A new mom delivered her baby 2 months ago.
The baby's father calls into the office to report that his wife is angry.
She is confused and having conversations with herself.
What is the appropriate response that the nurse should make?
Please take your wife to the nearest emergency room for evaluation.
Please bring your wife to the office for medication.
Your wife needs outpatient care.
Your wife needs behavioral therapy.
The Correct Answer is A
Choice A rationale:
Advising the caller to take his wife to the nearest emergency room for evaluation is the appropriate response. The new mom's symptoms, including confusion and auditory hallucinations (conversations with herself), are indicative of a serious mental health condition. These symptoms could be caused by postpartum psychosis, a rare but severe form of postpartum depression. Postpartum psychosis requires immediate medical attention and hospitalization for the safety of both the mother and the baby. It is essential to rule out any potential medical causes and provide appropriate psychiatric evaluation and treatment in an emergency setting.
Choice B rationale:
Bringing the wife to the office for medication is not appropriate in this situation. The symptoms described by the baby's father are severe and require urgent evaluation in an emergency room. Medication management should only be initiated after a comprehensive psychiatric evaluation, which can be conducted in an emergency room setting.
Choice C rationale:
Suggesting outpatient care is not appropriate in this case. The severity of the symptoms, including confusion and hallucinations, indicates the need for immediate evaluation in an emergency setting. Outpatient care is not sufficient for addressing acute psychiatric emergencies.
Choice D rationale:
Recommending behavioral therapy is not appropriate for a situation involving acute confusion and hallucinations. Behavioral therapy is a valuable treatment for various mental health conditions, but it is not the appropriate intervention for acute symptoms like those described in this scenario.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale:
Pouring water from a squeeze bottle over the woman's perineum is a common technique used to ease perineal discomfort after childbirth, but it does not address the issue of a full bladder preventing the uterus from contracting normally.
Choice B rationale:
Placing oil of peppermint in a bedpan under the woman is a technique used to encourage relaxation and help the woman empty her bladder spontaneously. The smell of peppermint can stimulate the relaxation of pelvic muscles, making it easier for the woman to urinate. This method is often effective in encouraging postpartum women to empty their bladders, which is important for uterine contraction and preventing postpartum hemorrhage.
Choice C rationale:
Asking the physician to prescribe analgesics may help manage pain but does not directly address the issue of a full bladder preventing normal uterine contractions.
Choice D rationale:
Inserting a sterile catheter is a medical intervention that might be necessary if the woman cannot empty her bladder spontaneously. However, it is typically considered after other non-invasive methods, such as the use of peppermint oil, have been attempted and failed. Inserting a catheter should be done with caution to avoid introducing infection and discomfort to the woman.
Correct Answer is C
Explanation
Choice A rationale:
Magnesium sulfate is not given to improve patellar reflexes and increase respiratory efficiency (Choice A). It is primarily used to prevent and treat seizures (convulsions) in patients with preeclampsia and eclampsia.
Choice B rationale:
Magnesium sulfate does not shorten the duration of labor (Choice B). Its use is not related to the progression of labor but rather to prevent and control seizures in the context of preeclampsia and eclampsia.
Choice C rationale:
Preventing and treating convulsions (Choice C) is the main indication for administering magnesium sulfate in cases of severe preeclampsia and eclampsia. Magnesium sulfate acts as a central nervous system depressant, reducing the risk of seizures in these patients.
Choice D rationale:
Preventing a boggy uterus and lessening lochial flow (Choice D) are unrelated to the use of magnesium sulfate. These concerns are typically managed through uterine massage and other postpartum care measures, not magnesium sulfate administration.
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