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 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.
Correct Answer is B
Explanation
The correct answer is choice B.“The placenta was blocking the opening of the womb.”
This statement shows that the patient understands that placenta previa is a condition where the placenta covers or is near the internal os of the cervix, which prevents a safe vaginal delivery.The patient would need a cesarean delivery to avoid bleeding and complications.
Choice A is wrong because it describes placental abruption, not placenta previa.
Placental abruption is when the placenta separates from the uterine wall before delivery, which can cause severe bleeding and fetal distress.
Choice C is wrong because it describes a normal position of the placenta at the top of the womb.
This does not interfere with vaginal delivery and does not cause bleeding.
Choice D is wrong because it describes placenta increta or percreta, not placenta previa.
Placenta increta or percreta is when the placenta grows too deeply into or through the uterine wall, which can cause severe bleeding and damage to the uterus and other organs.
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