A nurse is caring for a client who experienced a vaginal birth 20 hours ago. The nurse recognizes the client is in the taking-in phase of maternal postpartum adjustment. Which finding should the nurse expect during this phase?
Lack of appetite.
Eagerness to learn newborn care skills.
Discussion of birth experience.
Reconnection with her partner.
The Correct Answer is C
Choice A rationale
Lack of appetite is not typically associated with the taking-in phase of maternal postpartum adjustment. During this phase, the mother is more focused on her own needs, such as rest and recovery from childbirth.
Choice B rationale
Eagerness to learn newborn care skills is more characteristic of the taking-hold phase, which follows the taking-in phase. In the taking-in phase, the mother is more passive and dependent, focusing on her own needs.
Choice C rationale
Discussion of the birth experience is a common behavior during the taking-in phase. The mother often wants to talk about her labor and delivery experience as a way to process and integrate the event.
Choice D rationale
Reconnection with her partner is not a primary focus during the taking-in phase. The mother is more focused on her own recovery and the immediate needs of her newborn.
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Correct Answer is D
Explanation
Choice A rationale
Swelling in both breasts is more indicative of engorgement rather than mastitis. Mastitis typically affects only one breast.
Choice B rationale
A white patch on a nipple is more likely a sign of a yeast infection (thrush) rather than mastitis.
Choice C rationale
Cracked and bleeding nipples can be a risk factor for mastitis but are not a definitive sign of the condition.
Choice D rationale
A red and painful area in one breast is a classic sign of mastitis. This condition is often accompanied by flu-like symptoms such as fever and malaise.
Correct Answer is C
Explanation
Choice A rationale
A temperature of 99.0°F (37.3°C) is within the normal range and is not specifically associated with cardiovascular system changes in the postpartum period. It is a common finding and does not indicate any specific cardiovascular changes.
Choice B rationale
A respiratory rate of 18/min is within the normal range for adults and is not specifically associated with cardiovascular system changes in the postpartum period. It is a common finding and does not indicate any specific cardiovascular changes.
Choice C rationale
An elevated white blood cell (WBC) count of 22,000/mm³ is a common finding in the postpartum period due to the body’s response to the stress of childbirth. This leukocytosis is a normal physiological response and is associated with the cardiovascular system changes during this period.
Choice D rationale
Urinary retention is not specifically associated with cardiovascular system changes in the postpartum period. It can occur due to various reasons, including the effects of anesthesia or trauma during delivery, but it is not a direct result of cardiovascular changes.