Practice Quiz

CNM Certified Nurse Midwife

Category - Postpartum

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A client who gave birth two days ago informs the nurse midwife that she has not had a bowel movement since the delivery of her child. The client had a vaginal birth. Which of the following statements made by the nurse midwife is the most appropriate in this situation?
  1. “Bowel elimination usually returns a week after birth. Increase your fluid intake to prevent constipation."
  2. “Bowel elimination usually returns 5 to 7 days after birth. Ambulate and increase your fiber intake to prevent constipation.”
  3. “Bowel elimination usually returns within the first 24 hours. Stay here and I will notify your physician.”
  4. “Bowel elimination usually occurs within 2 to 3 days after birth. Increase your fiber intake to relieve constipation.”
Explanation
Answer: D - Bowel elimination usually occurs within 2 to 3 days after vaginal birth. For postpartum clients who had a cesarean section, bowel elimination may not occur until 3 or 4 days after birth. The client should be encouraged to increase her intake of fiber and fluids and to engage in safe physical activities to relieve constipation. Constipation commonly occurs after birth due to many factors, such as reduced intake of food, anesthesia and use of narcotics or pain medications.
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