During a telephone follow-up conversation with a woman who is 4 days postpartum, the woman tells the nurse, "I don't know what's wrong.
I love my son, but I feel so let down.
I seem to cry for no reason!" Which condition might this new mother be experiencing?

Postpartum blues.

Postpartum depression (PPD).

Postpartum delirium.

Attachment difficulty.

Answer and Explanation

The Correct Answer is A

Choice A rationale

Postpartum blues are characterized by labile mood, tearfulness, anxiety, and irritability that typically peak around the third to fifth postpartum day and resolve within two weeks. These feelings are often attributed to hormonal shifts, psychological adjustments, and fatigue experienced after childbirth. The woman's statement of feeling "let down" and crying for no reason, occurring on the fourth postpartum day, aligns with the typical presentation of postpartum blues.

Choice B rationale

Postpartum depression (PPD) involves more intense and persistent symptoms than postpartum blues, including depressed mood, loss of interest or pleasure, changes in appetite and sleep, fatigue, feelings of worthlessness or guilt, and difficulty concentrating. These symptoms typically last longer than two weeks and interfere with daily functioning. The woman's statement alone does not provide enough information to diagnose PPD.

Choice C rationale

Postpartum delirium is a rare but serious psychiatric emergency characterized by rapid onset of confusion, disorientation, hallucinations, delusions, and agitation. It typically occurs within the first few days postpartum. The woman's description of her feelings does not suggest the presence of delirium.

Choice D rationale

Attachment difficulty refers to challenges in forming a secure emotional bond between the mother and her infant. While the woman expresses loving her son, her emotional state of feeling "let down" and crying is not a direct indicator of attachment difficulties, which manifest as a lack of engagement or negative interactions with the baby.

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Correct Answer is C

Explanation

Choice A rationale

Assessing vital signs is important in evaluating a postpartum hemorrhage, but it is not the immediate priority. Significant blood loss can occur before changes in vital signs become apparent due to compensatory mechanisms in the body. Addressing the source of bleeding is the initial critical step.

Choice B rationale

Calling the primary health care provider is a necessary step, but it should occur after the nurse has taken immediate action to address the likely cause of the excessive bleeding. Direct intervention to control the hemorrhage takes precedence over notification.

Choice C rationale

Massaging the fundus is the highest priority because uterine atony, a soft and boggy uterus that does not contract effectively, is the most common cause of early postpartum hemorrhage. Stimulating uterine contraction by massage can help to compress the blood vessels at the placental site and reduce bleeding.

Choice D rationale

Initiating an intravenous (IV) infusion of Ringer's lactate solution is important for volume replacement if bleeding is significant, but it is not the immediate first action. Addressing the uterine atony through fundal massage should be done first to try and control the bleeding.

A. Indicates the need for increasing ambulation. B. Indicates the need for increasing oral fluids. C. Indicates the presence of infection. D. Is normal.

Correct Answer is C

Explanation

Choice A rationale

Increasing ambulation is generally encouraged in the postpartum period to prevent complications like thrombophlebitis, but it does not address the potential cause of foul-smelling lochia. Foul odor is a key indicator of infection, and ambulation will not resolve an existing infection.

Choice B rationale

Increasing oral fluids is important for hydration in the postpartum period, but it will not directly address a foul-smelling odor in the lochia. While adequate hydration supports overall healing, it does not treat an infection. A foul odor strongly suggests a localized infectious process in the uterus.

Choice C rationale

Lochia that is red (rubra) is normal in the first few days postpartum. However, a foul-smelling odor is an abnormal finding and a significant indicator of a potential uterine infection, also known as endometritis or puerperal infection. Further assessment and intervention are required to identify and treat the infection.

Choice D rationale

Normal lochia progresses from rubra (red) to serosa (pinkish-brown) to alba (yellowish-white) over several weeks postpartum. Normal lochia should have a fleshy, not foul, odor. A foul smell is an abnormal finding that suggests an infectious process within the uterus and requires prompt attention.

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During a telephone follow-up conversation with a woman who is 4 days postpartum, the woman tells the nurse, "I don't know what's wrong.I love my son, but I feel so let down.I seem to cry for no reason!" Which condition might this new mother be experiencing?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

On examining a woman who gave birth 5 hours ago, the nurse finds that the woman has completely saturated a perineal pad within 15 minutes.What is the nurse's highest priority?

Correct Answer is C

Explanation

The nurse is assessing the lochia on a 1-day postpartum patient.The nurse notes that the lochia is red and has a foul-smelling odor.The nurse determines that this assessment finding:

Correct Answer is C

Explanation

A nurse is caring for a client who is 5 hours postpartum following a vaginal birth of a newborn weighing 9 lb 6 oz (4252 g). The nurse should recognize that this client is at risk for which of the following postpartum complications?

The nurse assessing a postpartum client's fundus finds it firm, 2 centimeters above the umbilicus and displaced to the right.What is the most appropriate nursing intervention at this time?

The clinic nurse is caring for a client at 31 weeks gestation who is scheduled for induction of labor at 42 weeks gestation.Which teaching is a priority for this client?

Which of the following are common methods used for the induction of labor in obstetric practice? (Select All that Apply)

Methergine is prescribed for a woman to treat postpartum hemorrhage.Before administration of this medication, the priority nursing assessment is to check the:

A patient who is 36 weeks pregnant tells you she has been counting her baby's kicks and is concerned because within a 4-hour period the baby has only kicked 32 times.What nursing intervention is correct?

During a telephone follow-up conversation with a woman who is 4 days postpartum, the woman tells the nurse, "I don't know what's wrong.
I love my son, but I feel so let down.
I seem to cry for no reason!" Which condition might this new mother be experiencing?