A primipara client gave birth vaginally to a healthy newborn girl 12 hours ago. The nurse palpates the client's fundus. Which finding would the nurse identify as expected?

two fingerbreadths above the umbilicus

two fingerbreadths below the umbilicus

at the level of the umbilicus

four fingerbreadths below the umbilicus

Answer and Explanation

The Correct Answer is C

A. Two fingerbreadths above the umbilicus would be abnormal and may indicate uterine distension due to retained placental fragments or a full bladder, especially this long after delivery.

B. Two fingerbreadths below the umbilicus is typically expected 24 hours or more after delivery, not at 12 hours postpartum.

C. At the level of the umbilicus is normal and expected at about 12 hours postpartum. After delivery, the uterus rises slightly and is generally found at or near the umbilicus before it begins to descend (involute) by about 1 fingerbreadth per day.

D. Four fingerbreadths below the umbilicus would be expected several days postpartum, not within the first 12 hours.

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Correct Answer is D

Explanation

A. To enhance the clearing of the newborn's respiratory passages is not the primary reason for putting the newborn to the breast immediately. While early skin-to-skin contact and breastfeeding are beneficial, the clearing of respiratory passages is more directly related to the initial care the baby receives (such as suctioning if necessary), not breastfeeding.

B. To aid in maturing the newborn's sucking reflex is not the main reason for immediate breastfeeding. The sucking reflex is typically well-established in most newborns by the time of birth, and breastfeeding can help reinforce it. However, the reflex is present and functional even if the baby is not immediately breastfeeding.

C. To encourage the development of maternal antibodies is important in the longer term. Breastfeeding does provide immunological benefits to the baby (like colostrum), but the immediate reason for putting the baby to the breast is more about bonding and initiating breastfeeding.

D. To facilitate maternal-infant bonding is the primary reason for encouraging early breastfeeding. Skin-to-skin contact and breastfeeding immediately after birth promote emotional bonding between the mother and baby, which is beneficial for both. It also promotes the release of oxytocin in the mother, which supports uterine involution and maternal well-being.

A. temperature of 101° F (38.3° C) B. respiratory rate of 16 breaths per minute C. lochia rubra with a fleshy odor D. pain rating of 2 on a scale from 0 to 10

Correct Answer is A

Explanation

A. Temperature of 101° F (38.3° C) is concerning as it may indicate an infection, especially if it persists beyond the first 24 hours postpartum. A mild increase in temperature can be common during the first 24 hours after birth due to the physical stress of labor and delivery, but a temperature of 101° F is above the normal postpartum range and warrants further investigation for possible infection, such as endometritis or a urinary tract infection.

B. Respiratory rate of 16 breaths per minute is within the normal range for a postpartum woman, as normal respiratory rate is typically between 12 and 20 breaths per minute in adults. No immediate concerns are suggested by this finding.

C. Lochia rubra with a fleshy odor is a normal finding during the first few days postpartum. Lochia rubra, the initial discharge after childbirth, typically has a fleshy or musty odor and contains blood, mucus, and tissue from the uterine lining. A foul or offensive odor, however, would be indicative of infection, but a "fleshy" odor is normal.

D. Pain rating of 2 on a scale from 0 to 10 is within an acceptable range for postpartum pain. Mild discomfort is expected, especially around the perineum or from uterine contractions, and can usually be managed with over-the-counter pain relievers. A pain level of 2 suggests that the patient is coping well.

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A primipara client gave birth vaginally to a healthy newborn girl 12 hours ago. The nurse palpates the client's fundus. Which finding would the nurse identify as expected?

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