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

The client asks, “How can I take care of myself at home?” Which of the following responses should the nurse give?

You should avoid taking sitz baths until your stitches dissolve

You should change your perineal pad from back to front

You should drink plenty of fluids and eat high-fiber foods

You should resume sexual intercourse as soon as you feel comfortable

Answer and Explanation

The Correct Answer is C

The correct answer is choice C. You should drink plenty of fluids and eat high-fiber foods. This will help you prevent constipation and ease your bowel movements, which can be painful after an episiotomy.

Choice A is wrong because you should not avoid taking sitz baths until your stitches dissolve. Sitz baths can help reduce the pain, swelling, and bruising around the wound area.

However, you should consult your doctor before taking a sitz bath.

Choice B is wrong because you should not change your perineal pad from back to front. This can introduce bacteria into your wound and increase the risk of infection. You should change your perineal pad from front to back and use a squirt bottle filled with warm water to cleanse the area every time you use the bathroom.

Choice D is wrong because you should not resume sexual intercourse as soon as you feel comfortable. You should wait until your wound is fully healed and your bleeding has stopped, which may take several weeks. You should also use a lubricant and a condom to prevent irritation and infection.

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Correct Answer is D

Explanation

The correct answer is choice D. To stabilize the lower uterine segment.Palpating the uterus after delivery helps to determine its size, firmness and rate of descent, which are indicators of its involution.The nurse places one hand just above the symphysis pubis to support the lower uterine segment and prevent it from being pushed down by the pressure of the other hand on the fundus.This prevents complications such as uterine inversion or prolapse.

Choice A is wrong because uterine prolapse is not prevented by placing one hand above the symphysis pubis, but by supporting the lower uterine segment with that hand.

Choice B is wrong because uterine hemorrhage is not prevented by placing one hand above the symphysis pubis, but by massaging the fundus to make it firm and contract the blood vessels.

Choice C is wrong because uterine inversion is not prevented by placing one hand above the symphysis pubis, but by stabilizing the lower uterine segment with that hand and avoiding excessive traction on the umbilical cord.

A. Retained placental fragments B. Infection C. Uterine fibroids D. Multiparity

Correct Answer is A

Explanation

The correct answer is choice A.Retained placental fragments are the most common cause of subinvolution.Subinvolution is a condition where the uterus does not return to its normal size after childbirth.Retained placental fragments prevent the uterus from contracting properly and cause prolonged bleeding and infection.

Choice B is wrong because infection is not the most common cause of subinvolution, but it can be an aggravating factor.Infection can cause inflammation and interfere with the healing of the uterine lining.

Choice C is wrong because uterine fibroids are not the most common cause of subinvolution, but they can be a predisposing factor.Uterine fibroids are benign tumors that can distort the shape of the uterus and impair its contraction.

Choice D is wrong because multiparity is not the most common cause of subinvolution, but it can be a predisposing factor.Multiparity means having given birth more than once, which can weaken the uterine muscles and reduce their ability to contract.

Normal ranges for uterine involution are as follows:

• Uterus weight: decreases from about 1000 g at delivery to about 60 g at six weeks postpartum.

• Uterus height: decreases from about 20 cm above the pubic bone at delivery to about 12 cm at one week postpartum, and then descends into the pelvis by six weeks postpartum.

• Uterus size: decreases from about 20 times its normal size at delivery to about its normal size at six weeks postpartum.

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A nurse is providing discharge teaching to a postpartum client who had a vaginal delivery with an episiotomy. The client asks, “How can I take care of myself at home?” Which of the following responses should the nurse give?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is palpating a patient’s uterus 12 hours after a vaginal delivery. For which reason does the nurse place one hand just above the symphysis pubis?

Correct Answer is D

Explanation

What is the most common cause of subinvolution?

Correct Answer is A

Explanation

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

The client asks, “How can I take care of myself at home?” Which of the following responses should the nurse give?