The patient at 3 days postpartum has come to the maternity clinic ...

[justinmsk]

The patient at 3 days postpartum has come to the maternity clinic with complaints of urinary urgency and dysuria. Which statement is most important for the nurse to make?
 
  1. Void into this sterile cup without touching the inside of the cup.
  2. Be sure to wipe from back to front after you have a bowel movement.
  3. Call the clinic if you develop nausea and vomiting or constipation.
  4. Decrease your fluid intake for a few days, but eat a lot of vegetables.

Question 2

A patient is 3 days postop from a cesarean birth. She has tenderness, localized heat, and redness of the left leg. She is afebrile. As a result of these symptoms, she most likely will be:
 
  1. Encouraged to ambulate freely.
  2. Given aspirin 650 mg by mouth.
  3. Given Methergine IM.
  4. Placed on bed rest.

[amandalm]

Answer to Question 1

Correct Answer: 1
Rationale 1: A clean-catch urine sample will need to be obtained for urinalysis to determine if the patient has developed a urinary tract infection.
Rationale 2: Patients should be taught to wipe from front to back after bowel movements in order to prevent contamination of the urethra and bladder with normal bowel flora.
Rationale 3: A lower urinary tract infection can progress into pyelonephritis, the signs of which are fever and flank pain. Constipation is not associated with urinary tract infections.
Rationale 4: Patients should increase their fluid intake but decrease their consumption of carbonated beverages. Cranberries, or cranberry juice, are helpful, as they acidify the urine. Vegetables do not help clear or prevent urinary tract infections.

Answer to Question 2

Correct Answer: 4
Rationale 1: That would increase the inflammation.
Rationale 2: Aspirin 650 mg by mouth has anticoagulant properties, but usually is not necessary unless complications occur.
Rationale 3: Methergine is given only for postpartum hemorrhage, and would only cause vasoconstriction of an already inflamed vessel.
Rationale 4: These symptoms indicate the presence of superficial thrombophlebitis. The treatment involves bed rest and elevation of the affected limb, analgesics, and use of elastic support hose.

[justinmsk]

Thank you

[amandalm]

No problemo