A client has been diagnosed with postpartum psychosis. Which of the following actions should the nurse take? Select one:
Maintain the client on strict bedrest.
Carefully monitor intake and output.
Restrict visitation of the client's partner.
Closely supervise all infant care and interaction.
The Correct Answer is D
Choice A Reason: Maintain the client on strict bedrest. This is an inappropriate action that may worsen the client's condition and increase her isolation and depression. Postpartum psychosis requires prompt psychiatric treatment with medication and psychotherapy, not bedrest.
Choice B Reason: Carefully monitor intake and output. This is an irrelevant action that has no direct relation to postpartum psychosis or its management. Monitoring intake and output may be indicated for other postpartum complications such as hemorrhage, infection, or preeclampsia.
Choice C Reason: Restrict visitation of the client's partner. This is an unnecessary action that may deprive the client of social support and emotional comfort. The partner may be an important source of help and information for the client and the health care team. The partner should be involved in the client's care and education, unless there are signs of abuse or violence.
Choice D Reason: Closely supervise all infant care and interaction. This is because postpartum psychosis is a severe mental disorder that occurs in some women after childbirth, which can cause delusions, hallucinations, paranoia, mood swings, confusion, and suicidal or homicidal thoughts. Postpartum psychosis can pose a danger to both the mother and the infant, as the mother may harm herself or the infant due to distorted perceptions or impulses. The nurse should closely supervise all infant care and interaction to ensure safety and prevent injury.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A Reason: Milia. This is an incorrect answer that describes a different skin condition. Milia are tiny white or yellow cysts that appear on the nose, chin, or cheeks of newborns. They are caused by the retention of keratin in the sebaceous glands or hair follicles. They usually disappear within a few weeks without treatment.
Choice B Reason: Dermal melanosis. This is a correct answer that explains the finding of bluish markings across the newborn's lower back. Dermal melanosis. This is because dermal melanosis, also known as Mongolian spots, is a common benign skin condition that affects newborns of Asian, African, or Hispanic descent. It is characterized by bluish-gray or brown patches of pigmentation on the lower back, butocks, or extremities. It is caused by the migration of melanocytes from the neural crest to the dermis during embryonic development. It usually fades by 2 to 4 years of age.
Choice C Reason: Stork bites. This is an incorrect answer that refers to another skin condition. Stork bites, also known as salmon patches or nevus simplex, are flat pink or red marks that appear on the forehead, eyelids, nose, upper lip, or nape of the neck of newborns. They are caused by dilated capillaries in the superficial dermis. They usually fade by 18 months of age.
Choice D Reason: Birth trauma. This is an incorrect answer that implies an injury or damage to the newborn's skin or tissues during labor and delivery. Birth trauma can cause bruises, abrasions, lacerations, fractures, or nerve injuries. It is not related to bluish markings on the lower back.
Correct Answer is C
Explanation
Choice A Reason: 3-2-1-0-2. This is an incorrect answer that underestimates the number of pregnancies and overestimates the number of preterm births. The client has had four pregnancies, not three. She has had one preterm birth, not two.
Choice B Reason: 4-1-1-1-3. This is an incorrect answer that overestimates the number of living children. The client has two living children, not three.
Choice C Reason 4-1-1-1-2. This is because the GTPAL method is a way of summarizing a woman's obstetric history using five numbers: G (gravida), T (term births), P (preterm births), A (abortions), and L (living children). Gravida is the number of pregnancies, regardless of outcome. Term births are deliveries after 37 weeks' gestation. Preterm births are deliveries between 20 and 37 weeks' gestation. Abortions are pregnancies that end before 20 weeks' gestation, either spontaneously or electively. Living children are the number of children who are alive at the time of assessment.
Choice D Reason: 4-1-2-0-3. This is an incorrect answer that overestimates the number of preterm births and living children, and underestimates the number of abortions. The client has had one preterm birth, not two. She has had one abortion, not zero. She has two living children, not three.
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