A nurse in a clinic is caring for a client who is 3 weeks postpartum following the birth of a healthy newborn. The client reports feeling "down” and sad, having no energy, and wanting to cry.

Which of the following is a priority action by the nurse?

Assist the family to identify prior use of positive coping skills in family crises.

Ask the client if she has considered harming her newborn.

Anticipate a prescription by the provider for an antidepressant.

Reinforce postpartum and newborn care discharge teaching.

Answer and Explanation

The Correct Answer is B

Choice A rationale:

Assisting the family in identifying prior coping skills is a valuable nursing intervention, but it is not the priority action in this situation. The client's feelings of sadness and lack of energy raise concerns about postpartum depression, and the nurse should address potential harm to the newborn first.

Choice B rationale:

This is the priority action by the nurse. The client's symptoms are indicative of postpartum depression, and the nurse must assess if she has considered harming her newborn. This assessment is crucial for the safety and well-being of both the mother and the baby.

Choice C rationale:

Anticipating a prescription for an antidepressant may be appropriate once a proper assessment and diagnosis are made, but it is not the priority action at this stage. Assessing for potential harm to the newborn takes precedence.

Choice D rationale:

Reinforcing postpartum and newborn care discharge teaching is essential for the client's well- being. However, it is not the priority action when the client is showing signs of postpartum depression and possible harm to the newborn.

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Correct Answer is A

Explanation

Choice A rationale:

When late decelerations are noted in the fetal heart rate (FHR) tracing, it indicates that the fetal oxygen supply may be compromised. The nurse should first change the client's position, such as moving her to the left lateral position or a hands-and-knees position, to improve uteroplacental blood flow and relieve pressure on the vena cava.

Choice B rationale:

Palpating the uterus to assess for tachysystole is not the priority action when late decelerations are observed. Tachysystole refers to excessively frequent uterine contractions and may contribute to fetal distress, but the immediate concern is addressing the decelerations.

Choice C rationale:

Increasing the client's IV infusion rate may not address the underlying cause of late decelerations. While maintaining hydration is important, it's not the first action to take in this situation.

Choice D rationale:

Administering oxygen at 10 L/min via a non-rebreather mask may be beneficial for the client and fetus, but it is not the first action to take. The nurse should address the position change first to improve oxygenation through better blood flow before considering supplemental oxygen.

A. "Are you taking over-the-counter medications?” B. "Do you have a history of gastric problems?” C. "What kind of contraception will you be using?” D. "Are you being treated for high blood pressure?” E. "Do you have a history of cataracts?”

Correct Answer is ["A","B","D"]

Explanation

Choice A rationale:

The nurse should ask the client if they are taking over-the-counter medications because ibuprofen is also available over-the-counter. It is important to know if the client is already taking ibuprofen or any other non-prescription pain relievers to avoid potential drug interactions or overdosing.

Choice B rationale:

The nurse should inquire about the client's history of gastric problems because ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can cause gastrointestinal irritation and bleeding. If the client has a history of gastric ulcers or other gastric issues, the nurse may need to consider an alternative pain relief option.

Choice C rationale:

The question about contraception is not directly related to administering ibuprofen for postpartum cramping. It is essential to provide adequate pain relief, but the method of contraception the client plans to use is not relevant to the administration of the medication.

Choice D rationale:

This question is pertinent because NSAIDs like ibuprofen can cause fluid retention and potentially worsen hypertension.

Choice E rationale:

The presence of cataracts is not relevant to the administration of ibuprofen for postpartum cramping. Cataracts are a concern with eye health and are not associated with taking this pain medication.

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A nurse in a clinic is caring for a client who is 3 weeks postpartum following the birth of a healthy newborn. The client reports feeling "down” and sad, having no energy, and wanting to cry. Which of the following is a priority action by the nurse?

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Correct Answer is A

Explanation

A nurse is caring for a client who has a prescription for ibuprofen to treat postpartum cramping. Which of the following questions should the nurse ask prior to administering the medication? (Select all that apply.)

Correct Answer is ["A","B","D"]

Explanation

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A nurse in a clinic is caring for a client who is 3 weeks postpartum following the birth of a healthy newborn. The client reports feeling "down” and sad, having no energy, and wanting to cry.

Which of the following is a priority action by the nurse?