A nurse is assessing a postpartum client for signs of postpartum depression. Which of the following symptoms is most indicative of postpartum depression rather than normal postpartum adjustment?

Feeling anxious about the baby's health and well-being, but still able to care for the baby effectively

Experiencing occasional mood swings and irritability while adjusting to the new role of motherhood

Feeling overwhelmed and having difficulty sleeping due to the demands of a newborn

Persistent feelings of sadness, severe fatigue, and loss of interest in activities, including caring for the baby

Answer and Explanation

The Correct Answer is D

A. Feeling anxious about the baby's health and well-being, but still able to care for the baby effectively
Mild anxiety about the baby’s health is a common experience for new mothers and does not necessarily indicate PPD. It becomes concerning if anxiety becomes overwhelming or interferes with daily functioning.

B. Experiencing occasional mood swings and irritability while adjusting to the new role of motherhood
Mood swings and irritability are normal postpartum adjustments, often due to hormonal changes, sleep deprivation, and new responsibilities. These symptoms typically resolve within a few weeks.

C. Feeling overwhelmed and having difficulty sleeping due to the demands of a newborn
Feeling overwhelmed and sleep disturbances are common in the postpartum period due to frequent infant care needs. However, severe or persistent sleep disturbances, especially with loss of interest in daily activities, may indicate PPD.

D. Persistent feelings of sadness, severe fatigue, and loss of interest in activities, including caring for the baby
Postpartum depression is characterized by prolonged sadness, extreme fatigue, withdrawal, and difficulty bonding with the baby. These symptoms extend beyond normal postpartum blues (which typically resolve within two weeks) and require medical intervention, including therapy and possibly medication.

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Correct Answer is ["B","C"]

Explanation

A. Discontinue the oxytocin infusion The patient is not receiving an oxytocin infusion; therefore, discontinuing it is not applicable. Oxytocin is typically stopped in cases of uterine tachysystole or fetal distress, neither of which is present in this scenario. The fetal heart rate (FHR) is within normal range, and no contractions have been noted.

B. Notify the health care provider: The nurse should notify the healthcare provider because the patient is exhibiting severe hypertension (168/100 mmHg), minimal fetal heart rate variability, and laboratory findings consistent with preeclampsia with severe features (elevated liver enzymes, thrombocytopenia, and proteinuria).

C. Assist the patient onto her left side: Repositioning the patient onto her left side can improve uteroplacental blood flow by reducing pressure on the inferior vena cava, thereby enhancing oxygen delivery to the fetus.

D. Administer oxygen at 10L/min via nonrebreather face mask : Oxygen therapy is typically reserved for cases of acute fetal distress. In this case, the FHR is within the normal range, and there are no signs of immediate fetal compromise requiring supplemental oxygen.

E. Stop the magnesium sulfate: Magnesium sulfate is administered to prevent seizures in preeclampsia with severe features and should not be stopped unless there are signs of magnesium toxicity, such as absent deep tendon reflexes (DTRs), respiratory depression, or altered mental status.

F. Assist with a vaginal exam for cord prolapse: A vaginal examination for cord prolapse is only indicated when there is a sudden, severe fetal bradycardia or variable decelerations, particularly following rupture of membranes.

A. The client's level of sexual stimulation B. If taken with a high fat meal, the medication is more effective C. The client's recent consumption of caffeine D. If client took an additional dose to achieve an erection

Correct Answer is A

Explanation

A. The client's level of sexual stimulation
Sildenafil requires sexual stimulation to be effective. It enhances blood flow to the penis but does not automatically cause an erection. The client should be educated that adequate sexual arousal is necessary for the medication to work.

B. If taken with a high-fat meal, the medication is more effective
Taking sildenafil with a high-fat meal can actually delay its absorption and reduce effectiveness. Clients should be advised to take it on an empty stomach or with a light meal for optimal results.

C. The client's recent consumption of caffeine
Caffeine intake does not interfere with sildenafil’s effectiveness. However, excessive caffeine consumption may contribute to vasoconstriction, which could indirectly affect erectile function.

D. If client took an additional dose to achieve an erection
Taking an extra dose of sildenafil is not recommended and can increase the risk of serious side effects such as hypotension, priapism (prolonged erection), and cardiovascular complications. The client should follow prescribed dosing guidelines.

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A nurse is assessing a postpartum client for signs of postpartum depression. Which of the following symptoms is most indicative of postpartum depression rather than normal postpartum adjustment?

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Correct Answer is ["B","C"]

Explanation

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Correct Answer is A

Explanation

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