A woman gave birth to a 7-lb, 3-ounce infant boy 2 hours ago. The nurse determines that the woman's bladder is distended because her fundus is now 3 cm above the umbilicus and to the right of the midline. In the immediate after birth period, the most serious consequence likely to occur from bladder distention is:
Excessive uterine bleeding
urinary tract infection
ruptured bladder
bladder wall atony
The Correct Answer is A
A. Excessive uterine bleeding:
Bladder distention can displace the uterus to the right and elevate it above the umbilicus, interfering with uterine contraction. This displacement prevents the uterus from contracting effectively, which can lead to excessive uterine bleeding, a serious complication. When the uterus does not contract properly, it may not effectively compress the blood vessels, increasing the risk of hemorrhage. Immediate attention to bladder distention is crucial to prevent this potentially life-threatening issue.
B. Urinary tract infection:
While urinary tract infections (UTIs) can occur in the postpartum period, especially if the bladder is not emptied completely, they are not the most immediate or serious consequence of bladder distention. The priority is to address the distended bladder to prevent complications like excessive bleeding. A UTI would be a concern later, but it would not be the most acute risk following delivery.
C. Ruptured bladder:
A ruptured bladder is a rare and severe complication but is not the most likely consequence of bladder distention in the immediate postpartum period. Bladder rupture typically occurs due to significant trauma or extreme distention, which is not common in this situation. The more immediate concern is uterine atony and hemorrhage due to displaced uterine tone from bladder distention.
D. Bladder wall atony:
Bladder wall atony could result from severe bladder distention, causing difficulty in voiding. However, this is not the most serious consequence immediately after birth. Bladder distention typically results in impaired uterine contraction, which causes bleeding rather than atony of the bladder wall itself. Addressing bladder distention will help prevent complications such as hemorrhage rather than focusing on bladder atony initially.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A) Skin to Skin contact:
Skin-to-skin contact, also known as "kangaroo care," is a highly beneficial practice for both the mother and the infant in the immediate postpartum period. It promotes bonding by enhancing emotional connections, helps the infant maintain their body temperature through the transfer of warmth from the mother’s chest, and supports the initiation of breastfeeding, which is essential for the infant's nourishment. Additionally, skin-to-skin contact stimulates the release of oxytocin, which can aid in uterine contractions and promote involution of the uterus.
B) Swaddling the infant:
While swaddling the infant can provide comfort and a sense of security, it does not directly promote bonding or help with temperature regulation as effectively as skin-to-skin contact does. Swaddling can help the infant feel secure and prevent the startle reflex but does not have the same physiological benefits in terms of promoting involution or maintaining body temperature.
C) Allowing family members to hold the infant:
While allowing family members to hold the infant can help with bonding, it does not offer the same immediate physical benefits as skin-to-skin contact between the mother and infant. Skin-to-skin contact is particularly beneficial in terms of temperature regulation and promoting the early stages of breastfeeding, which can help with the involution of the uterus.
D) None of the above:
This option is incorrect because skin-to-skin contact has been shown to promote bonding, help regulate the infant's temperature, and support postpartum recovery processes, including uterine involution.
Correct Answer is A
Explanation
A) Postpartum blues are transient and usually occur within the first week after delivery:
Postpartum blues, also known as "baby blues," are common and generally transient. They typically occur within the first few days to a week after delivery and can last for a few days to a week or two. Symptoms may include mood swings, irritability, crying, anxiety, and difficulty sleeping. These feelings are normal and typically resolve without the need for medical intervention. It's important for the nurse to provide reassurance that this is a common experience for many new mothers and that it is usually temporary.
B) Medications are available to relieve the symptoms:
While medications may be necessary for more severe postpartum mood disorders, such as postpartum depression, they are not typically required for postpartum blues. Since postpartum blues are mild and transient, most women do not need medications. Psychosocial support and rest are usually sufficient. Medications, especially antidepressants, are considered for women who develop postpartum depression, which is more persistent and severe than postpartum blues.
C) The father may become sad and weepy:
While fathers can experience emotional changes during the postpartum period, the phenomenon of postpartum blues is specific to the mother due to the hormonal and physiological changes related to childbirth and breastfeeding. Fathers may experience mood changes due to the stresses of parenthood, but postpartum blues is typically not recognized as a condition affecting men. However, men can experience postpartum depression or anxiety, which warrants different attention and support.
D) Very few women experience postpartum blues:
On the contrary, postpartum blues is very common, affecting a large percentage of women after childbirth. Studies show that 50-80% of women experience some form of postpartum blues. This makes the statement incorrect. It's important to normalize the experience and emphasize that it is a common and temporary reaction to the changes associated with childbirth.
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