A woman with a history of mild heart failure has just vaginally ...

[CORALGRILL2014]

A woman with a history of mild heart failure has just vaginally given birth to a healthy baby. What action by the nurse is most important?
 
  A.
  Assess the woman for signs of heart failure.
  B.
  Facilitate an EKG.
  C.
  Insert a Foley catheter for hourly urine output assessments.
  D.
  Auscultate the woman's heart sounds.

Question 2

A diabetic patient is 1 day postpartum after an uncomplicated vaginal birth. She wants to know why her blood sugar levels are so much lower than usual. What explanation by the nurse is best?
 
  A.
  Because you are dehydrated, your blood sugar decreases for a few days.
  B.
  I will call the dietician to see if you are getting enough calories.
  C.
  The levels of hormones that cause an anti-insulin effect are decreased.
  D.
  The exertion from childbirth is like a massive workout for your body.

[jojobee318]

Answer to Question 1

ANS: A
Dramatic changes occur in the maternal hemodynamic system after the birth of the baby. This can lead to cardiac instability. In a woman with known heart failure, the nurse should be vigilant about assessing for signs of heart failure. Listening to heart sounds is part of the assessment, but is not sufficient. The woman may or may not need a catheter for hourly urine output assessments or an EKG.

Answer to Question 2

ANS: C
After childbirth, levels of hormones that exert an anti-insulin effect, such as estrogen, progesterone, human placental lactogen, cortisol, growth hormone, and insulinase, all decline. This leads to a drop in blood glucose in the few days following childbirth.