Your patient is 12 hours postpartum. You ask her in your assessment when the last time she urinated was. She tells you it has been 4 hours. You advise her that she needs to urinate every 2 hours even if she does not feel the urge to go You know this is good advice because of which of the following? (Select All that Apply)

The urethra, bladder and urinary meatus is edematous

She has decreased sensitivity to fluid pressures after a vaginal birth

At 12 hours postpartum she will begin diuresing

There is no cause for concern as long as the patient urinates once shift

A full bladder can lead to postpartum hemorrhage

Answer and Explanation

Correct Answer : A,B,C,E

A) The urethra, bladder, and urinary meatus are edematous:
Postpartum women often experience edema in the urethra, bladder, and urinary meatus due to the pressure exerted during delivery. This swelling can make it difficult for the woman to feel the urge to urinate, even when her bladder is full. Encouraging her to urinate every 2 hours helps prevent overdistension of the bladder, which can lead to urinary retention and other complications.

B) She has decreased sensitivity to fluid pressures after a vaginal birth:
After childbirth, especially a vaginal birth, the pelvic floor and surrounding tissues can be numb or less sensitive due to trauma, swelling, and the effects of anesthesia. This decreased sensitivity makes it harder for the woman to sense when she needs to urinate. Encouraging regular voiding even without the urge helps to prevent urinary retention, which is common in the immediate postpartum period.

C) At 12 hours postpartum, she will begin diuresing:
Diuresis, the process of excreting excess fluid retained during pregnancy, typically begins within 12 hours postpartum. This increased urine output can make it even more important for the mother to void regularly to prevent urinary retention. If the bladder is not emptied regularly, it can lead to discomfort and increase the risk of complications like bladder distention or infection.

D) There is no cause for concern as long as the patient urinates once per shift:
This is not true. A postpartum woman should void more frequently than once per shift (which is about every 8 hours). Urinating only once every shift can lead to urinary retention, bladder overdistension, and possible infection. The recommendation to urinate every 2 hours helps ensure proper bladder emptying and reduces the risk of complications.

E) A full bladder can lead to postpartum hemorrhage:
A full bladder can indeed contribute to postpartum hemorrhage (PPH). An overdistended bladder can displace the uterus, preventing it from contracting effectively after delivery. This can increase the risk of excessive bleeding. Regular voiding helps prevent bladder distention and supports uterine contraction, thereby reducing the risk of hemorrhage.

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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.

A. Mother Rh-, baby Rh+ B. Mother Rh-, baby Rh- C. Mother Rh+, baby Rh+ D. Mother Rh+, baby Rh-

Correct Answer is A

Explanation

A. Mother Rh-, baby Rh+:
Rh immune globulin (RhoGAM) is given to Rh-negative mothers after childbirth if the baby is Rh-positive. This is to prevent the mother from developing antibodies against Rh-positive blood cells, which could affect future pregnancies. If the mother’s immune system recognizes Rh-positive cells as foreign, it may start producing antibodies that can cross the placenta and harm future Rh-positive fetuses, potentially leading to hemolytic disease of the newborn. Administering RhoGAM prevents this sensitization from occurring.

B. Mother Rh-, baby Rh-:
If the mother is Rh-negative and the baby is also Rh-negative, there is no risk of Rh incompatibility. Since there is no Rh-positive blood in the mix, the mother will not develop antibodies against Rh-positive cells. Therefore, Rh immune globulin is not needed in this situation.

C. Mother Rh+, baby Rh+:
If the mother is Rh-positive, there is no risk of Rh incompatibility regardless of the baby’s Rh status. Rh-positive mothers do not produce antibodies against Rh-positive blood cells, so RhoGAM is unnecessary in this scenario.

D. Mother Rh+, baby Rh-:
Again, since the mother is Rh-positive, there is no risk of sensitization, even if the baby is Rh-negative. In this situation, the mother's immune system will not generate antibodies against Rh-negative blood cells, and RhoGAM is not needed.

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Naxlex Comprehensive Predictor Exams

A nurse is counseling a woman about postpartum blues. Which of the following should be included in the discussion?

Correct Answer is A

Explanation

Rh, immune globulin will be ordered after birth if which situation occurs?

Correct Answer is A

Explanation

A mother asks whether or not she should be concerned that her baby never opens his mouth to breathe when his nose is so small. Which of the following is the nurse's best response?

While assessing a patient who gave birth 5 hours ago, the nurse finds that the woman has completely saturated: pad within 15 minutes. What is the nurse's first action?

What hormone remains elevated in the immediate postpartum period in a breastfeeding patient?

The nurse is caring for a postpartum patient who experienced a second-degree laceration at delivery 2 hours ago. Which of the following interventions should the nurse perform at this time?

A breastfeeding woman develops engorged breasts at 3 days postpartum. What action would help this woman achieve her goal of reducing the engorgement? The woman:

The nurse is teaching a newborn care class to parents who are about to give birth to their first babies. Which statement indicates that teaching was effective?

A patient delivered 2 hours ago without medication. She is alert and active in bed but has not been out of bed yet. She states she needs to go the bathroom. What is the nurse's most appropriate response?