CH 12

A multiparous patient reports severe uterine cramps the first day after a vaginal delivery. The nurse

is aware the patient is breastfeeding and associates the patient’s pain primarily with which

occurrence?

An increase in oxytocin release related to the newborn suckling

The nurse is palpating a patient’s uterus 12 hours after a vaginal delivery. For which reason does

the nurse place one hand just above the symphysis pubis?

To prevent uterine inversion

The nurse is providing postpartum care to a patient 24 hours after a vaginal delivery. Which action

does the nurse perform prior to assessing the patient’s uterus?

Ask the patient to void.

A postpartum patient calls the OB office 8 days following a vaginal delivery. The patient reports

concern regarding vaginal bleeding. Which patient-reported symptom causes the nurse concern?

A description of the lochia as being red in color

The nurse is collecting the urine of a postpartum patient who is passing large clots. For which

reason does the nurse examine the large collected clots?

To determine the presence of tissue

The nurse is preparing a postpartum patient for discharge. Which patient teaching is most important for the nurse to provide?

The signs and symptoms of secondary hemorrhage

The nurse in a postpartum unit frequently teaches patients regarding breast care. Which teaching is

most helpful to the breastfeeding patient?

Express milk by a breast pump or manually.

The nurse is providing care to a patient who is postpartum. Using anatomy and physiology

knowledge, which expectation does the nurse relate to the cardiovascular system?

WBC laboratory level of 30,000/mm a few hours after delivery

Prior to discharge from the birthing center, the nurse informs the patient that she will receive

vaccines for rubella, hepatitis B, pertussis, and influenza. For which reason does the nurse explain the need for the vaccinations?

Vaccinating the mother will protect the neonate from serious illnesses.

A patient who is 12 hours postpartum after a vaginal delivery continues to have difficulty in

initiating urination. The nurse is aware that an integrative method used when a woman is unable to void is peppermint oil. In which manner will the peppermint oil be used?

A saturated cotton ball is placed in a “hat” on the toilet.

The nurse is discussing contraception with a couple before discharge following the birth of a first

child. The couple are uncertain about the method but are certain about avoiding pregnancy for at

least 2 years. Which method does the nurse recommend?

Depo-Provera

The nurse is performing a uterus assessment on a patient who is 20 hours postpartum. The nurse finds the fundus of the uterus to be soft and boggy. In addition, the uterus is displaced to the left and moderate bleeding is noted. If the uterus does not respond to uterine massage, which actions

does the nurse implement? Select all that apply.

Assist the patient to the bathroom to void.

Reassess to determine response to treatment.

Administer oxytocin as prescribed.

Make the patient NPO for surgery.

The nurse is preparing to perform a visual assessment of the perineum of a postpartum patient. The nurse will use the REEDA acronym. Which specific assessments are covered by REEDA? Select all that apply.

Perineal coloration

Suture line appearance

Amount of swelling

Soft tissue trauma

 A postpartum patient states, “I am really in pain.” For which sources of pain will the nurse specifically assess the patient? Select all that apply

Uterine contractions

Perineal trauma

Breast engorgement

Hemorrhoids

General soreness