Promo-LP 1

What does oxytocin do, if given after birth?

• decrease uterine contractions

• contract the uterus

• soften the uterus

• decrease the blood pressure

Which patient is at highest risk for post partum bleeding

• a breast feeding postpartum patient

• a postpartum patient who began early ambulation

• a patient who delivered vaginally after a prolonged labor

• a primiparous patient

The nurse assists a patient out of bed for the first time 5 hours after giving birth. She becomes frightened when she passes a small blood clot and notices an increase in her lochia. The nurse should explain to the patient that:

• the lochia pools in the vagina when lying in bed; gravity caused increased discharge as she ambulated

• placental fragments have probably been retained in her uterus

• she probably has a UTI or uterine infection

• the amount of lochia will increase during the postpartum period

The nurse teaches the patient about breastfeeding on her first postpartum day. Two hours later, the patient seems to remember very little of the teaching. The nurse understands this memory lapse to be due to:

• the taking-hold phase

• the postpartum hemorrhage phase

• the taking-in phase

• the epidural anesthesia

Answer explanation

During the taking-in phase, the new mother is focusing more on her own needs.

Taking-hold is when she focuses to more taking care of the baby.

The nurse is assessing maternal-infant bonding in a postpartum patient, the nurse should:

• ask the mother if she is having any difficulty in caring for her baby

• observe a feeding and watch the mother's reactions when the baby cries

• ask the father if the mother is able to care for the baby without help

• determine if the mother has been to child care classes or has read any books

Initially, what can the nurse do if she palpates a fundus and it is boggy?

• document the findings

• catheterize the patient

• massage gently and reassess the fundus

• call the physician immediately!

A nurse is caring for a patient approximately 10 minutes after delivery of her newborn; the patient experiences a chill. Which action is most appropriate for the nurse to take?

• administer an analgesic

• obtain the patient's temperature

• get the patient an extra blanket

• call the physician

Answer explanation

This is very normal after delivery

The nurse is caring for a patient twelve hours after giving birth, the patient's temperature is 100 degrees F. The nurse should:

• Notify the physician

• obtain vaginal and cervical cultures

• assess the breasts for engorgement

• offer the patient fluids every 2 hours

A nurse is preparing to discharge a postpartum patient. The nurse notes on her chart that she is non-immune to rubella. The nurse should:

• encourage the rubella (MMR) vaccine prior to discharge

• encourage the patient to receive the rubella (MMR) vaccine at the 6 week follow up

• chart this information in the discharge summary notes

• take no action because none is needed

The nurse is caring for a postpartum patient who states her sleep was interrupted the night before because of sweating and the need to have her gown and bed linen changed. The nurse's first action would be to:

• assess for additional signs of postpartum infection

• immediately alert her physician

• Explain sweating is her body's attempt to eliminate fluid accumulated during pregnancy.

• document the finding as normal postpartum diaphoresis.