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 D
Explanation
The correct answer is choice D. Insufficient relaxation of the uterus between contractions.This is also known astachysystoleorhyperstimulation, which can cause fetal distress and uterine rupture.Oxytocin is a hormone that stimulates uterine contractions, but it can also cause them to be too strong or too frequent if given in high doses or for too long.
Choice A is wrong because oxytocin does not decrease body temperature.
Choice B is wrong because oxytocin does not cause maternal cardiac arrhythmias.
Choice C is wrong because oxytocin does not cause urinary retention.
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