Postpartum Care Flashcards

A postpartum client is found to be rubella non-immune. What is the appropriate recommendation?

Answer: Give MMR vaccine postpartum and advise avoiding pregnancy for about one month

MMR is recommended postpartum, is compatible with breastfeeding, and pregnancy should be avoided for 28 days after vaccination.

Two hours after birth, the fundus is boggy, above the umbilicus, and deviated to the right. What should the midwife do first?

Answer: Help the client empty her bladder

A full bladder pushes the uterus up and to one side and interferes with contraction, so emptying it comes first.

Which set of conditions must ALL be met for the lactational amenorrhea method (LAM) to be a reliable contraceptive?

Answer: Exclusive or nearly exclusive breastfeeding, no return of menses, under 6 months postpartum

LAM is about 98% effective only when all three criteria are present: full breastfeeding, amenorrhea, and less than 6 months postpartum.

While completing the Edinburgh Postnatal Depression Scale, a client marks that thoughts of harming herself occur 'sometimes.' What is the priority action?

Answer: Conduct an immediate safety assessment regardless of total score

Any positive response on item 10 (self-harm) warrants immediate safety assessment no matter what the total score is.

On day 3 postpartum, a client is tearful and irritable but sleeps when the baby sleeps, bonds well, and functions normally. What is the most likely explanation?

Answer: Postpartum blues

Postpartum blues typically begin within 2 to 3 days of birth and resolve on their own within about 2 weeks.

Ten days after birth, a client has confusion, hallucinations, and has not slept in 48 hours. Which history most increases her risk for this condition?

Answer: History of bipolar disorder

Postpartum psychosis is a psychiatric emergency, and bipolar disorder is its strongest risk factor.

On day 3 after a home birth with membranes ruptured 30 hours before delivery, a client has a temperature of 38.4°C (101.1°F), uterine tenderness, and foul-smelling lochia. What is the most likely diagnosis?

Answer: Endometritis

Fever with uterine tenderness and foul lochia suggests endometritis, and prolonged rupture of membranes is a key risk factor that requires medical referral for antibiotics.