Chapter 34 The Postpartum Family: Needs and Care My Nursing Test Banks

Olds Maternal-Newborn Nursing and Womens Health, 10e (Davidson)

Chapter 34 The Postpartum Family: Needs and Care

1) The nurse assesses the postpartum client to have moderate lochia rubra with clots. Which nursing intervention would be appropriate?

1. Assess fundus and bladder status.

2. Catheterize the client.

3. Administer Methergine IM per order.

4. Contact the physician immediately.

Answer: 1

Explanation: 1. The amount, consistency, color, and odor of the lochia are monitored on an ongoing basis. Increased bleeding is most often related to uterine atony and responds to fundal massage, expression of any clots, and emptying the bladder.

Page Ref: 891

Cognitive Level: Applying

Client Need/Sub: Physiological Integrity: Reduction of Risk Potential

Standards: QSEN Competencies: V. B. 1. Demonstrate effective use of technology and standardized practices that support safety and quality. | AACN Essentials Competencies: IX. 7. 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: Implementation

Learning Outcome: 2 Discuss appropriate nursing interventions to promote maternal comfort and well-being.

MNL LO: 5.1.1 Examine the components of a postpartum assessment.

2) The nurse is providing education to the new family. Which question by the nurse 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?

Answer: 3

Explanation: 3. This is an open-ended question about an important physiologic issue. A discussion that includes both partners can facilitate an open dialog between them and can provide an opportunity for questions and answers.

Page Ref: 887

Cognitive Level: Applying

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

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Learning Outcome: 4 Identify patient teaching topics for promoting postpartum family wellness.

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

3) The postpartum nurse provides anticipatory guidance for the new mother as well as teaching on self-care and infant care before discharge. Which topics should be included?

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

Select all that apply.

1. Role changes brought on by the addition to the family unit

2. The realities of having a new baby, and how it affects previous lifestyle

3. Potential complications such as infant colic and postpartum issues

4. Sexuality and contraception

5. Toilet-training and preschool options

Answer: 1, 2, 3, 4

Explanation: 1. It is helpful for the nurse to advise parents that they may experience feelings of uncertainty as they grow into the parental role and alter their family processes to accommodate the new family member.

2. Guidance is essential in assisting the family to cope with role changes and the realities of a new baby.

3. Guidance is essential in assisting the family to cope with potential complications such as infant colic and postpartum health issues.

4. It is important for the nurse to present information about changes that may affect sexual activity and to discuss the importance of contraception during the early postpartum period.

Page Ref: 887, 888

Cognitive Level: Applying

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

Learning Outcome: 1 Delineate nursing responsibilities for patient teaching during the early postpartum period.

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

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4) A client is preparing to take a sitz bath for the first time. What will the nurse do?

1. Allow the client privacy during the sitz bath.

2. Place a call bell well within reach and check on the client frequently.

3. Discourage the client from taking a sitz bath.

4. Check on the client after the sitz bath.

Answer: 2

Explanation: 2. The nurse should explain the purpose and use of the sitz bath, anticipated effects, benefits, possible problems, and safety measures to prevent slipping or an injury from hot water. A call bell would be a safety measure.

Page Ref: 895

Cognitive Level: Understanding

Client Need/Sub: Safe and Effective Care Environment: Safety and Infection Control

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: 2 Discuss appropriate nursing interventions to promote maternal comfort and well-being.

MNL LO: 5.2.1 Determine nursing interventions that promote maternal comfort during the postpartum period.

5) A postpartum client has just received a rubella vaccination. The client demonstrates understanding of the teaching associated with administration of this vaccine when she states which of the following?

1. I will need another vaccination in 3 months.

2. I must avoid getting pregnant for 1 month.

3. This will prevent me from getting chickenpox.

4. This will protect my newborn from getting the measles.

Answer: 2

Explanation: 2. The client must avoid pregnancy for at least 1 month after receiving the rubella vaccine.

Page Ref: 898

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn 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 Delineate nursing responsibilities for patient teaching during the early postpartum period.

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

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6) The incidence of complications and discomforts in the first year postpartum is common and women may experience which of the following?

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

Select all that apply.

1. Pain

2. Excess energy

3. Urinary incontinence

4. Changes in mental health status

5. Sleep deprivation

Answer: 1, 3, 4, 5

Explanation: 1. Pain can be a discomfort in the first year postpartum.

3. Urinary incontinence can be a complication in the first year postpartum.

4. Changes in mental health status can be a complication in the first year postpartum.

5. Sleep deprivation can be a complication in the first year postpartum.

Page Ref: 888

Cognitive Level: Applying

Client Need/Sub: Physiological Integrity: Reduction of Risk Potential

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: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 2 Discuss appropriate nursing interventions to promote maternal comfort and well-being.

MNL LO: 5.3.1 Apply the nursing process to the care of women with postpartum complications.

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7) A variety of drugs are used either alone or in combination to provide relief of postpartum pain. Which of the following would be an option for pain relief?

1. Nonsteroidal anti-inflammatory agents

2. Proquad

3. Methergine

4. Intravenous oxytocin

Answer: 1

Explanation: 1. A variety of drugs are used alone or in combination to provide relief of postpartum pain. An option would include nonsteroidal anti-inflammatory agents such as ibuprofen and ketorolac.

Page Ref: 898

Cognitive Level: Applying

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

Standards: QSEN Competencies: I. A. 3. Demonstrate comprehensive understanding of the concepts of pain and suffering, including physiologic models of pain and comfort. | AACN Essentials Competencies: IX. 5. Deliver compassionate, patient-centered, evidence-based care that respects patient and family preferences. | NLN Competencies: Quality and Safety: Use technologies that contribute to safety. | Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 2 Discuss appropriate nursing interventions to promote maternal comfort and well-being.

MNL LO: 5.2.1 Determine nursing interventions that promote maternal comfort during the postpartum period.

8) On the 3rd day postpartum, a client who is not breastfeeding experiences engorgement. To relieve her discomfort, the nurse should encourage the client to do which of the following?

1. Remove her bra

2. Apply heat to the breasts

3. Apply cold packs to the breasts

4. Use a breast pump to release the milk

Answer: 3

Explanation: 3. Applying cold packs to the breasts relieves discomfort and helps suppress lactation.

Page Ref: 896

Cognitive Level: Applying

Client Need/Sub: Physiological Integrity: Basic Care and Comfort

Standards: QSEN Competencies: I. B. 7. Initiate effective treatments to relieve pain and suffering in light of patient values, preferences, and expressed needs. | 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: Use technologies that contribute to safety. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 2 Discuss appropriate nursing interventions to promote maternal comfort and well-being.

MNL LO: 5.2.1 Determine nursing interventions that promote maternal comfort during the postpartum period.

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9) The nurse is caring for a client who had a cesarean birth 4 hours ago. Which interventions would the nurse implement at this time?

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

Select all that apply.

1. Administer analgesics as needed.

2. Encourage the client to ambulate to the bathroom to void.

3. Encourage leg exercises every 2 hours.

4. Encourage the client to cough and deep-breathe every 2 to 4 hours.

5. Encourage the use of breathing, relaxation, and distraction.

Answer: 1, 3, 4, 5

Explanation: 1. The nurse continues to assess the womans pain level and provide relief measures as needed.

3. Within the first 12 hours postoperatively, unless medically contraindicated, the woman should be assisted to dangle her legs on the side of the bed.

4. The woman is encouraged to cough and breathe deeply and to use incentive spirometry every 2 to 4 hours while awake for the first few days following cesarean birth.

5. The nurse should encourage the use of breathing, relaxation, and distraction techniques.

Page Ref: 905

Cognitive Level: Applying

Client Need/Sub: Physiological Integrity: Reduction of Risk Potential

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: Quality and Safety: Use technologies that contribute to safety. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 5 Compare the nursing needs of a woman who experienced a cesarean birth with the needs of a woman who gave birth vaginally.

MNL LO: 5.2.4 Determine the nursing care specific to a woman who has undergone a cesarean birth.

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10) A client who delivered 2 hours ago tells the nurse that she is exhausted and feels guilty because her friends told her how euphoric they felt after giving birth. How should the nurse respond?

1. Everyone is different, and both responses are normal.

2. Most mothers do feel euphoria; I dont know why you dont.

3. Its good for me to know that because it might indicate a problem.

4. Let me bring your baby to the nursery so that you can rest.

Answer: 1

Explanation: 1. Following birth, some women feel exhausted and in need of rest. Other women are euphoric and full of psychic energy, ready to retell their experience of birth repeatedly.

Page Ref: 900

Cognitive Level: Analyzing

Client Need/Sub: Psychosocial Integrity: Therapeutic Communication

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: 1 Delineate nursing responsibilities for patient teaching during the early postpartum period.

MNL LO: 5.1.3 Explore maternal postpartum psychological adaptation.

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11) The breastfeeding client asks the nurse about appropriate contraception. What is the nurses best response?

1. Breastfeeding has many effects on sexual intercourse.

2. IUDs are easy to use and easy to insert prior to sexual intercourse.

3. Its possible to get pregnant before your menstrual period returns. Lets talk about some different options for contraception.

4. Breastfeeding hampers ovulation, so no contraception is needed.

Answer: 3

Explanation: 3. The nurse should discuss the importance of contraception during the early postpartum period and provide information on the advantages and disadvantages of different methods, including special considerations for breastfeeding mothers. The womans body needs adequate time to heal and recover from the stress of pregnancy and childbirth.

Page Ref: 903

Cognitive Level: Applying

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

Learning Outcome: 1 Delineate nursing responsibilities for patient teaching during the early postpartum period.

MNL LO: 5.2.3 Determine nursing interventions that promote health maintenance in the postpartum client.

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12) The postpartum client expresses concern about getting back to her prepregnant shape, and asks the nurse when she will be able to run again. Which statement by the client indicates that teaching was effective?

1. I can start running in 2 weeks, and can breastfeed as soon as I am done.

2. I should see how my energy level is at home, and increase my activity slowly.

3. Running is not recommended for breastfeeding women.

4. If I am getting 8 hours of sleep per day, I can start running.

Answer: 2

Explanation: 2. Women should be encouraged to limit the number of activities to prevent excessive fatigue, increase in lochia, and negative psychologic reactions, such as feeling overwhelmed. A regular exercise program including vigorous activities such as running, weight lifting, or competitive sports can usually be initiated after the 6-week postpartum examination or when approved by the clients physician/CNM.

Page Ref: 900, 901

Cognitive Level: Applying

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

Learning Outcome: 3 Describe the nurses role in promoting maternal rest and helping the mother to gradually resume an appropriate level of activity.

MNL LO: 5.2.2 Apply strategies to promote maternal well-being after birth including nutrition, rest, and activity.

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13) The nurse is teaching a new mother about ways to manage fatigue after she returns home. Which instructions should the nurse include?

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

Select all that apply.

1. Take frequent rest periods.

2. Nap when the newborn is sleeping.

3. Avoid overdoing housework and unnecessary chores. Do not clean when infant is sleeping.

4. Avoid having others come to the house to do housework and interfere with rest.

5. Utilize friends and family to provide help and support, such as cooking a meal.

Answer: 1, 2, 3, 5

Explanation: 1. Adequate rest is essential to a smooth postpartum transition. The nurse can encourage rest by organizing activities to avoid frequent interruptions for the woman.

2. Mothers should be counseled to sleep when the baby sleeps.

3. Mothers should be counseled to delegate or postpone unnecessary chores and activities and to sleep when the baby sleeps.

5. Mothers should be counseled to utilize family and friends for support.

Page Ref: 900

Cognitive Level: Applying

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

Learning Outcome: 3 Describe the nurses role in promoting maternal rest and helping the mother to gradually resume an appropriate level of activity.

MNL LO: 5.2.2 Apply strategies to promote maternal well-being after birth including nutrition, rest, and activity.

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14) The hospital is developing a new maternity unit. What aspects should be included in the planning of the new unit to best promote family wellness?

1. Normal newborn nursery centrally located to all client rooms

2. A kitchen with a refrigerator stocked with juice and sandwiches

3. Small, cozy rooms with a client bed and rocking chair

4. A nursing care model based on providing couplet care

Answer: 4

Explanation: 4. Couplet care, which is care of both the mother and her baby, is an important part of the family-centered care approach, in which the infant remains at the mothers bedside and both are cared for by the same nurse.

Page Ref: 901

Cognitive Level: Analyzing

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. 12. Create a safe environment that results in high quality patient outcomes. | NLN Competencies: Teamwork: Contributions of other individuals and groups in helping patient/family achieve health goals. | Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 4 Identify patient teaching topics for promoting postpartum family wellness.

MNL LO: 5.2.3 Determine nursing interventions that promote health maintenance in the postpartum client.

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15) Which statement by a nursing student preparing to care for a postpartum lesbian mother would indicate the need for further teaching?

1. I cant let the client know Ive never worked with lesbian mothers.

2. I will have to adjust some of my discharge instruction for this mother.

3. I dont need to include the partner when I provide care and instruction.

4. Discharge teaching is exactly the same for lesbian mothers as for all others.

Answer: 2

Explanation: 2. The nurse should be aware that standardized postpartum instructions, particularly those related to intercourse and contraception might need to be individualized and amended.

Page Ref: 909

Cognitive Level: Analyzing

Client Need/Sub: Safe and Effective Care Environment: Safety and Infection Control

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: 8 Describe possible approaches to sensitive, holistic nursing care for targeted populations of childbearing patients: lesbian birth mothers and co-mothers, women who are developmentally or intellectually challenged, women who have experienced abuse, and women relinquishing their newborns.

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

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16) A new grandmother comments that when her children were born, they stayed in the nursery. The grandmother asks the nurse why her daughters baby stays mostly in the room instead of the nursery. How should the nurse respond?

1. Babies like to be with their mothers more than they like to be in the nursery.

2. Contact between parents and babies increases attachment.

3. Budget cuts have decreased the number of nurses in the nursery.

4. Why do you ask? Do you have concerns about your daughters parenting?

Answer: 2

Explanation: 2. In a mother-baby unit, the newborns crib is placed near the mothers bed, where she can see her baby easily; this is conducive to an on-demand feeding schedule for both breastfeeding and formula-feeding infants.

Page Ref: 901

Cognitive Level: Applying

Client Need/Sub: Psychosocial Integrity: Family Dynamics

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: 2 Discuss appropriate nursing interventions to promote maternal comfort and well-being.

MNL LO: 5.1.4 Contrast newborn attachment and bonding behaviors and their effect on familial adaptation.

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17) What maternity unit policies promote postpartal family wellness and shared parenting?

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

Select all that apply.

1. Mother-baby care or couplet care on the postpartum unit

2. Skin-to-skin contact between the mother and baby and the father and baby

3. Newborn kept in the nursery to allow mother to rest between feedings

4. On-demand feeding schedule for both breastfed and bottle-fed infants

5. Limited visiting hours for the father so that the mother can sleep as needed

Answer: 1, 2, 4

Explanation: 1. Mother-baby care is an important part of the family-centered care approach.

2. The nurse should encourage skin-to-skin contact between mother (or father) and baby to promote breastfeeding and bonding.

4. The mother-baby unit is conducive to an on-demand feeding schedule for both breastfeeding and formula-feeding infants.

Page Ref: 901

Cognitive Level: Applying

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

Standards: QSEN Competencies: I. A. 4. Examine how the safety, quality, and cost effectiveness of health care can be improved through the active involvement of patients and families. | AACN Essentials Competencies: VII. 10. Collaborate with others to develop an intervention plan that takes into account determinants of health, available resources, and the range of activities that contribute to health and prevention of illness, injury, disability, and premature death. | NLN Competencies: Teamwork; System barriers and facilitators of effective team functioning; strategies for improving systems to support team functioning. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 4 Identify patient teaching topics for promoting postpartum family wellness.

MNL LO: 5.1.4 Contrast newborn attachment and bonding behaviors and their effect on familial adaptation.

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18) What information should the nurse include when teaching the postpartal client and partner about resumption of sexual activity?

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

Select all that apply.

1. Couples should be encouraged to abstain from intercourse until the episiotomy is healed and the lochial flow has stopped.

2. Postpartum women often experience vaginal dryness, and should be encouraged to use some kind of lubrication initially during intercourse.

3. Breastfeeding the newborn after intercourse can reduce the chance of milk spouting from the nipples.

4. Maternal changes in libido are usually indicative of psychological depression.

5. Maternal fatigue is often a significant factor limiting the resumption of sexual intercourse.

Answer: 1, 2, 5

Explanation: 1. Currently, the couple is advised to abstain from intercourse until the episiotomy is healed and the lochia has stopped.

2. Because postpartum women often experience vaginal dryness due to hormonal changes, the use of a water-based lubrication, such as K-Y jelly or Astroglide, may initially be necessary during intercourse.

5. Maternal fatigue is often a significant factor limiting the resumption of sexual intercourse. While interest and desire vary, most couples resume sexual activity within 3 months.

Page Ref: 902

Cognitive Level: Applying

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

Learning Outcome: 4 Identify patient teaching topics for promoting postpartum family wellness.

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

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19) What is the advantage of a client using a patient-controlled analgesia (PCA) following a cesarean birth?

1. The client receives a bolus of the analgesia when pressing the button.

2. The client experiences pain relief within 30 minutes.

3. The client feels a greater sense of control, and is less dependent on the nursing staff.

4. The client can deliver as many doses of the medication as needed.

Answer: 3

Explanation: 3. Using a special intravenous (IV) pump system, the woman presses a button to self-administer small doses of the medication as needed. For safety, the pump is preset with a time lockout so that the pump cannot deliver another dose until a specified time has elapsed. Women using PCA feel less anxious and have a greater sense of control with less dependence on the nursing staff.

Page Ref: 905

Cognitive Level: Applying

Client Need/Sub: Physiological Integrity: Pharmacological and Parenteral Therapies

Standards: QSEN Competencies: I. C. 9. Recognize that patient expectations influence outcomes in management of pain or suffering. | AACN Essentials Competencies: IX. 5. Deliver compassionate, patient-centered, evidence-based care that respects patient and family preferences. | NLN Competencies: Relationship-Centered Care: Promote and accept the patients emotions; accept and respond to distress in patient and self; facilitate hope, trust, and faith. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 5 Compare the nursing needs of a woman who experienced a cesarean birth with the needs of a woman who gave birth vaginally.

MNL LO: 5.2.4 Determine the nursing care specific to a woman who has undergone a cesarean birth.

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20) The client having her second child is scheduled for a cesarean birth because the baby is in a breech presentation. The client states, Im wondering what will be different this time compared with my first birth, which was vaginal. What response is best?

1. Well take good care of you and your baby. Youll be home before you know it.

2. Youll be wearing a sequential compression device until you start walking.

3. You will have a lot of pain, but there are medications that we give when it gets really bad.

4. You wont be able to nurse until the baby is 12 hours old, because of your epidural.

Answer: 2

Explanation: 2. The use of sequential compression devices (SCDs) and early ambulation are essential to the prevention of deep vein thrombosis, especially if the client had a cesarean birth.

Page Ref: 905

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: Implementation

Learning Outcome: 5 Compare the nursing needs of a woman who experienced a cesarean birth with the needs of a woman who gave birth vaginally.

MNL LO: 5.2.4 Determine the nursing care specific to a woman who has undergone a cesarean birth.

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21) The nurse is caring for a client who delivered by cesarean birth. The client received a general anesthetic. To prevent or minimize abdominal distention, which of the following would the nurse encourage?

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

Select all that apply.

1. Increased intake of cold beverages

2. Leg exercises every 2 hours

3. Abdominal tightening

4. Ambulation

5. Using a straw when drinking fluids

Answer: 2, 3, 4

Explanation: 2. Immobility increases the risk of abdominal distention and discomfort. Leg exercises serve to prevent or minimize abdominal distention in a surgical client who received a general anesthetic.

3. Abdominal tightening serves to prevent or minimize abdominal distention in a surgical client who received a general anesthetic.

4. Early ambulation prevents abdominal distention that can occur with excess accumulation of gas in the intestines.

Page Ref: 905

Cognitive Level: Applying

Client Need/Sub: Safe and Effective Care Environment: Management of 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: Quality and Safety: Use technologies that contribute to safety. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 5 Compare the nursing needs of a woman who experienced a cesarean birth with the needs of a woman who gave birth vaginally.

MNL LO: 5.2.4 Determine the nursing care specific to a woman who has undergone a cesarean birth.

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22) A multiparous client delivered her first child vaginally 2 years ago, and delivered an infant by cesarean yesterday due to breech presentation. Which statement would the nurse expect the client to make?

1. I cant believe how much more tired I was with the first baby.

2. Im having significantly more pain this time than with my last birth.

3. It is disappointing that I cant breastfeed because of the cesarean.

4. Getting in and out of bed feels more comfortable than last time.

Answer: 2

Explanation: 2. Women with cesarean births have special needs: increased need for rest and sleep; incisional care; self-care; and relief of pain and discomfort.

Page Ref: 906

Cognitive Level: Understanding

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

Standards: QSEN Competencies: I. A. 3. Demonstrate comprehensive understanding of the concepts of pain and suffering, including physiologic models of pain and comfort. | AACN Essentials Competencies: IX. 1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | NLN Competencies: Relationship-Centered Care: Promote and accept the patients emotions; accept and respond to distress in patient and self; facilitate hope, trust, and faith. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 5 Compare the nursing needs of a woman who experienced a cesarean birth with the needs of a woman who gave birth vaginally.

MNL LO: 5.2.4 Determine the nursing care specific to a woman who has undergone a cesarean birth.

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23) When caring for a new mother after cesarean birth, what complications would the nurse anticipate?

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

Select all that apply.

1. Back pain

2. Pulmonary infection

3. Deep vein thrombosis

4. Pulmonary embolism

5. Perineal edema

Answer: 2, 3, 4

Explanation: 2. Immobility after delivery increases the risk of pulmonary infection.

3. Immobility after delivery increases the risk of deep vein thrombosis.

4. Immobility after delivery increases the risk of pulmonary embolism.

Page Ref: 905

Cognitive Level: Applying

Client Need/Sub: Physiological Integrity: Physiological Adaptation

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: Planning

Learning Outcome: 5 Compare the nursing needs of a woman who experienced a cesarean birth with the needs of a woman who gave birth vaginally.

MNL LO: 5.2.4 Determine the nursing care specific to a woman who has undergone a cesarean birth.

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24) The nurse is supervising a student nurse who is working with a 14-year-old client who delivered her first child yesterday. Which statement indicates that the nursing student understands the particular needs of an adolescent client?

1. This client will need less teaching, because she will have gotten the right information in school.

2. Because of her age, this client will require less frequent fundal checks to assess for postpartal hemorrhage.

3. Because of her age, this client will probably need extra teaching about the terminology for her anatomy.

4. This client will need to have her grandmother provide day care and help raise the baby.

Answer: 3

Explanation: 3. Some adolescents may not have a working knowledge of their own anatomy and physiology or the related terminology, and they may require special assistance with postpartum hygiene and care.

Page Ref: 908

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: 7 Summarize the nursing needs of the childbearing adolescent during the postpartum period.

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

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25) The nurse is caring for a 15-year-old client who gave birth to her first child yesterday. What action is the best indicator that the nurse understands the parenting adolescent?

1. The clients mother is included in all discussions and demonstrations.

2. The father of the baby is encouraged to change a diaper and give a bottle.

3. The nurse explains the characteristics and cues of the baby when assessing him.

4. A discussion on contraceptive methods is the first topic of teaching.

Answer: 3

Explanation: 3. A newborn physical examination performed at the bedside gives the parent(s) immediate feedback about the newborns health and demonstrates methods of handling an infant. This action helps the client learn about her baby as an individual and facilitates maternal-infant attachment. This is the highest priority.

Page Ref: 908

Cognitive Level: Applying

Client Need/Sub: Psychosocial Integrity: Therapeutic Communication

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: Planning

Learning Outcome: 7 Summarize the nursing needs of the childbearing adolescent during the postpartum period.

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

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26) The nurse is planning care for three newly delivered adolescents and their babies. What should the nurse keep in mind when planning their care?

1. The babys father should be encouraged to participate when the nurse is providing instruction.

2. A class for all the adolescents would decrease teaching effectiveness.

3. The schools that the adolescents attend will provide teaching on bathing.

4. Adolescents understand the danger signals in newborns.

Answer: 1

Explanation: 1. The father, if he is involved, should be included as much as possible. If classes are offered in the hospital during the postpartum stay, the adolescent mother and father should be strongly encouraged to attend and participate.

Page Ref: 908

Cognitive Level: Applying

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

Learning Outcome: 7 Summarize the nursing needs of the childbearing adolescent during the postpartum period.

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

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27) The nurse is preparing to receive a newly delivered client. The client is a young single mother who is relinquishing custody of her newborn through an open adoption. What action is most important?

1. Assign the client a room on the GYN surgical floor instead of on the postpartum floor.

2. Prepare to complete teaching in time for discharge at 24 hours post-delivery.

3. Make an effort not to bring up the topic of the baby, and discuss the mothers health instead.

4. Ask the client how much contact she would like with the baby, and whether she wants to feed it.

Answer: 4

Explanation: 4. Assessing the birth mothers preferences by respectfully asking questions and making no assumptions facilitates a more positive experience.

Page Ref: 910

Cognitive Level: Analyzing

Client Need/Sub: Psychosocial Integrity: Grief and Loss

Standards: QSEN Competencies: I. C. 10. Value active partnership with patients or designated surrogates in planning, implementation, and evaluation of care. | AACN Essentials Competencies: IX. 5. Deliver compassionate, patient-centered, evidence-based care that respects patient and family preferences. | NLN Competencies: Relationship-Centered Care: Promote and accept the patients emotions; accept and respond to distress in patient and self; facilitate hope, trust, and faith. | Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 8 Describe possible approaches to sensitive, holistic nursing care for targeted populations of childbearing patients: lesbian birth mothers and co-mothers, women who are developmentally or intellectually challenged, women who have experienced abuse, and women relinquishing their newborns.

MNL LO: 5.2.1 Determine nursing interventions that promote maternal comfort during the postpartum period.

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28) The nurse is caring for a client who plans to relinquish her baby for adoption. The nurse would implement which approach to care?

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

Select all that apply.

1. Encourage the client to see and hold her infant.

2. Encourage the client to express her emotions.

3. Respect any special requests for the birth.

4. Acknowledge the grieving process in the client.

5. Allow access to the infant, if the client requests it.

Answer: 2, 3, 4, 5

Explanation: 2. The mother who decides to relinquish her baby needs emotional support and validation of her loss.

3. The woman should decide whether to see and hold her baby and should have any special requests regarding the birth honored.

4. Perinatal nurses should be aware that relinquishing mothers are at risk for disenfranchised grief, in which they are unable to proceed through the grieving process and come to resolution with the loss. The nurse should acknowledge the womans loss and support her decision.

5. The amount of contact she chooses to have with her newborn should be respected.

Page Ref: 909, 910

Cognitive Level: Applying

Client Need/Sub: Psychosocial Integrity: Grief and Loss

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. 5. Deliver compassionate, patient-centered, evidence-based care that respects patient and family preferences. | NLN Competencies: Relationship-Centered Care: Promote and accept the patients emotions; accept and respond to distress in patient and self; facilitate hope, trust, and faith. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 8 Describe possible approaches to sensitive, holistic nursing care for targeted populations of childbearing patients: lesbian birth mothers and co-mothers, women who are developmentally or intellectually challenged, women who have experienced abuse, and women relinquishing their newborns.

MNL LO: 5.2.1 Determine nursing interventions that promote maternal comfort during the postpartum period.

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29) What possible approaches should the nurse use to provide sensitive, holistic nursing care for the mother who is relinquishing her newborn?

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

Select all that apply.

1. Allow the mother minimal control over the infant.

2. Use active listening strategies to determine the clients needs.

3. Provide only physical care in the early postpartum period.

4. Demonstrate empathy, concern, and compassion.

5. Provide nonjudgmental support and personalized care.

Answer: 2, 4, 5

Explanation: 2. The nurse can support the mother by encouraging her to share her feelings, by listening actively, and by being present for her.

4. The mother who decides to relinquish her baby needs emotional support and validation of her loss. The nurse should demonstrate empathy, concern, and compassion.

5. The nurse needs to acknowledge the significance of the birth mothers experience. The nurse should acknowledge the womans loss and support her decision.

Page Ref: 909, 910

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn 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. 5. Deliver compassionate, patient-centered, evidence-based care that respects patient and family preferences. | NLN Competencies: Relationship-Centered Care: Promote and accept the patients emotions; accept and respond to distress in patient and self; facilitate hope, trust, and faith. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 8 Describe possible approaches to sensitive, holistic nursing care for targeted populations of childbearing patients: lesbian birth mothers and co-mothers, women who are developmentally or intellectually challenged, women who have experienced abuse, and women relinquishing their newborns.

MNL LO: 5.2.1 Determine nursing interventions that promote maternal comfort during the postpartum period.

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30) The nurse is planning discharge teaching for a postpartum woman. What information recommendations should the woman receive before being discharged?

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

Select all that apply.

1. To abstain from sexual intercourse for 6 months

2. To avoid showers for 4 weeks

3. To avoid overexertion

4. To practice postpartum exercises

5. To obtain adequate rest

Answer: 3, 4, 5

Explanation: 3. The client should avoid overexertion.

4. The client should receive information and instruction on postpartum exercises.

5. The client should receive information on the need for adequate rest.

Page Ref: 911

Cognitive Level: Applying

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

Learning Outcome: 4 Identify patient teaching topics for promoting postpartum family wellness.

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

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31) The nurse is preparing a teaching brochure for Spanish-speaking postpartum clients. Which topics are critical for this population?

1. Baby baths and birth certificates

2. Hygiene practices

3. When and how to contact their healthcare provider

4. Pain-relief options in labor and after birth

Answer: 3

Explanation: 3. Knowing how to contact their healthcare provider at all times is critical so that clients receive appropriate advice and care in case of a problem or emergency. Knowing what to watch for and when to call the healthcare provider also facilitates safety. These are the highest priorities.

Page Ref: 890

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: Planning

Learning Outcome: 4 Identify patient teaching topics for promoting postpartum family wellness.

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

32) To actively involve the postpartal client during discharge teaching, the postpartum nurse applies which learning principle?

1. Reprints of magazine articles

2. Classroom lectures

3. Audiotapes

4. Interactive nurse-patient relationships

Answer: 4

Explanation: 4. Effective parent learning requires precise timing of teaching, as well as choice of a teaching method that is effective for the family, such as DVDs and return demonstration. Content on self-care, infant care, and anticipatory guidance is important.

Page Ref: 912

Cognitive Level: Understanding

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

Learning Outcome: 4 Identify patient teaching topics for promoting postpartum family wellness.

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

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33) The nurse is performing discharge teaching for a newly delivered first-time mother and her infant on the 2nd postpartum day. Which statement by the mother indicates that teaching has been successful?

1. Taking baths will help my perineum feel less sore each day.

2. If I develop heavy bleeding, I should take my temperature.

3. My bowel movements should resume in a week.

4. I will go back to the doctor in 4 days for my RhoGAM shot.

Answer: 1

Explanation: 1. A sitz bath or tub bath promotes healing and provides relief from perineal discomfort during the initial weeks following birth.

Page Ref: 894, 895

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn 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: 4 Identify patient teaching topics for promoting postpartum family wellness.

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

34) The nurse is assessing clients after delivery. For which client is early discharge at 24 hours after delivery appropriate?

1. Woman and baby who have had two successful breastfeedings

2. Woman who is bottle-feeding her infant and has not voided since delivery

3. Twins delivered at 35 weeks, bottle-feeding

4. Cesarean birth performed for fetal distress

Answer: 1

Explanation: 1. Early discharge may be advantageous if mother and baby are doing well, help is available for the mother at home, and the family and physician/CNM agree that both clients are healthy and ready for discharge.

Feeding successfully is one of the physiologic needs of the infant and both mother and infant appear to be doing well.

Page Ref: 904

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. 1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | NLN Competencies: Relationship-Centered Care: Factors that contribute to or threaten health. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 9 Delineate the nurses responsibilities related to early postpartum discharge.

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MNL LO: 5.1.1 Examine the components of a postpartum assessment.

35) The nurse is providing postpartum care to an obese client. As part of care for this client, the nurse should do which of the following?

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

Select all that apply.

1. Apply sequential compression devices

2. Have the mother ambulate as early as possible

3. Encourage bottle-feeding over breastfeeding

4. Supervise breastfeeding

5. Instruct the client on signs of infection

Answer: 1, 2, 4, 5

Explanation: 1. The use of sequential compression devices (SCDs) and early ambulation are essential to the prevention of deep vein thrombosis, especially if the client had a cesarean birth.

2. Ambulation should be encouraged as soon as possible to prevent pneumonia.

4. The new mother may need extra supervision and assistance when breastfeeding her baby to ensure newborn safety.

5. The obese client has needs similar to all postpartum client, but she needs special attention to prevent injury, respiratory complications, thromboembolic disease, and infection, for which she is at high risk.

Page Ref: 907

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: Quality and Safety: Use technologies that contribute to safety. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 6 Identify critical physiologic, psychosocial, and safety needs related to the care of obese and morbidly obese postpartum women.

MNL LO: 5.3.1 Apply the nursing process to the care of women with postpartum complications.

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