In planning the postpartum care of a multipara who had a normal pregnancy, labor, and delivery, which factor should be considered? The client needs to have:
breast care teaching because she is predisposed to mastitis.
frequent uterine fundal assessments because she is at risk for developing a prolapsed uterus.
a strict toileting schedule because she is prone to developing a urinary tract infection.
an “as needed” order for an analgesic because she is likely to have pain.
The Correct Answer is B
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
The correct answer is choice C. Assess the client’s blood pressure.Methylergonovine is a uterotonic medication that can cause hypertension and is contraindicated for clients with preeclampsia or cardiac disease.
Therefore, the nurse should check the client’s blood pressure before administering this medication to ensure it is within normal range (120/80 mm Hg or lower).
Choice A is wrong because assessing the client’s pain scale is not a priority assessment before giving methylergonovine.
Pain is not a contraindication for this medication and does not affect its effectiveness.
Choice B is wrong because assessing the client’s respiratory rate is not a priority assessment before giving methylergonovine.
Respiratory rate is not affected by this medication and does not indicate any adverse effects.
Choice D is wrong because assessing the client’s last bowel movement is not a priority assessment before giving methylergonovine.
Bowel movement is not related to postpartum hemorrhage or uterine atony, which are the indications for this medication.
Correct Answer is A
Explanation
The correct answer is choice A. The patient has heart disease, and the antibiotics will decrease the risk to her fetus of developing endocarditis.Endocarditis is an infection of the inner lining of the heart and valves, which can be caused by bacteria entering the bloodstream during labor and delivery.Patients with mitral valve prolapse (MVP) are more prone to develop endocarditis because their valve leaflets are floppy and do not close tightly, creating a site for bacterial attachment.Antibiotics can help prevent this complication by killing the bacteria before they reach the heart.
Choice B is wrong because pericarditis is an inflammation of the outer layer of the heart, not the inner lining or valves.It is not related to MVP or bacterial infection.
Choice C is wrong because chorioamnionitis is an infection of the membranes and fluid that surround the fetus, not the heart.It is usually caused by bacteria ascending from the vagina or cervix, not from the bloodstream.
Choice D is wrong because delivering post-term does not increase the risk of systemic infection for the fetus.Systemic infection means infection that affects multiple organs or systems in the body, not just one specific site.
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