Petirilli Chapter 22 Nursing Care Of A Postpartal Woman And Family

Front 1

Needed to promote tissue healing?

Back 1

2200 to 2300 kcal, high-protein diet

Front 2

Decreases opportunity for infection and promotes comfort?

Back 2

Sitz bath

Front 3

Tension feeling of breast on day 3 or 4 postpartum?

Back 3

Primary engorgement

Front 4

Increased size of ureters during pregnancy?

Back 4

Hydonephrosis

Front 5

Can be resumed 2 to 3 weeks postpartum?

Back 5

Oral contraception

Front 6

Detects potential for postpartum hemorrhage?

Back 6

Uterine tone assessment

Front 7

Occurs 4 to 6 weeks after delivery?

Back 7

Follow-up examination visit

Front 8

Decreases constipation and urinary retention?

Back 8

Early ambulating

Front 9

Prevents displacement of the uterus and ensures accurate assessment of uterine tone?

Back 9

Empty bladder

Front 10

Facilitates bonding?

Back 10

Immediate maternal-child contact

Front 11

Inflammation of the lining of the blood vessel?

Back 11

Thrombophlebitis

Front 12

At each encounter?

Back 12

Observing mother-child interaction

Front 13

Provide supplementary mild for infant?

Back 13

Mother's temperature is 102 degrees fahrenheight

Front 14

Major danger during the immediate postoperative period?

Back 14

Hemorrhage

Front 15

Urine residual greater than 100mL after catheterization?

Back 15

Urinary retention

Front 16

Infection of the breast?

Back 16

Mastitis

Front 17

1. Mrs. Peters states that her newborn daughter Millie is so thin and has so little hair. The nurse could best help Mrs. Peters by doing which of the following?
A. Recognizing that Mrs. Peters is feeling jealous and emphasizing that she doesn't have to find fault with the child to make herself feel attractive.
B. Acknowledging Mrs. Peters' statements, explaining that the child will grow a lot during the first months, and then pointing out many of the baby's good features and behaviors.
C. Asking Mrs. Peters if she was thin as a child and discussing the many dangers of being an underweight, malnourished newborn.
D. Discussing postpartal blues with Mrs. Peters and the fact that negative observations and thoughts are common during this time.

Back 17

B. Acknowledging Mrs. Peters' statements, explaining that the child will grow a lot during the first months, and then pointing out many of the baby's good features and behaviors.

Front 18

The nurse, in planning to help a woman adjust to her new baby, must consider which of the following?
A. The mother will require little assistance because parental love is instinctive.
B. The more difficult the labor process, the stronger the mother's bond with her child.
C. It may be natural for the mother to be hesitant initally when touching the child.
D. Holding the child immediately after birth is overwhelming to a new mother and should be avoided.

Back 18

B. Acknowledging Mrs. Peters' statements, explaining that the child will grow a lot during the first months, and then pointing out many of the baby's good features and behaviors.

Front 19

Mrs. Peters has a 4-year-old son at home and is concerned about his reaction to the new baby. The nurse might do which of the following to best assist this postpartal family?
A. Instruct Mrs. Peters to write her son a letter and include a picture of the new baby.
B. Encourage Mrs. Pters to have another family member spend a lot of time with her son.
C. Arrange for the son to visit with Mrs. Peters and the baby as soon as possible.
D. Discuss the dangers of sibling rivalry with Mrs. Peters and encourage strict discipline.

Back 19

C. Arrange for the son to visit with Mrs. Peters and the baby as soon as possible.

Front 20

When examining a postpartal woman, the nurse should immediately report:
A. A fundus that is palpated 2cm below the umbilicus on the second postpartal day.
B. A fundus that cannot be located by palpation on the ninth postpartal day.
C. A soft, spongy uterine fundus noted during the first hour postpartum.
D. Red, bloody vaginal discharge on the perineal pad on the first day postpartum.

Back 20

C. A soft, spongy uterine fundus noted during the first hour postpartum.

Front 21

5. During the postpartal period, the new mother may experience an alteration in urinary elimination related to loss of bladder sensation. Which of the following data would indicate this problem?
A. A resonant sound noted on percussion of the lower abdominal area.
B. A firm fundus located 1cm below the umbilicus on the first postpartal day.
C. Complaints of pain at the episiotomy site, particularly after ambulation.
D. Urinary output greater than 1500 mL during a 24-hour period.

Back 21

A. A resonant sound noted on percussion of the lower abdominal area.

Front 22

6. The nurse could encourage which of the following measures to decrease the sense of abandonment experienced by the woman and her mate during the postpartal period?
A. The couple should plan extensive time with the new baby to increase their sense of bonding and decrease jealousy.
B. The father should be encouraged to share in the care and feeding of the child to increase feelings of involvement.
C. Discussions of parenting should be avoided during the immediate postpartal period to minimize anticipatory resentment.
D. The mother should be warned that being jealous of the attention her child is receiving is a sign of postpartal psychosis.

Back 22

B. The father should be encouraged to share in the care and feeding of the child to increase feelings of involvement.

Front 23

7. Which of the following statements related to the patient's nutritional status is a common finding ofr recommended meausre during the postpartal period?
A. Breast-feeding mothers should limit caloric intake to prevent fat-cell buildup in newborns, which could lead to obesity.
B. Fluid intake is limited for 48 hours because of the high fluid volume retained in the body after deliver.
C. High intake of meats, fish, chicken, and dairy products should be ecrouaged to facilitate good tissue repair.
D. The mother will have little desire for food or fluids for 24 hours because of the gluconeogenesis that occurs postpartum.

Back 23

C. High intake of meats, fish, chicken, and dairy products should be ecrouaged to facilitate good tissue repair.

Front 24

8. Which of the following is an appropriate nursing diagnosis for a postpartal mother with an episiotomy during the first 5 days postpartum?
A. Anxiety related to vaginal scar formation and decreased body image.
B. Alteration in nutrition: more than body requirements related to increased appetite.
C. High risk for infection related to lochia and decreased perineal skin integrity.
D. Self-care deficit related to poor opportunity for independence.

Back 24

C. High risk for infection related to lochia and decreased perineal skin integrity.

Front 25

9. The postpartal mother asks the nurse when her body will return to "normal." The nurse should implement a teaching plan about postpartal bodily changes that includes which of the following information?
A. A fast heart rate and thready pulse will occasionally be noted and should be expected.
B. Mentrual flow will return within 6 to 10 weeks after delivery unless the mother is breast-feeding.
C. Varicosities and vascular blemishes will disappear by the sixth postpartal week.
D. The weight gained during pregnancy is usually retained regardless of dietary and exercise efforts.

Back 25

B. Mentrual flow will return within 6 to 10 weeks after delivery unless the mother is breast-feeding.

Front 26

10. Which of the following would be cause for concern if found during a postpartal assessment?
A. Diaphoresis during the period immeidately after delivery.
B. Hair loss over the postpartal period.
C. Pale coloring of the inner conjunctiva
D. Reprots of slight breast tenderness

Back 26

C. Pale coloring of the inner conjunctiva

Front 27

11. The appropriate method for assessment of the fundus would be to:
A. Massage the uterus between the thumb and middle finger until firm, then use a ruler to measure location.
B. Palpate the fundus while the woman has a full bladder to facilitate detection of the uterus.
C. Place both hands below the symphysis pubis and push upward until the lower end of the fundus is located.
D. Support the lower segment of the uterus while palpating the fundus to prevent inversion.

Back 27

D. Support the lower segment of the uterus while palpating the fundus to prevent inversion.

Front 28

12. Placing the infant at the breast to breast-feed has what effect on uterine tone?
A. Breast-feeding stimulates lactation, which increases the formation of clots in the uterus.
B. Stimulation of the breast causes oxytocin release and decreased tone in the uterine wall.
C. The pressure of the infant breast-feeding can cause uterine rupture.
D. Uterine contraction is stimulated by the infant sucking on the breast.

Back 28

A. Breast-feeding stimulates lactation, which increases the formation of clots in the uterus.

Front 29

14. The nurse is caring for 14-year-old Lisa, who has decided to giver her baby up for adoption. Which of the following should the nurse keep in mind?
A. Lisa would probably keep her baby if she were given encouragement.
B. After the delivery, Lisa may express a desire to keep her baby, or she may want to continue with the adoption.
C. During the taking-in phase of the pueperium, the nurse should encourage Lisa to reconsider her decision to abandon her baby.
D. Lisa should not hold, see, or touch her baby after the delivery to decrease her feelings of loss after giving the child away.

Back 29

B. After the delivery, Lisa may express a desire to keep her baby, or she may want to continue with the adoption.

Front 30

15. An appropriate goal for a postpartal client who complains of being exhausted and unable to sleep would be that the client:
A. Abstain from performing self-care and rest instead
B. State she feels rested during the postpartal period
C. Sleep during the night in order to stay awake all day
D. Sleep 8 hours every night after discharge from the hospital

Back 30

B. State she feels rested during the postpartal period

Front 31

16. A client with the diagnosis of "Self-esteem disturbance related to lack of knowledge regarding psychological changes during the postpartal period" might have which of the following defining characteristics?
A. She denies that she has feelings of abandonment or fatigue.
B. She performs grooming and infant care activities.
C. She state that she will not be jealous of her child any longer.
D. She verbalizes that sh e has conflicting feelings.

Back 31

D. She verbalizes that sh e has conflicting feelings.

Front 32

___________ exercises consist of contracting and relaxing the muscles of the perineum.

Back 32

Kegel (perineal)

Front 33

The pink or brownish vaginal drainage noted around the fourth postpartal day is called ___________.

Back 33

lochia serosa

Front 34

Select All That Apply

Data supporting a diagnosis of "High risk for fluid volume deficit related to subinvolution" would include:
A. Blood pressure of 90/62 mm Hg noted on the third day after delivery
B. Firm uterine fundus located at standard measurement level
C. Lochia saturating one perineeal pad per hour 12 hours postpartum
D. Pulse slow and bounding during the first postpartal day

Back 34

A. Blood pressure of 90/62 mm Hg noted on the third day after delivery
C. Lochia saturating one perineeal pad per hour 12 hours postpartum

Front 35

Select All That Apply

Which of the following nursing interventions would be appropriate when caring for an episiotomy client who has the nursing diagnosis, "Pain related to perineal sutures"?
A. Apply ice packs to the perineal incision site to decrease edema.
B. Encourage the client to contract and relax perineal muscles.
C. Instruct client to use petroleum jelly or mineral oil on the episiotomy as desired.
D. Limit pain medication to prevent dependence on narcotic analgesics.
E. Encourage sexual activity after 1 week to loosen sutures.

Back 35

A. Apply ice packs to the perineal incision site to decrease edema.
B. Encourage the client to contract and relax perineal muscles.

Front 36

Select All That Apply

What characteristics would indicate that lochia flow is normal.
A. Lochia amount increases with strenuous exercise.
B. Lochia contains no large clots.
C. Lochia is absent during the first 1 to 3 weeks after a cesarean birth.
D. Lochia is white for the first 1 to 3 days postpartum.
E. Lochia has the same odor as menstrual blood.

Back 36

A. Lochia amount increases with strenuous exercise.
B. Lochia contains no large clots.
E. Lochia has the same odor as menstrual blood.