Postpartum Nursing Care Quiz
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Questions and Answers

What is an effective strategy to relieve breast engorgement for a patient who is not breastfeeding?

  • Frequent nipple stimulation to express milk
  • Warm compresses for 20 minutes several times a day
  • Use of a supportive bra and ice packs (correct)
  • Taking hormonal medications to reduce milk production
  • What is the expected location of the uterine fundus after delivery?

  • Just above the umbilicus and firm
  • Low in the pelvis and soft
  • Firm and midline between the symphysis pubis and umbilicus (correct)
  • Prolapsed into the vaginal canal
  • Which intervention should a nurse take if the uterus is not involuting as expected?

  • Assess for signs of infection and report findings (correct)
  • Immediately begin antibiotic treatment
  • Administer pain medication without assessment
  • Encourage the patient to increase fluid intake
  • How frequently should breastfeeding occur to prevent engorgement?

    <p>Every 2-2.5 hours</p> Signup and view all the answers

    Which phase of postpartum adjustment is characterized by the mother focusing on her own needs and feeling dependent?

    <p>Taking-in phase</p> Signup and view all the answers

    What should a nurse assess in a patient regarding her knowledge of breastfeeding?

    <p>Knowledge of proper latch-on techniques</p> Signup and view all the answers

    What is a key nursing intervention when caring for a mother who may be at risk for postpartum depression?

    <p>Educate on signs and symptoms of postpartum depression</p> Signup and view all the answers

    What is an important aspect of the letting-go phase for new parents?

    <p>Establishing a positive relationship with the infant</p> Signup and view all the answers

    During which phase does the mother begin to initiate care of her baby and seek more independence?

    <p>Taking-hold phase</p> Signup and view all the answers

    Which intervention is crucial for postpartum women susceptible to Rubella before discharge?

    <p>Administering the MMR vaccine</p> Signup and view all the answers

    What is an effective method to promote bonding during the taking-in phase?

    <p>Encourage eye contact and skin-to-skin contact</p> Signup and view all the answers

    How should the nursing staff support a new mother in managing breast care postpartum?

    <p>Encouraging the use of supportive bras</p> Signup and view all the answers

    In postpartum nursing care for a woman relinquishing her infant for adoption, what is a priority assessment?

    <p>Understand her birth plan and preferences regarding the infant</p> Signup and view all the answers

    What emotional response may older siblings display towards a newborn?

    <p>Mixed feelings of jealousy and protectiveness</p> Signup and view all the answers

    What is a common symptom postpartum women should be advised to follow up on?

    <p>Severe laceration pain that persists</p> Signup and view all the answers

    Study Notes

    Postpartum Nursing Care

    • Family dynamics become more complex with each child born
    • Support family dynamics and include family in teaching and care
    • Observe sibling interactions to identify potential problems and make referrals

    Puerperium

    • Period after childbirth, from placenta delivery until reproductive organs return to non-pregnant state
    • Usually about 6 weeks, potentially longer with multiple pregnancies

    Postpartum Physical Adaptations

    • Body changes immediately after delivery
    • Postpartum shivering has an unknown cause, possibly due to fetal/maternal blood mixing or amniotic fluid in the bloodstream
    • Provide patients with warmth to alleviate shivering
    • Reproductive system experiences substantial changes, primarily focused on uterus involution
      • Oxytocin release causes uterine contractions to shrink the uterus
      • Uterus size and weight decreases
      • Fundus is firm at the umbilicus 1 hour after delivery and descends 1 cm daily
      • 10 days post-delivery, the uterus may not be palpable.
    • Afterpains (intermittent uterine contractions) may occur, often more noticeable in women who have had multiple children
    • Lochia (vaginal discharge) may last up to 6 weeks, gradually decreasing in amount and color over time
    • Cervix slowly closes, becoming barely dilated by 14 days post-delivery
    • Vagina experiences diminished tone and swelling, but normal vaginal rugae (folds) should return in 4 weeks.
    • Perineum may be bruised and edematous after delivery, Muscle tone should restore over 4-6 weeks

    Ovaries and Ovulation

    • Normal function after delivery is variable, potentially influenced by breastfeeding
    • Menstruation may be delayed

    Breasts

    • Breasts secrete colostrum at first, then transition to mature milk
    • Nipple stimulation triggers prolactin release to initiate milk production
    • Engorgement (swelling) commonly occurs between the second and fourth day of postpartum
    • Pain and tenderness may be present, but pain is not normal
    • Interventions may be needed to suppress milk production if breastfeeding is not desired

    Integumentary System

    • Stretch marks may persist after delivery
    • Linea nigra (line along the abdomen) may fade but may not fully disappear

    Gastrointestinal System

    • Increased hunger and thirst are common post-delivery
    • Sluggish bowel movements and constipation may occur due to decreased movement and progesterone and anesthesia, stool softener or other treatments might be necessary.

    Cardiovascular System

    • Blood loss varies (250-500 mL vaginal birth, 800-1000 mL C-section)
    • Cardiac output increases after delivery

    Removal of excess fluid

    • Diuresis: increased urine output (up to 3000 mL/day)
    • Diaphoresis (sweating) is a means to remove excess fluid

    Respiratory System

    • Diaphragm returns to its normal position
    • Respiration rate returns to pre-pregnancy levels
    • Nasal congestion decreases

    Urinary System

    • Bladder tone decreases
    • Bladder distension can obstruct uterine involution/lead to hemorrhage
      • Urinary problem is often reported and monitored
    • Encourage fluids to support excretion of excess fluid
    • Monitor output

    Musculoskeletal System

    • Relaxin levels decrease
    • Hip pain may persist
    • Diastasis recti (separation of abdominal muscles) can occur and may involve surgery.
      • Should be assessed and treated by healthcare provider as needed

    Nursing Care During Early Postpartum Period

    • Immediate postpartum care: typically in the hospital for 1-2 days (vaginal birth) or 3-4 days (C-section)
    • Nurses provide physical care, monitor for complications and teach self-care

    Uterine Assessment

    • Palpate fundus to assess location and consistency
    • Assess for tone
    • Never palpate without supporting the lower uterine segment

    Lochia Assessment

    • Inspect amount and character to observe for complications
    • Assess amount and color of lochia postpartum

    Nursing Care During First Hour Post Delivery

    • Vital signs monitored at regular intervals (every 15 minutes)
    • Palpating the uterus is performed every 15 minutes
    • Assess uterine tone, amount of vaginal bleeding, and condition of lochia
    • Most crucial hour to identify and address potential postpartum complications
    • Check for vital changes and other conditions like hemorrhage

    Breast Assessment

    • Assess for breast engorgement and nipple and breast pain
    • Icepacks or supportive bras can help lessen the pain, discomfort and help with engorgement if not breastfeeding
    • Teach mothers about supportive bra, ice-packs and analgesics.

    Nursing Care for Women Who Relinquish Infants for Adoption

    • Assessing emotional and psychological considerations
    • Supporting patient decisions
    • Including the mother's partner in the process

    Development of Family Attachment

    • Partner involvement is encouraged from prenatal and throughout the labor and delivery process
    • Fostering sibling bonding, possibly requires strategies to establish and maintain a positive and healthy relationship among siblings.

    Preparation for Discharge

    • Self-care instructions, including perineal care, analgesics (pain relief medication), and dietary recommendations are vital to enable a stable transition home
    • Follow-up appointments are essential
    • Symptoms requiring medical attention are documented and reported

    Postpartum Depression

    • Risk assessment to help prevent or identify and treat the condition

    C-section

    • Uterine assessment, incisions, medications
    • Support for Post-Surgical Adjustments
    • Post-op care to prevent complications and monitor the patients
    • Monitor for complications, including: atelectasis, thrombosis, infections, and deep vein thrombosis.

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    Related Documents

    Postpartum Nursing Care PDF

    Description

    This quiz covers essential aspects of postpartum nursing care, including family dynamics, physical adaptations after childbirth, and the puerperium period. Test your knowledge on how to support patients and their families during this critical time, as well as identify important changes in the reproductive system postpartum.

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