In planning the postpartum care of a multipara who had a normal pregnancy, labor, and delivery, which factor should be considered? The client needs to have:
breast care teaching because she is predisposed to mastitis.
frequent uterine fundal assessments because she is at risk for developing a prolapsed uterus.
a strict toileting schedule because she is prone to developing a urinary tract infection.
an “as needed” order for an analgesic because she is likely to have pain.
The Correct Answer is B
The correct answer is choice B. A multipara is a woman who has given birth more than once.
After delivery, the uterus contracts to return to its normal size and position.
However, in multiparas, the uterine muscles may be weaker and less able to contract effectively.
This can lead to a condition called uterine atony, where the uterus does not contract enough to prevent bleeding.
Uterine atony can also cause the uterus to descend into the vagina, which is called a prolapsed uterus.
Therefore, multiparas need frequent uterine fundal assessments to monitor the tone and position of the uterus and prevent complications.
Choice A is wrong because breast care teaching is important for all postpartum women, regardless of parity.
Mastitis is an inflammation of the breast tissue that can occur in any woman who is breastfeeding or not.
It is not more common in multiparas.
Choice C is wrong because a strict toileting schedule is not necessary for multiparas.
Urinary tract infections (UTIs) are caused by bacteria entering the urinary tract, usually from the urethra.
UTIs are not more common in multiparas, unless they have other risk factors such as catheterization, diabetes, or sexual activity.
Choice D is wrong because an “as needed” order for an analgesic may not be adequate for multiparas.
Pain after delivery can vary depending on the type and duration of labor, the size and position of the baby, and the use of anesthesia or episiotomy.
Multiparas may experience more pain due to stretching of the pelvic muscles and ligaments, or due to afterpains, which are contractions of the uterus that occur after delivery.
Therefore, multiparas may need regular doses of analgesics to manage their pain effectively.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
The correct answer is choice B. The patient’s uterine contraction pattern is enhanced.Prostaglandin E2 gel is used to induce labor by ripening and dilating the cervix and stimulating uterine contractions.The effectiveness of the gel can be measured by the frequency, duration and intensity of the contractions.
A stronger and more regular contraction pattern indicates that the gel is working and labor is progressing.
Choice A is wrong because cervical dilation is not the only indicator of labor induction.Cervical dilation can occur without contractions or with weak and irregular contractions, which means that labor is not established yet.
Choice C is wrong because cervical softening (or effacement) is a prerequisite for cervical dilation, but it does not necessarily mean that labor has started.Cervical softening can occur weeks before labor or even during pregnancy.
Choice D is wrong because uterine softening (or relaxation) is the opposite of what prostaglandin E2 gel is supposed to do.Uterine softening reduces the contractility and tone of the uterus, which can lead to prolonged labor or fetal distress.
Correct Answer is A
Explanation
The correct answer is choice A. Maintaining the infants’ airways is the nurse’s priority when caring for a set of twins delivered by cesarean delivery.This is because twins are more likely to be born early and need special care after birth than single babies.They may have breathing difficulties or low oxygen levels and require oxygen therapy or ventilation.
The nurse should assess the infants’ respiratory status and intervene as needed.
Choice B is wrong because keeping the infants in a warm, draft-free environment is important but not as urgent as ensuring their airways are clear and they are breathing well.Premature twins may have trouble regulating their body temperature and need to be kept warm, but this can be done after their airways are secured.
Choice C is wrong because placing identification bands on the infants is a standard procedure but not a priority.
The nurse should make sure the infants are correctly identified and matched with their mother, but this can be done after their vital signs are stable.
Choice D is wrong because monitoring the infants’ vital signs is also important but not as urgent as maintaining their airways.
The nurse should check the infants’ heart rate, blood pressure, temperature and blood sugar levels regularly, but this can be done after their respiratory status is assessed and managed.
Normal ranges for vital signs in newborns are:
• Heart rate: 100 to 160 beats per minute
• Blood pressure: 50 to 75 mm Hg systolic and 30 to 45 mm Hg diastolic
• Temperature: 36.5 to 37.5°C (97.7 to 99.5°F)
• Blood sugar: 40 to 80 mg/dL
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