Postpartum Questions and Answers with Verified Solutions

Postpartum Questions and Answers with Verified Solutions A nurse in the postpartum unit is assessing a newborn infant for signs of breastfeeding problems. Which of the following indicates a problem? Select all that apply. 1 The infant exhibits dimpling of the cheeks. 2 The infant makes smacking or clicking sounds. 3 The mother's breast gets softer during a feeding. 4 Milk drips from the mother's breast occasionally. 5 The infant falls asleep after feeding less than 5 minutes. 6 The infant can be heard swallowing frequently during a feeding. Answer: 1, 2, 5 Rationale: It is important for the nurse to identify breast-feeding problems while the mother is hospitalized so that the nurse can teach the mother how to prevent and treat any problems. Infant signs of breastfeeding problems include dimpling of the cheeks; making smacking or clicking sounds; falling asleep after feeding less than 5 minutes; refusing to breastfeed; tongue thrusting; failing to open the mouth at latch-on; turning the lower lip in; making short, choppy motions of the jaw; and not swallowing audibly. Softening of the breast during feeding, noting milk in the infant's mouth or dripping from the mother's breast occasionally, and hearing the infant swallow are signs that the infant is receiving adequate nutrition. Priority Nursing Tip: If the mother is breast-feeding, calorie needs increase by 200 to 500 calories per day; increased fluids and the continuance of prenatal vitamins and minerals are important. It has been 12 hours since the client's delivery of a newborn. The nurse assesses the client for the process of involution and documents that it is progressing normally when palpation of the client's fundus is noted: 1 At the level of the umbilicus 2 One finger breadth below the umbilicus 3 Two finger breadths below the umbilicus 4 Midway between the umbilicus and the symphysis pubis Answer: 1 Rationale: The term "involution" is used to describe the rapid reduction in size and the return of the uterus to a normal condition similar to its nonpregnant state. Immediately after the delivery of the placenta, the uterus contracts to the size of a large grapefruit . The fundus is situated in the midline between the symphysis pubis and the umbilicus. Within 6 to12 hours after birth, the fundus of the uterus rises to the level of the umbilicus. The top of the fundus remains at the level of the umbilicus for about a day and then descends into the pelvis approximately one finger breadth on each succeeding day. Priority Nursing Tip: By approximately 10 days postpartum, the uterus cannot be palpated abdominally. A nurse teaches a postpartum client about observation of lochia. The nurse determines the client's understanding when the client says that on the second day postpartum , the lochia should be: 1 Red 2 Pink 3 White 4 Yellow Answer: 1 Rationale: The uterus rids itself of the debris that remains after birth through a discharge called "lochia," which is classified according to its appearance and contents. Lochia rubra is dark red in color. It occurs from delivery to 3 days postpartum and contains epithelial cells, erythrocytes, leukocytes, shreds of decidua, and occasionally fetal meconium, lanugo, and vernix caseosa. Lochia serosa is a brownish pink discharge that occurs from days 4 to 10. Lochia alba is a white discharge that occurs from days 10 to 14. Lochia should not be yellow in color or contain large clots; if it does, the cause should be investigated without delay. Priority Nursing Tip: The amount of lochial discharge may increase with ambulation. A physician has written a prescription to administer methylergonovine maleate (Methergine) to a postpartum client with uterine atony. The nurse would contact the physician to verify the prescription if which of the following conditions were