A nurse is providing discharge teaching to a client who had a vaginal delivery with a midline episiotomy.

Which of the following instructions should the nurse include in the teaching? (Select all that apply.)

Use a sitz bath three times per day and after each bowel movement

Wipe from back to front after voiding or having a bowel movement

Apply ice packs to the perineum for the first 24 hours

Perform Kegel exercises several times per day

Report any increase in redness, swelling, or discharge from the episiotomy site.

Answer and Explanation

Correct Answer : A,C,D,E

The correct answer is choice A, C, D and E. These are the instructions that the nurse should include in the teaching for a client who had a vaginal delivery with a midline episiotomy.

• Choice A is correct because using a sitz bath three times per day and after each bowel movement can help reduce pain, swelling and infection of the perineum.

• Choice C is correct because applying ice packs to the perineum for the first 24 hours can help reduce inflammation and bleeding.

• Choice D is correct because performing Kegel exercises several times per day can help strengthen the pelvic floor muscles and improve urinary continence.

• Choice E is correct because reporting any increase in redness, swelling or discharge from the episiotomy site can help detect signs of infection or wound breakdown.

• Choice B is wrong because wiping from back to front after voiding or having a bowel movement can increase the risk of infection by introducing bacteria from the anal area to the vaginal area. The correct way to wipe is from front to back.

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Correct Answer is ["E"]

Explanation

Increased sleepiness and difficulty waking up are signs of central nervous system (CNS) depression in breastfed infants exposed to codeine through breast milk.Codeine is converted into morphine in the body, which can pass into breast milk and cause adverse effects in the baby.Codeine use by breastfeeding mothers can cause CNS depression in breastfed infants.

Therefore, the nurse should watch for increased sleepiness and difficulty waking up in the baby.

Choice A is wrong because increased alertness and activity are not signs of CNS depression.

They are more likely to be signs of stimulation or agitation.

Choice B is wrong because decreased appetite and weight gain are not specific signs of codeine exposure.

They can be caused by many other factors, such as illness, infection, or poor latch.

Choice C is wrong because increased respiratory rate and depth are not signs of CNS depression.

They are more likely to be signs of respiratory distress or infection.

Choice D is wrong because decreased heart rate and blood pressure are not signs of CNS depression.

They are more likely to be signs of shock or hypovolemia.

Normal ranges for vital signs in newborns are:

• Heart rate: 100 to 160 beats per minute

• Respiratory rate: 30 to 60 breaths per minute

A. Decreased vaginal bleeding. B. Increased abdominal pain. C. Increased temperature. D. Decreased white blood cell count

Correct Answer is D

Explanation

The correct answer is D) Decreased white blood cell count.Postpartum endometritis is an infection of the lining of the uterus that causes fever, abdominal pain, uterine tenderness and sometimes discharge.It is usually caused by bacteria from the lower genital or gastrointestinal tract.White blood cell count is a marker of inflammation and infection, so a decreased white blood cell count indicates that the treatment is effective and the infection is resolving.

A) Decreased vaginal bleeding is not a sign of effective treatment for postpartum endometritis.

Vaginal bleeding after delivery is normal and gradually decreases over time.It is not related to the infection of the uterus.

B) Increased abdominal pain is a sign of worsening infection, not effective treatment.Abdominal pain is one of the symptoms of postpartum endometritis and should improve with antibiotic therapy.

C) Increased temperature is also a sign of worsening infection, not effective treatment.Fever is another symptom of postpartum endometritis and should decrease with antibiotic therapy.

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A nurse is providing discharge teaching to a client who had a vaginal delivery with a midline episiotomy. Which of the following instructions should the nurse include in the teaching? (Select all that apply.)

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Naxlex Comprehensive Predictor Exams

(Select all that apply) A nurse is monitoring a postpartum woman who is taking codeine for severe pain after birth. The nurse knows that codeine can pass through breastmilk and cause adverse effects in the baby. Which signs and symptoms should the nurse watch for in the baby?

Correct Answer is ["E"]

Explanation

A nurse is caring for a client who has postpartum endometritis and is receiving IV antibiotics. Which of the following findings indicates that the treatment is effective? A) Decreased vaginal bleeding.

Correct Answer is D

Explanation

A nurse is caring for a postpartum client who has an episiotomy wound infection. Which of the following should the nurse do? (Select all that apply.) A) Administer antibiotics as prescribed.

A nurse is caring for a client who has postpartum endometritis and is receiving IV antibiotics. Which of the following findings indicates that the client is experiencing an adverse effect of the medication?

A nurse is caring for a postpartum client who delivered vaginally yesterday and has been experiencing heavy vaginal bleeding since delivery. Which of the following actions should the nurse take first?

A nurse is preparing a discharge plan for a postpartum woman who had a vaginal delivery with a second-degree perineal tear. The nurse includes instructions on how to care for the perineum at home. Which statement by the woman indicates that she understands the instructions?

A nurse is providing discharge teaching to a client who had a vaginal delivery with a midline episiotomy. Which of the following instructions should the nurse include in the teaching? (Select all that apply.)

A nurse is caring for a client who delivered an infant vaginally 2 days ago and notes that there are no clots present in the lochia flow, but there is moderate bleeding with bright red blood and small clots present when massaging the fundus which is firm, midline, and at the level of the umbilicus.

A nurse is caring for a postpartum client who reports heavy vaginal bleeding and passing large clots since delivery 2 days ago. Which of the following actions should the nurse take first?

A nurse is caring for a client who has postpartum endometritis and is receiving IV antibiotics. Which of the following instructions should the nurse include in the plan of care? A) Encourage fluid intake to promote hydration.

A nurse is providing discharge teaching to a client who had a vaginal delivery with a midline episiotomy.

Which of the following instructions should the nurse include in the teaching? (Select all that apply.)