A nurse is caring for a client who is 5 hours postpartum following a successful vaginal birth of twins. The nurse should recognize that this client is at increased risk for which of the following postpartum complications?
Mastitis.
Uterine infection.
Uterine atony.
Retained placental fragments.
The Correct Answer is C
Choice A rationale
Mastitis is an infection of the breast tissue that results in breast pain, swelling, warmth, and redness. It is more common in breastfeeding women and typically occurs when bacteria enter the breast tissue through a cracked or sore nipple. While it is a postpartum complication, it is not specifically associated with the delivery of twins.
Choice B rationale
Uterine infection, also known as endometritis, is an infection of the uterine lining. It can occur after childbirth, especially if there were complications such as prolonged labor, multiple vaginal exams, or manual removal of the placenta. However, it is not specifically associated with the delivery of twins.
Choice C rationale
Uterine atony is the most common cause of postpartum hemorrhage. It occurs when the uterus fails to contract effectively after childbirth, leading to excessive bleeding. The risk of uterine atony is higher in cases of overdistension of the uterus, such as with multiple gestations (twins), polyhydramnios, or a large baby. Therefore, a client who has delivered twins is at increased risk for uterine atony.
Choice D rationale
Retained placental fragments occur when parts of the placenta remain in the uterus after childbirth. This can lead to postpartum hemorrhage and infection. While it is a potential complication, it is not specifically associated with the delivery of twins.
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Correct Answer is C
Explanation
Choice A rationale
A high-fat diet is not recommended for breastfeeding mothers. While fats are an essential part of a balanced diet, excessive intake of high-fat foods can lead to unhealthy weight gain and may not provide the necessary nutrients for both the mother and the baby. Breastfeeding mothers should focus on a balanced diet that includes healthy fats, proteins, and carbohydrates to support their nutritional needs and milk production.
Choice B rationale
Stopping prenatal vitamins is not advisable for breastfeeding mothers. Prenatal vitamins contain essential nutrients such as folic acid, iron, and calcium that support the health of both the mother and the baby. Continuing to take prenatal vitamins can help ensure that breastfeeding mothers receive adequate nutrients, especially if their diet may not provide all the necessary vitamins and minerals.
Choice C rationale
Breastfeeding mothers need an additional 450-500 kCal per day to meet their increased energy requirements. This extra caloric intake supports milk production and helps the mother maintain her energy levels. The additional calories should come from a balanced diet that includes a variety of nutrient-dense foods.
Choice D rationale
Consuming only 8-16 oz of water per day is insufficient for breastfeeding mothers. Adequate hydration is crucial for milk production and overall health. Breastfeeding mothers should aim to drink at least 8-10 cups (64-80 oz) of water per day to stay hydrated and support their body’s increased fluid needs.
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.