Nokea
Following an amniocentesis, a client verbalizes several concerns. Which reported finding indicates to the nurse that the client is experiencing a complication from the amniocentesis?
- A. Low back pain with pelvic cramping.
- B. Headache and blurred vision.
- C. Increased fetal movement.
- D. Epigastric pain.
Correct Answer: A
Rationale: Low back pain and pelvic cramping post-amniocentesis may signal complications like premature labor or infection, requiring immediate evaluation.
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A primipara presents to the perinatal unit describing rupture of the membranes (ROM) occurring 12 hours prior to coming to the hospital. An oxytocin infusion is begun, and 8 hours later the client's contractions are irregular and mild. Based on this data, the nurse plans to monitor which sign more frequently than for the average laboring client?
- A. Color of amniotic fluid.
- B. Maternal temperature.
- C. Deep tendon reflexes.
- D. Maternal blood pressure.
Correct Answer: B
Rationale: Prolonged ROM increases infection risk, necessitating frequent maternal temperature monitoring to detect chorioamnionitis early.
History and Physical:
Nurses' Notes:
Vital Signs:
Laboratory Results:
The client is a 28-year-old primiparous female who was induced at 41 weeks gestation with misoprostol and oxytocin. She gave birth vaginally 4 days ago, and her prenatal course and delivery were uncomplicated. She was discharged home on day two with her newborn and has been breastfeeding around the clock.
A nurse is caring for a primiparous client in the postpartum unit. The client was induced at 41 weeks gestation with misoprostol and oxytocin and gave birth vaginally 4 days ago. She was discharged home on day two with her newborn and has been breastfeeding around the clock. She called her healthcare provider this morning with fatigue, new-onset headache, nausea, dizziness, weakness, and seeing "flashing lights."
The nurse reviews the client's history, physical, and flow sheet to determine the cause of the client's symptoms. Highlight the information from the history, physical, and flow sheet that require further evaluation. Select all that apply.
- A. Hemoglobin 10.4 g/dL (6.45 mmol/L)
- B. Platelets 150,000/mm³ (150 x 10â¹/L)
- C. New-onset headache
- D. Vomiting small amount of yellow fluid
- E. Right upper quadrant pain
- F. Seeing flashing lights
- G. Elevated blood pressure
Correct Answer: C,D,E,F,G
Rationale: Headache, vomiting, right upper quadrant pain, flashing lights, and elevated blood pressure suggest postpartum preeclampsia or HELLP syndrome, requiring urgent evaluation.
One day after vaginal delivery of a full-term baby, a postpartum client's white blood cell (WBC) count is 15,000/mm³ (15 x 10â¹/L). Which action should the nurse take first?
- A. Check the differential, since the WBC is normal for this client.
- B. Assess the client's perineal area for signs of a perineal hematoma.
- C. Assess the client's temperature, heart rate, and respirations every 4 hours.
- D. Notify the healthcare provider (HCP), since this finding is indicative of infection.
Correct Answer: A
Rationale: A WBC count of 15,000/mm³ is normal postpartum due to physiological stress; checking the differential confirms this, avoiding unnecessary interventions.
A client in active labor receives a prescription for oxytocin 6 milliunits/minute intravenously (IV). The IV bag contains oxytocin 10 units in lactated Ringer's 1,000 mL. How many mL/hour should the nurse program the infusion pump to deliver? (Enter numerical value only.)
Correct Answer: 36
Rationale: Calculated as: (6 milliunits/min ÷ 10,000 milliunits) × 1,000 mL = 0.6 mL/min; 0.6 mL/min × 60 min/hour = 36 mL/hour.
A client who delivered vaginally 18 hours ago develops a slight fever. The client's delivery record shows spontaneous rupture of membranes (SROM) for 36 hours prior to delivery and labor lasting 24 hours. An epidural was placed during labor, and she experienced a third-degree perineal laceration. The nurse should recognize which information poses the greatest risk for developing postpartum endometritis?
- A. SROM for 36 hours.
- B. Labor lasting for 24 hours.
- C. Third-degree perineal laceration.
- D. Epidural anesthesia.
Correct Answer: A
Rationale: Prolonged SROM significantly increases the risk of postpartum endometritis due to extended exposure to pathogens.