A nurse is reinforcing postpartum discharge teaching to a client who had no immunity to varicella and was given the varicella vaccine.Which of the following statements by the client indicates understanding?
I need a second vaccination at my postpartum visit.
I will need to use contraception for 3 months before considering pregnancy.
I was given the vaccine because my baby is O-positive.
I will be tested in 3 months to see if I have developed immunity.
The Correct Answer is A
Choice A rationale
The client needs a second varicella vaccination at her postpartum visit to ensure full immunity. The initial dose provides partial immunity, and the second dose completes the vaccination series.
Choice B rationale
The client needs to use contraception for 1 month, not 3 months, before considering pregnancy after receiving the varicella vaccine. This is to prevent potential harm to a developing fetus.
Choice C rationale
The varicella vaccine is not given based on the baby’s blood type. It is administered to protect the client from varicella infection.
Choice D rationale
There is no need for testing to see if the client has developed immunity after receiving the varicella vaccine. The second dose is given to ensure full immunity.
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Correct Answer is B
Explanation
Choice A rationale
A decreased urge to void is a common postpartum finding due to the effects of anesthesia and the trauma of childbirth. It does not require immediate intervention unless it leads to bladder distention.
Choice B rationale
A displaced fundus from the midline, especially if it is accompanied by a boggy uterus, indicates uterine atony, which can lead to postpartum hemorrhage. Immediate intervention is required to prevent severe blood loss.
Choice C rationale
A fundal height below the umbilicus is an expected finding 1 day postpartum as the uterus begins to involute. This does not require immediate intervention.
Choice D rationale
Increased urine output is common in the postpartum period as the body eliminates excess fluid accumulated during pregnancy. This is not a cause for immediate concern.
Correct Answer is D
Explanation
Choice A rationale
Staying home until one week after delivery is not a specific intervention for postpartum depression. Social support and monitoring are more effective strategies.
Choice B rationale
While adequate rest is important, advising to sleep as much as possible is not a targeted intervention for postpartum depression. Structured support and counseling are more beneficial.
Choice C rationale
Returning to work two weeks after delivery is not advisable for someone with a history of postpartum depression. Early return to work can increase stress and exacerbate symptoms.
Choice D rationale
Contacting a crisis counselor once a week provides structured support and monitoring, which is crucial for managing postpartum depression. Regular counseling helps in early identification and management of symptoms.