A client who is two weeks postpartum calls the office and tells a nurse, "l am having a small amount of brownish discharge from my vagina." Which response is appropriate for the nurse to make?
"The discharge that you are describing is normal at this time."
"Have you been running a fever?".
“It sounds as if you have begun to ovulate again."
"Are you taking iron supplements?".
The Correct Answer is A
The correct answer is choice A: “The discharge that you are describing is normal at this time.” This is because the client is experiencing lochia serosa, which is a brownish discharge that occurs from about day 4 to day 10 postpartum.
Lochia serosa is composed of old blood, serum, leukocytes, and tissue debris.
It indicates that the placental site is healing and the uterus is involuting.
Choice B is wrong because fever is a sign of infection, not normal lochia.
Choice C is wrong because ovulation usually does not resume until 6 weeks postpartum for nonbreastfeeding women and later for breastfeeding women.
Choice D is wrong because iron supplements do not affect lochia color or amount.
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Correct Answer is B
Explanation
The correct answer is choice B. A multipara is a woman who has given birth more than once.
After delivery, the uterus contracts to return to its normal size and position.
However, in multiparas, the uterine muscles may be weaker and less able to contract effectively.
This can lead to a condition called uterine atony, where the uterus does not contract enough to prevent bleeding.
Uterine atony can also cause the uterus to descend into the vagina, which is called a prolapsed uterus.
Therefore, multiparas need frequent uterine fundal assessments to monitor the tone and position of the uterus and prevent complications.
Choice A is wrong because breast care teaching is important for all postpartum women, regardless of parity.
Mastitis is an inflammation of the breast tissue that can occur in any woman who is breastfeeding or not.
It is not more common in multiparas.
Choice C is wrong because a strict toileting schedule is not necessary for multiparas.
Urinary tract infections (UTIs) are caused by bacteria entering the urinary tract, usually from the urethra.
UTIs are not more common in multiparas, unless they have other risk factors such as catheterization, diabetes, or sexual activity.
Choice D is wrong because an “as needed” order for an analgesic may not be adequate for multiparas.
Pain after delivery can vary depending on the type and duration of labor, the size and position of the baby, and the use of anesthesia or episiotomy.
Multiparas may experience more pain due to stretching of the pelvic muscles and ligaments, or due to afterpains, which are contractions of the uterus that occur after delivery.
Therefore, multiparas may need regular doses of analgesics to manage their pain effectively.
Correct Answer is D
Explanation
This is based on the fact that HIV is a virus that attacks the body’s immune system and is spread through certain body fluids, including breast milk.Perinatal transmission can occur during pregnancy, birth, or breastfeeding.Treatment for HIV (antiretroviral therapy, or ART) substantially reduces the risk of perinatal transmission.
Choice A is wrong because sterilizing breast milk does not kill the HIV virus.
Choice B is wrong because colostrum can also contain the HIV virus and testing it is not feasible or reliable.
Choice C is wrong because breastfeeding may still pose a risk of HIV transmission even if the infant is determined to be HIV positive.
The current recommendation in the United States supports shared decision-making between mothers and their healthcare providers regarding infant feeding.Mothers who have questions about breastfeeding or who want to breastfeed should receive patient-centered, evidence-based counseling on infant feeding options, allowing for shared decision-making.
Counseling should begin before conception, or as early as possible in pregnancy and should be
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