Question 1 of 6
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Which nursing questions are appropriate for a patient 9 days postpartum who feels tired and still has vaginal discharge?
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- “What color is your lochia?”Lochia is associated with uterine involution and changes in the endometrium, is described according to color and amount, and should be serosa by 9 days postpartum.
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- “Is your lochia red?”Lochia rubra (red) typically stops by postpartum days 1 to 3. The nurse would ask the woman about the color of the lochia rather than inquiring about one specific color because the color is important.
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- “Is there an odor to your lochia?”Lochia should not have an offensive odor but should smell like normal menstrual flow.
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- “When did your lochia turn clear?”Lochia alba, which is white, cream, or light-yellow lochia, does not begin until postpartum days 11 to 14, so it would not be appropriate to ask when the patient’s lochia turned clear at 9 days postpartum.
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- “How often are you changing your peripads?”The volume of lochia should be decreasing 9 days postpartum, so it would be helpful to know how often the woman is changing her peripad to approximate discharge amount.
Question 2 of 6
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Which statements explain how plasma volume returns to baseline after delivery?
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- Increased oxytocin secretion accelerates fluid depletion.Decreased, not increased, oxytocin levels promote diuresis of excess plasma volume after birth.
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- Profuse sweating aids in decreasing plasma volume levels.Diaphoresis, or profuse sweating, especially at night, aids in the depletion of excess plasma volume after birth.
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- Sodium retention aids in the diaphoresis of excess plasma volume.Sodium is released, rather than retained, to help with the depletion of excess plasma volume after birth.
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- Increased urinary output promotes the excretion of excess plasma volume.Increased urinary output (diuresis) promotes the excretion of excess plasma volume after birth. Diuresis is caused by decreased aldosterone, decreased oxytocin, and decreased sodium retention after delivery.
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- Decreased aldosterone hormone levels promote diuresis of excess plasma volume.Decreased aldosterone hormone levels promote diuresis and depletion of excess plasma volume after birth.
Question 3 of 6
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Which effects can a full bladder have on the uterus in the postpartum period?
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- Displaces the uterusThe uterus is displaced to the right of the umbilicus when the bladder is full.
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- Increases uterine toneThe uterine tone is decreased, not increased, with a full bladder, which leads to increased blood loss.
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- Promotes a boggy uterusA boggy uterus is associated with a full bladder, which leads to increased blood loss.
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- Inhibits uterine involutionThe uterus is unable to contract and involute when the bladder is full.
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- Increases uterine involutionUterine involution is decreased, not increased, when the bladder is full.
Question 4 of 6
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Which nursing findings are concerning when assessing the breasts and nipples of a postpartum woman?
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- Nipples are pink with intact skin.The nurse would anticipate that a postpartum mother’s nipples would be pink and nontender if breastfeeding is going well with a good latch by the infant.
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- Nipples are pink with a blister line.The nurse would not anticipate that a postpartum mother’s nipples would be pink with blisters. Nipple damage is often the result of a poor latch by a breastfeeding infant.
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- Breasts are symmetric.The nurse would anticipate that a postpartum mother’s breasts would be symmetric. Asymmetry could indicate engorgement.
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- Breasts are red and firm.The nurse would not anticipate that a postpartum mother’s breasts would be red and firm. This finding may be a symptom of mastitis.
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- Breasts are soft and nontender.The nurse would anticipate that a postpartum mother’s breasts would be soft and palpable after delivery. This finding does not indicate a potential complication.
Question 5 of 6
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Which nursing finding requires intervention when assessing a postpartum woman who delivered by cesarean birth?
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- A small amount of lochiaA small amount of lochia would not concern the nurse. This is a reassuring finding.
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- Foley catheter output of 200 mL/hourA Foley catheter output of 200 mL/hour would not concern the nurse. This is a reassuring finding. Urinary output of less than 30 mL/hour may indicate excessive blood loss and/or shock.
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- Abdominal dressing with a small amount of serosanguinous drainageA small amount of serosanguinous drainage on the abdominal dressing would not concern the nurse. A saturated dressing with bright red blood may indicate bleeding at the incision site.
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- Distended abdomen with no bowel sounds auscultatedAbdominal distention and the absence of bowel sounds would concern the nurse. This may indicate the presence of bowel obstruction.
Question 6 of 6
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Which assessment findings suggest excessive blood loss requiring immediate intervention for a postpartum patient who had a cesarean delivery?
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- Firm fundus, midlineA firm, midline fundus would not require additional investigation. This is a reassuring finding. A boggy, displaced uterus can be related to a full bladder that requires emptying.
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- Heart rate of 120 beats/minAn elevated heart rate of 120 beats/min may be related to excessive blood loss/shock and requires immediate intervention.
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- Blood pressure of 80/40 mm HgA low blood pressure of 80/40 mm Hg may be related to excessive blood loss/shock and requires immediate intervention.
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- Urinary output of 20 mL/hourUrinary output of less than 30 mL/hour may be related to excessive blood loss/shock and requires immediate intervention.
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- Abdominal distension and severe painAbdominal distension and severe pain may be related to internal bleeding and require immediate intervention.