Postpartum Nursing Care Quiz

Postpartum Nursing Care

• Postpartum Nursing Care (100 points): Comprises 50 questions.
• Hyperemesis Gravidarum Intervention: Keep patient NPO until vomiting stops completely, reintroduce foods slowly, monitor input and output (I&O), vital signs, and daily weight, hydrate with Lactated Ringers IV, and administer antiemetic medications.
• Hyperemesis Gravidarum Medications: Administer Lactated Ringers IV, pyridoxine (Vitamin B6), antiemetic medications, and corticosteroids for resistant cases; provide total parenteral nutrition (TPN) for intravenous nutrition support if necessary. Potential complications include intrauterine growth restriction (IUGR) in the neonate.
• Postpartum Physiological Changes: A topic with 1 question.
• Postpartum Assessment: Includes 9 questions.
• Postpartum Client Education: Includes 3 questions.
• Hypertension in Pregnancy: A topic with 2 questions regarding medications..
• Iron-Deficiency Anemia: A topic with 1 question.
• Gestational Diabetes Mellitus (GDM): A topic with 3 questions.
• Postpartum Complications - PPH (Postpartum Hemorrhage): A topic with 9 questions, including medications related to PPH.
• Postpartum Complications - DVT (Deep Vein Thrombosis): A topic with 2 questions.
• Postpartum Infections: A topic with 2 questions. This includes infections like endometritis.
• Postpartum Affective Disorders: A topic with 1 question.
• Dosage Calculation: A topic with 3 questions on dosage calculation.

Hyperemesis Gravidarum

• Risk Factors: Pregnancies with less than 2 years between them, heavy prior periods, decreased oxygen in the mother and baby, fatigue, and weakness increase the risk of hyperemesis gravidarum.
• Intervention: Keeping the patient NPO until vomiting ceases is crucial. Slow reintroduction of food, monitoring vital signs and weight, and hydration are vital.
• Medication: Lactated Ringers IV, vitamin B6 (pyridoxine), antiemetics, and corticosteroids may be used for resistant cases; total parenteral nutrition (TPN) is an option for severe cases. Potential complications include IUGR in newborns.
• Potential Complications: Intrauterine growth restriction in infants (IUGR) is a potential complication.

Other Conditions

• Iron-deficiency anemia: Risk factors, intervention and medication for this complication are noted.
• Gestational Diabetes Mellitus (GDM): Intervention includes increased dietary intake (beef and green veggies), vitamin C with iron, increased fluids and fiber, and medication (ferrous sulfate, iron infusions). Mothers with hypertension have similar weight gain and nutritional needs.
• Hypertension in Pregnancy: Risk factors include mothers younger than 19 or older than 40, first pregnancy, obesity, and multifetal gestation; complications include placental abruption and end-organ failure. Chronic hypertension exists before pregnancy; gestational hypertension appears for the first time during pregnancy. A blood pressure of 140/90 or higher before pregnancy or after 20 weeks is a concern; treatment with medication may be needed.
• DKA (Diabetic Ketoacidosis): This is linked to insulin overdose, missed meals, or increased exercise. Symptoms include nervousness, headache, weakness, irritability, hunger, and blurred vision. Intervention includes a 1-hour and 3-hour glucose challenge; increasing water intake, and dietary changes are crucial. Insulin therapy is the primary treatment for DKA.
• Preeclampsia: Criteria include systolic blood pressure of 140 or higher OR diastolic blood pressure of 90 or higher with proteinuria 1+ or higher; OR systolic blood pressure of 160 or higher OR diastolic blood pressure of 110 or higher with 3+ proteinuria, and Hyperreflexia (4+, very brisk reflex).
• Eclampsia: Seizures occur with preeclampsia, associated with high blood pressure and proteinuria.
• HELLP Syndrome: Characterized by low hemoglobin, elevated liver enzymes, and low platelets. The only cure is delivery of the baby.

General Information

• Nursing Process: Different levels of thinking within the nursing procedure process are covered.
• NCLEX Test Plan: Indicates the exam's focus on specific areas.

Postpartum Assessment and Complications

• Postpartum Assessment: Frequent assessments of the uterus, bladder, and bowel are critical to identify and manage potential complications.
• Uterus: Position, firmness, and any abnormal bleeding.
• Bladder: Adequate emptying to prevent uterine atony.
• Bowel: Assess for bowel sounds and movements.
• Postpartum complications: Include issues like hemorrhage (PPH), deep vein thrombosis (DVT), infections (e.g., endometritis, mastitis), and affective disorders.
• Additional Notes: Special instructions and precautions related to specific conditions (e.g., hypertension) are included.

Postpartum Physiological Changes

• Hormone Changes and Blood Changes: Increased oxytocin, decreased estrogen, progesterone, and insulinase during the postpartum period. Blood volume decreases, and blood loss varies according to delivery method (vaginal or cesarean).

Other Postpartum Topics

• PPH (Postpartum Hemorrhage): Early identification of PPH is essential.
• Endometritis: Assessment, planning, and interventions for this condition are covered.
• DVT: Complications, assessments, and planning for deep vein thrombosis are detailed.
• Mastitis: Identification and treatment are highlighted.
• Pain Management: Effective pain management methods should be explored, and interventions noted.
• Patient Education: Comprehensive patient education about breastfeeding techniques, preventing infections, and recognizing potential issues is necessary.
• Postpartum Complications and Assessments: Detailed assessments and interventions for postpartum infections such as endometritis.
• Physical Assessments: Specific assessments for uterine tone and other important body systems are noted.
• Medications for PPH: Pitocin, Methergine, Hemabate (with considerations for pre-existing conditions). Medication side effects need to be noted.
• Postpartum infections and DVT assessment: Early identification of possible causes and complications like infection or DVT in the postpartum period is crucial.