hands with soap, and make feeding relaxing time
Powder formula best with room temp water
Do not microwave formula
Never prop the bottle against newborn
137
Nursing Interventions - Txing About Breast Care: How long should woman wear bra for?
24 hours a day to support enlarged breasts
138
Nursing Interventions - Assessing Breasts: Daily assessments include what?
The milk supply, condiitons of nipples, and success of breast feeding
139
Nursing Interventions - Alleviating Breast Engorgement: When does this occur?
During first week postpartum.
140
Nursing Interventions - Alleviating Breast Engorgement in Breast-Feeding Women: Encourage frequent feedings, how often?
At least every 2-3 hours. using manual expression just before feeding to soften the breast.
141
Nursing Interventions - Alleviating Breast Engorgement And Suppressing Lactation in Bottle Fed: Tell women that engorgement will disappear as what happens?
As increasing estrogen levels suppress milk formation
142
Nursing Interventions - Alleviating Breast Engorgement And Suppressing Lactation in Bottle Fed: What could be done to alleviate engorgement?
Ice packs, wear snug supporitive bra 24 hours a day, and take acetaminophen. Avoid stimulation to the brasts such as warm shorts or massages breass
143
Nursing Interventions - Txing About Postpartum Blues: What may the woman report feelings of?
Emotional lability such as crying 1 minute and laughing the next
144
Nursing Interventions - Txing About Postpartum Blues: What has this been defined as?
Brief, benign and without clinical significance but several studies have proposed a link between blues and subsequent depression in 6 months following birth
145
Nursing Interventions - Txing About Postpartum Blues: Treatment?
Requires no formal treatment other than suport and reassurance because they do not interfere with womans ability to function
146
Nursing Interventions - Preparing for Discharge: How long should they stay before dischagred?
At least 24 hours
147
Nursing Interventions - Preparing for Discharge: Shortened hospital stay may be indicated if what criteria met?
Mother is afebrile and VS within normal range
Lochia is approiate amount
Hgb adn Hct within normal range.
Fundus firm
RhoGAM administerd if needs
Surgical wounds healing
148
Nursing Interventions - Preparing for Discharge and Providing Immunization: What vaccine should you check for?
Rubella.
149
Nursing Interventions - Preparing for Discharge and Providing Immunization: Who should Rubella not be given to?
Those who are immune compromised
150
Nursing Interventions - Preparing for Discharge and Providing Immunization: What should mother avoid after receiving vaccine?
Pregnancy for at least 28 days as it increases risk of teratogenic effects
151
Nursing Interventions - Preparing for Discharge and Providing Immunization: What to do if patient Rh-negative?
check Rh status of newborn. Verify that she has not been sensitized, indirect Coombs test (antibody screen) negative, adn that newborn is Rh positive
Recieve RhoGAm shot.
152
Nursing Interventions - Preparing for Discharge and Providing Immunization: What does the RhoGam shot do?
Prevents initial isoimmunization in Rh negative mothers by destroying fetal erythrocytes in the maternal system before maternal antibodies can develop
153
Nursing Interventions - Preparing for Discharge and Providing Immunization: When is Rho(D) immune globulin usuall fiven?
One at 28 weeks and another at 72 hours after childbirth
154
Nursing Interventions - Ensuring Follow-Up Care: Women who are discharged too early run the risk of what problems?
Uterine subinvolution, discomfort at an episiotomy or cesarean site, infection, fatigue, and maladjustment to their new role.
155
Nursing Interventions - Ensuring Follow-Up Care: When is office visit usually scheduled?
4-6 weeks after childbirth after vaginal birth.
2 Weeks for C-Section
156
Nursing Interventions - Ensuring Follow-Up Care: When are home visits usually made?
About one week after discharge to assess the mother and newborn.
157
Nursing Interventions - Ensuring Follow-Up Care: MAternal assessment during home visit includes what?
General well-being, VS, breast health and care, abdominal and musculoskeletal statuss, voiding status, fundus and lochia status.
158
Nursing Interventions - Ensuring Follow-Up Care: Infant assessment during home visit includes what?
Physical exam, general appearance, VS, hoem safety check, and child development status
159
When assessing a postpartum woman, which of the following would lead the nurse to suspect postpartum blues?
Panic attacks and suicidal thoughts
Anger toward self and infant
Periodic crying and insomnia
Obsessive thoughts and hallucinations
Periodic crying and insomnia
160
Which of these activities would best help the postpartum nurse to provide culturally sensitive care for the childbearing family?
Taking a transcultural course
Caring for only families of his or her cultural origin
Teaching Western beliefs to culturally diverse families
Educating himself or herself about diverse cultural practice
Educating himself or herself about diverse cultural practice
161
Which of the following suggestions would be most appropriate to include in the teaching plan for a postpartum woman who needs to lose weight?
Increase fluid intake and acid-producing foods in her diet.
Avoid empty-calorie foods, breast-feed, increase exercise.
Start a high-protein, low carbohydrate diet and restrict fluids.
Eat no snacks or carbohydrates after dinner.
Avoid empty-calorie foods, breast-feed, increase exercise.
162
After teaching a group of breast-feeding women about nutritional needs, the nurse determines that the teaching was successful when the women state that they need to increase their intake of which nutrients?
Carbohydrates and fiber
Fats and vitamins
Calories and protein
Iron-rich foods and minerals
Calories and proteins
163
Which of the following would lead the nurse to suspect that a postpartum woman was developing a complication?
Fatigue and irritability
Perineal discomfort and pink discharge
Pulse rate of 60 bpm
Swollen, tender, hot area on breast
Sweollen, tender, hot area on breast
164
Which of the following would the nurse assess as indicating positive bonding between the parents and their newborn?
Holding the infant close to the body
Having visitors hold the infant
Buying expensive infant clothes
Requesting that the nurses care for the infant
Holding the infant close to the body
165
Which activity would the nurse include in the teaching plan for parents with a newborn and an older child to reduce sibling rivalry when the newborn is brought home?
Punishing the older child for bedwetting behavior
Sending the sibling to the grandparents’ house
Planning a daily “special time” for the older sibling
Allowing the sibling to share a room with the infant
Planning a daily “special time” for the older sibling
166
The major purpose of the first postpartum homecare visit is to:
Identify complications that require interventions
Obtain a blood specimen for PKU testing
Complete the official birth certificate
Support the new parents in their parenting roles
Identify complications that require interventions
167
The nurse is instructing the postpartum client who plans to bottle-feed her newborn about measures to prevent breast engorgement when she is discharged. Which of the following measures should the nurse include in the teaching plan?
Decreasing her fluid intake for the first week at home
Wearing a tight-fitting supportive bra 24 hours daily
Take a diuretic to release the extra fluid in the breasts
Manually express the milk that is accumulating
Wearing a tight-fitting supportive bra 24 hours daily
168
A new mother was brought to the postpartum unit who gave birth 12 hours ago. Because this is her first child, which of the following goals by the nurse is most appropriate?
Early discharge for the mother and newborn
Rapid transition into her role of being a parent/caretaker
Minimal need for expression of her feelings now
Effective education of both parents before discharge
Effective education of both parents before discharge
