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Cesarean Section (11 Questions)
1. Mme. Anaïs Leblanc, 32 years old, is 8 hours postoperative following a scheduled low transverse cesarean section performed under spinal anesthesia for breech presentation. Her pregnancy and delivery were otherwise uncomplicated.
Current medical orders include:
*Acetaminophen 1,000 mg PO q6h scheduled
*Ibuprofen 600 mg PO q6h PRN mild to moderate pain
*Morphine 2 mg IV q4h PRN severe pain (≥7/10)
*Vital signs q4h
During routine assessment, Mme. Leblanc reports incisional pain rated 8/10, especially when coughing or changing position. She appears tense and guarded but is alert, oriented, and hemodynamically stable.
Question:
What is the most appropriate nursing action?
*
Encourage deep breathing
Administer morphine 2 mg IV
Wait for the next scheduled acetaminophen
Apply heat directly over the incision
2. Mme. Karine Morin, 29 years old, is postoperative day 1 following an emergency cesarean section for fetal distress. She received IV oxytocin in the immediate postpartum period.
Current orders include:
*Fundal and lochia assessment q4h
*Foley catheter removed 4 hours ago
On assessment, the nurse notes that the uterus is boggy and displaced to the right, with moderate lochia rubra. Mme. Morin reports lower abdominal discomfort and has not voided since catheter removal.
Question:
What is the nurse’s priority intervention?
*
Perform fundal massage
Notify the physician
Assist the patient to void
Restart oxytocin infusion
3. Mme. Sophie Tremblay, 35 years old, is postoperative day 1 following a C-section under spinal anesthesia. She has started clear fluids but complains of abdominal bloating and discomfort. Bowel sounds are hypoactive, and she has not yet passed flatus.
Orders include:
*Advance diet as tolerated
*Encourage early ambulation
Question:
Which nursing intervention best promotes return of peristalsis?
*
Maintain NPO status
Encourage chewing sugar-free gum
Administer opioid analgesics
Limit movement until bowel sounds return
4. Mme. Nadia Pelletier, 27 years old, is postoperative day 1 following her first cesarean section. She expresses fear of getting out of bed due to pain at the incision site.
Orders include:
*Ambulate with assistance
*Acetaminophen and ibuprofen as prescribed
Question:
What explanation best supports early ambulation?
*
It prevents wound infection
It eliminates the need for pain medication
It decreases uterine bleeding
It promotes circulation
5. Mme. Mélanie Gagnon, 38 years old, is postoperative day 2 following a cesarean section. On inspection, the incision is well approximated, clean, and dry. There is mild redness along the incision edges, but no warmth, swelling, or drainage. She is afebrile.
Question:
How should the nurse interpret this finding?
*
Early wound infection
Wound dehiscence
Normal postoperative healing
Allergic reaction to sutures
6. Mme. Laurence Côté, 31 years old, is 12 hours post-cesarean and wishes to breastfeed her newborn. She reports increased incisional pain when holding the baby close to her abdomen.
Question:
Which breastfeeding position is most appropriate?
*
Cradle hold
Football hold
Supine without support
Sitting upright unsupported
7. Mme. Véronique Roy, 36 years old, is postoperative day 1 following a prolonged cesarean section. She reports feeling weak and lightheaded. Assessment reveals a soft uterus and heavy lochia.
Question:
What is the nurse’s priority action?
*
Administer analgesia
Encourage oral fluids
Assist with ambulation
Perform fundal massage
8. Mme. Pascale Boucher, 40 years old, is postoperative day 1 following a repeat cesarean section. She has limited mobility.
Orders include:
*Elastic compression stockings
*Early ambulation
Question:
What is the primary purpose of the compression stockings?
*
Reduce incisional pain
Promote venous return
Prevent uterine bleeding
Improve bowel motility
9. Mme. Chloé Lapointe, 28 years old, had her Foley catheter removed 6 hours ago after a cesarean section. She reports suprapubic discomfort and has not voided despite oral fluids.
Question:
What is the most appropriate nursing action?
*
Encourage additional fluids
Reinsert the catheter immediately
Notify the physician
Perform a bladder scan
10. Mme. Julie Fortin, 34 years old, is preparing for discharge 48 hours after a cesarean section. She asks about activity limitations at home.
Question:
Which instruction is most important to prevent complications?
*
Resume normal household lifting
Avoid lifting objects heavier than the baby
Begin abdominal strengthening exercises
Take daily tub baths
11. Mme. Laurence Côté, 30 years old, is postoperative day 1 following a low transverse cesarean section performed under spinal anesthesia for arrest of labor. Her newborn is healthy and rooming-in. Mme. Côté wishes to exclusively breastfeed but expresses concern about the medications she is receiving.
Current medical orders include:
*Acetaminophen 1,000 mg PO q6h scheduled
*Ibuprofen 600 mg PO q6h PRN pain
*Morphine 2 mg IV q4h PRN severe pain (≥7/10)
*Encourage breastfeeding on demand
During assessment, Mme. Côté reports incisional pain rated 7/10 and states:
“I’m worried that taking morphine might harm my baby. I’m not sure if I should breastfeed while I’m on this medication.”
Vital signs are stable, and the newborn shows normal feeding behavior.
Question:
What is the most appropriate nursing response?
*
Advise the patient to stop breastfeeding while taking opioid analgesics
Encourage breastfeeding only after completely stopping all pain medications
Recommend switching to formula feeding until pain resolves
Explain that prescribed opioids are compatible with breastfeeding when used as ordered and that the baby should be monitored for excessive sleepiness