A nurse is caring for a postpartum client, 2 days after birth. Which of the following expected findings does the nurse associate with the cardiovascular system changes in the postpartum period?
Temperature 99.0°F (37.3°C).
Respiratory rate of 18/min.
WBC 22,000/mm³.
Urinary retention.
The Correct Answer is C
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.
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Correct Answer is A
Explanation
Choice A rationale
An intrauterine device (IUD) is one of the most reliable methods of contraception. It is a small, T-shaped device inserted into the uterus by a healthcare provider. IUDs can be hormonal or non-hormonal (copper). Hormonal IUDs release progestin, which thickens cervical mucus to prevent sperm from reaching the egg and thins the uterine lining to prevent implantation. Copper IUDs release copper ions, which are toxic to sperm. Both types of IUDs are over 99% effective and can last for several years, making them a highly reliable form of contraception.
Choice B rationale
Oral contraceptives, commonly known as birth control pills, are also effective but require daily adherence. They contain hormones (estrogen and progestin) that prevent ovulation, thicken cervical mucus, and thin the uterine lining. However, their effectiveness can decrease with missed doses, certain medications, or gastrointestinal disturbances. With typical use, their effectiveness is around 91%, meaning 9 out of 100 women may become pregnant each year.
Choice C rationale
Male condoms are a barrier method of contraception that prevent sperm from entering the uterus. They are also effective in preventing sexually transmitted infections (STIs). However, their effectiveness can be compromised by improper use, breakage, or slippage. With typical use, male condoms are about 85% effective, meaning 15 out of 100 women may become pregnant each year.
Choice D rationale
A diaphragm with spermicide is a barrier method of contraception. The diaphragm is a shallow, dome-shaped cup inserted into the vagina to cover the cervix, and spermicide is applied to kill sperm. Its effectiveness depends on correct and consistent use. With typical use, diaphragms are about 88% effective, meaning 12 out of 100 women may become pregnant each year. Additionally, diaphragms do not protect against STIs.
Correct Answer is D
Explanation
Choice A rationale
Pumping out the milk when breasts become engorged can provide temporary relief, but it can also stimulate further milk production, leading to continued engorgement. This is not recommended for clients who are not planning to breastfeed.
Choice B rationale
Not wearing a bra throughout the day can lead to discomfort and inadequate support for engorged breasts. Wearing a supportive bra, such as a sports bra, can help alleviate discomfort and provide necessary support.
Choice C rationale
Applying hot packs to the breasts can increase blood flow and exacerbate engorgement. Cold packs or ice packs are recommended to reduce swelling and provide relief from discomfort.
Choice D rationale
Avoiding stimulation to the nipples is an effective measure to reduce milk production and alleviate breast engorgement. This includes avoiding activities that may stimulate the nipples, such as pumping or hand expressing milk.