What instructions should the nurse provide to a new mother regarding postpartum care and monitoring the newborn’s health?
You will need to set up an appointment with your obstetrician in 8 weeks.
You will need to abstain from sexual activities until you see your obstetrician.
Contact the pediatrician if the baby is not breastfeeding well or has fewer wet diapers and stools.
The lactation nurse will be coming by to work with you and your baby.
The Correct Answer is C
Choice A rationale
The obstetrician follow-up appointment is typically scheduled at 6 weeks postpartum, not 8 weeks. Accurate timing of follow-up visits is crucial for monitoring the mother's health and recovery.
Choice B rationale
While abstaining from sexual activities postpartum is generally advised, it is usually recommended until the 6-week follow-up appointment, not specified by the obstetrician's discretion.
Choice C rationale
Contacting the pediatrician if the baby is not breastfeeding well or has fewer wet diapers and stools is critical for early detection of feeding issues, dehydration, or other health concerns.
Choice D rationale
A lactation nurse visit is beneficial for breastfeeding support but does not cover the broader scope of postpartum care and monitoring the newborn's health. Comprehensive instructions are essential for new mothers.
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Correct Answer is A
Explanation
Choice A rationale
Bradycardia (heart rate 56 beats/minute) is common postpartum due to increased stroke volume and reduced heart rate, reflecting physiological adaptation after delivery.
Choice B rationale
Saturating two perineal pads per hour is excessive and could indicate postpartum hemorrhage, requiring immediate evaluation and intervention.
Choice C rationale
A soft, spongy fundus indicates uterine atony, a serious condition requiring urgent intervention to prevent postpartum hemorrhage.
Choice D rationale
Unilateral lower leg pain could indicate deep vein thrombosis (DVT), a significant postpartum complication needing immediate medical attention.
Correct Answer is B
Explanation
Choice A rationale
Starting oxytocin infusion immediately may cause uterine hyperstimulation in clients who have already responded to misoprostol. Close monitoring and spacing out uterotonic agents help prevent adverse effects like uterine tachysystole and fetal distress.
Choice B rationale
Beginning oxytocin 4 hours after misoprostol ensures sufficient time for cervical ripening and reduces the risk of uterine hyperstimulation. This allows for safer labor induction and better outcomes for both mother and fetus.
Choice C rationale
Ambulating the client after misoprostol administration is generally safe but doesn't address the need for controlled uterotonic administration. Monitoring and timing of further uterotonics are crucial to avoid adverse effects and ensure safe induction.
Choice D rationale
Administering misoprostol every 2 hours is not recommended due to the risk of uterine hyperstimulation. It’s important to follow safe dosing intervals to reduce the risk of complications such as uterine tachysystole and fetal compromise.
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