Chapter 34 Home Care of the Postpartum Family
1) The nurse is speaking to a community group about the controversy regarding
the length of the hospital stay for postpartum clients. Which statement indicates
that a participant needs additional information?
1. As of 1998, theres a law that requires insurance to pay for a 48-hour stay
after an uncomplicated birth.
2. The length of stay was shortened by insurance companies to decrease
healthcare costs.
3. Early discharge became more popular in the 1980s as an alternative to having
a home birth.
4. With current length-of-stay laws, newborns have no problems at home, and
get recommended follow-up care.
Answer: 4
Explanation: 4. Even with the current length-of-stay laws, many newborns do
not always receive the recommended follow-up care when they go home
early. The health and stability of the mother and baby, the mothers ability and
confidence regarding self and newborn care, support systems available, and
access to follow-up care should form the basis of the decision.
Page Ref: 914
Cognitive Level: Applying
Client Need/Sub: Safe and Effective Care Environment: Management of Care
Standards: QSEN Competencies: I. B. 10. Engage patients or designated
surrogates in active partnerships that promote health, safety and well-being, and
self-care management. | AACN Essentials Competencies: IX. 7. Provide
appropriate patient teaching that reflects developmental stage, age, culture,
spirituality, patient preferences, and health literacy considerations to foster
patient engagement in their care. | NLN Competencies: Relationship-
,Centered Care: Communicate information effectively; listen openly and
cooperatively. | Nursing/Integrated Concepts: Nursing Process: Evaluation
Learning Outcome: 1 Explain the history of the controversy surrounding
length of stay (LOS).
MNL LO: 5.4.1 Develop a discharge teaching plan for the postpartum
patient.
1
Copyright 2016 Pearson Education, Inc.
2) A nurse is performing a postpartum assessment during the first home visit
to a client 3 days postdelivery. Which actions will the nurse perform?
Note: Credit will be given only if all correct choices and no incorrect choices
are selected.
Select all that apply.
1. Palpate the breasts.
2. Auscultate the carotid.
3. Check vaginal discharge.
4. Assess the extremities.
5. Inspect the perineum.
Answer: 1, 3, 4, 5
Explanation: 1. The nurse needs to assess for fullness and engorgement.
3. The nurse should check vaginal discharge for amount and color.
4. The extremities should be checked for any redness, edema, and tenderness.
5. The perineum needs to be checked for healing.
Page Ref: 929
Cognitive Level: Analyzing
Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum
and Newborn Care
Standards: QSEN Competencies: V. B. 1. Demonstrate effective use of
technology and standardized practices that support safety and quality. |
AACN Essentials Competencies: IX. 8. Implement evidence-based nursing
,interventions as appropriate for managing the acute and chronic care of patients
and promoting health across the lifespan. | NLN Competencies: Relationship-
Centered Care: Factors that contribute to or threaten health. | Nursing/Integrated
Concepts: Nursing Process: Assessment
Learning Outcome: 2 Discuss the components of postpartum home care.
MNL LO: 5.4.2 Explain the purpose and components of the postpartum home
visit.
2
Copyright 2016 Pearson Education, Inc.
3) A mother and her newborn have been discharged after a hospital stay of
less than 48 hours. What are essential components the nurse must include in the
first postpartum home visit?
Note: Credit will be given only if all correct choices and no incorrect choices
are selected.
Select all that apply.
1. Assessment of color
2. Measurement of weight
3. Measurement of height
4. Assessment of mother-newborn interaction
5. Reinforcement of information about feeding and sleep patterns
Answer: 1, 2, 4, 5
Explanation: 1. The nurse should assess the newborns general health,
hydration, and degree of jaundice.
2. The nurse should weigh the infant.
4. This is an opportune time to assess the quality of mother-newborn
interaction and details of newborn behavior.
5. Parents frequently need further clarification and reinforcement of maternal
or family education in neonatal care, particularly feeding and sleep position.
Page Ref: 915
Cognitive Level: Applying
Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum
, and Newborn Care
Standards: QSEN Competencies: V. B. 1. Demonstrate effective use of
technology and standardized practices that support safety and quality. |
AACN Essentials Competencies: IX. 8. Implement evidence-based nursing
interventions as appropriate for managing the acute and chronic care of patients
and promoting health across the lifespan. | NLN Competencies: Relationship-
Centered Care: Factors that contribute to or threaten health. | Nursing/Integrated
Concepts: Nursing Process: Implementation
Learning Outcome: 2 Discuss the components of postpartum home care.
MNL LO: 5.4.2 Explain the purpose and components of the postpartum home
visit.
3
Copyright 2016 Pearson Education, Inc.
4) A new mother is concerned about spoiling her newborn. The home care
nurse teaches the mother which of the following?
1. Newborns can be manipulative, so caution is advised.
2. Meeting the infants needs develops a trusting relationship.
3. An infant who is rocked to sleep every night is being spoiled.
4. Crying is good for babies, and letting them cry it out is advised.
Answer: 2
Explanation: 2. Picking babies up when they cry teaches them that adults are
responsive to their needs. This helps build a sense of trust and security.
Page Ref: 927
Cognitive Level: Applying
Client Need/Sub: Psychosocial Integrity: Coping Mechanisms
Standards: QSEN Competencies: I. B. 10. Engage patients or designated
surrogates in active partnerships that promote health, safety and well-being, and
self-care management. | AACN Essentials Competencies: IX. 7. Provide
appropriate patient teaching that reflects developmental stage, age, culture,
spirituality, patient preferences, and health literacy considerations to foster
patient engagement in their care. | NLN Competencies: Relationship-
Centered Care: Communicate information effectively; listen openly and
1) The nurse is speaking to a community group about the controversy regarding
the length of the hospital stay for postpartum clients. Which statement indicates
that a participant needs additional information?
1. As of 1998, theres a law that requires insurance to pay for a 48-hour stay
after an uncomplicated birth.
2. The length of stay was shortened by insurance companies to decrease
healthcare costs.
3. Early discharge became more popular in the 1980s as an alternative to having
a home birth.
4. With current length-of-stay laws, newborns have no problems at home, and
get recommended follow-up care.
Answer: 4
Explanation: 4. Even with the current length-of-stay laws, many newborns do
not always receive the recommended follow-up care when they go home
early. The health and stability of the mother and baby, the mothers ability and
confidence regarding self and newborn care, support systems available, and
access to follow-up care should form the basis of the decision.
Page Ref: 914
Cognitive Level: Applying
Client Need/Sub: Safe and Effective Care Environment: Management of Care
Standards: QSEN Competencies: I. B. 10. Engage patients or designated
surrogates in active partnerships that promote health, safety and well-being, and
self-care management. | AACN Essentials Competencies: IX. 7. Provide
appropriate patient teaching that reflects developmental stage, age, culture,
spirituality, patient preferences, and health literacy considerations to foster
patient engagement in their care. | NLN Competencies: Relationship-
,Centered Care: Communicate information effectively; listen openly and
cooperatively. | Nursing/Integrated Concepts: Nursing Process: Evaluation
Learning Outcome: 1 Explain the history of the controversy surrounding
length of stay (LOS).
MNL LO: 5.4.1 Develop a discharge teaching plan for the postpartum
patient.
1
Copyright 2016 Pearson Education, Inc.
2) A nurse is performing a postpartum assessment during the first home visit
to a client 3 days postdelivery. Which actions will the nurse perform?
Note: Credit will be given only if all correct choices and no incorrect choices
are selected.
Select all that apply.
1. Palpate the breasts.
2. Auscultate the carotid.
3. Check vaginal discharge.
4. Assess the extremities.
5. Inspect the perineum.
Answer: 1, 3, 4, 5
Explanation: 1. The nurse needs to assess for fullness and engorgement.
3. The nurse should check vaginal discharge for amount and color.
4. The extremities should be checked for any redness, edema, and tenderness.
5. The perineum needs to be checked for healing.
Page Ref: 929
Cognitive Level: Analyzing
Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum
and Newborn Care
Standards: QSEN Competencies: V. B. 1. Demonstrate effective use of
technology and standardized practices that support safety and quality. |
AACN Essentials Competencies: IX. 8. Implement evidence-based nursing
,interventions as appropriate for managing the acute and chronic care of patients
and promoting health across the lifespan. | NLN Competencies: Relationship-
Centered Care: Factors that contribute to or threaten health. | Nursing/Integrated
Concepts: Nursing Process: Assessment
Learning Outcome: 2 Discuss the components of postpartum home care.
MNL LO: 5.4.2 Explain the purpose and components of the postpartum home
visit.
2
Copyright 2016 Pearson Education, Inc.
3) A mother and her newborn have been discharged after a hospital stay of
less than 48 hours. What are essential components the nurse must include in the
first postpartum home visit?
Note: Credit will be given only if all correct choices and no incorrect choices
are selected.
Select all that apply.
1. Assessment of color
2. Measurement of weight
3. Measurement of height
4. Assessment of mother-newborn interaction
5. Reinforcement of information about feeding and sleep patterns
Answer: 1, 2, 4, 5
Explanation: 1. The nurse should assess the newborns general health,
hydration, and degree of jaundice.
2. The nurse should weigh the infant.
4. This is an opportune time to assess the quality of mother-newborn
interaction and details of newborn behavior.
5. Parents frequently need further clarification and reinforcement of maternal
or family education in neonatal care, particularly feeding and sleep position.
Page Ref: 915
Cognitive Level: Applying
Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum
, and Newborn Care
Standards: QSEN Competencies: V. B. 1. Demonstrate effective use of
technology and standardized practices that support safety and quality. |
AACN Essentials Competencies: IX. 8. Implement evidence-based nursing
interventions as appropriate for managing the acute and chronic care of patients
and promoting health across the lifespan. | NLN Competencies: Relationship-
Centered Care: Factors that contribute to or threaten health. | Nursing/Integrated
Concepts: Nursing Process: Implementation
Learning Outcome: 2 Discuss the components of postpartum home care.
MNL LO: 5.4.2 Explain the purpose and components of the postpartum home
visit.
3
Copyright 2016 Pearson Education, Inc.
4) A new mother is concerned about spoiling her newborn. The home care
nurse teaches the mother which of the following?
1. Newborns can be manipulative, so caution is advised.
2. Meeting the infants needs develops a trusting relationship.
3. An infant who is rocked to sleep every night is being spoiled.
4. Crying is good for babies, and letting them cry it out is advised.
Answer: 2
Explanation: 2. Picking babies up when they cry teaches them that adults are
responsive to their needs. This helps build a sense of trust and security.
Page Ref: 927
Cognitive Level: Applying
Client Need/Sub: Psychosocial Integrity: Coping Mechanisms
Standards: QSEN Competencies: I. B. 10. Engage patients or designated
surrogates in active partnerships that promote health, safety and well-being, and
self-care management. | AACN Essentials Competencies: IX. 7. Provide
appropriate patient teaching that reflects developmental stage, age, culture,
spirituality, patient preferences, and health literacy considerations to foster
patient engagement in their care. | NLN Competencies: Relationship-
Centered Care: Communicate information effectively; listen openly and
