Nokea
In caring for an immediate postpartum client, you note she has
- A. You monitor closely for which clotting disorder? (Which bleeding problem causes this: HEELP
- C. DIC
Correct Answer: A
Rationale: In caring for an immediate postpartum client, you should monitor closely for HELLP syndrome, which stands for Hemolysis, Elevated Liver enzymes, and Low Platelet count. HELLP syndrome is a serious complication of pregnancy characterized by high blood pressure, protein in the urine, and problems with the liver and blood-clotting system. It can lead to severe bleeding issues, organ failure, and other life-threatening complications if not promptly recognized and managed. Therefore, close monitoring for signs of HELLP syndrome is crucial in the postpartum period to ensure timely intervention and prevent adverse outcomes.
You may also like to solve these questions
A patient at 24 weeks of gestation reports that she has a glass of wine with dinner every evening. Which rationale should the nurse provide this patient regarding the necessity to eliminate alcohol intake? N R I G B.C M U S N T O
- A. The fetus is placed at risk for altered brain growth.
- B. The fetus is at risk for severe nervous system injury.
- C. The patient will be at risk for abusing other substances as well.
- D. A daily consumption of alcohol indicates a risk for alcoholism.
Correct Answer: A
Rationale: The correct rationale that the nurse should provide to the patient regarding the necessity to eliminate alcohol intake during pregnancy is that the fetus is placed at risk for altered brain growth. Alcohol consumption during pregnancy can lead to a condition known as Fetal Alcohol Syndrome (FAS), which is characterized by various physical and intellectual disabilities in the child. One of the major consequences of alcohol exposure during pregnancy is impaired brain development in the fetus. This can result in cognitive, behavioral, and neurological problems that may persist throughout the child's life. Therefore, it is crucial for pregnant women to completely abstain from alcohol to protect the health and well-being of the developing fetus.
After her baby's birth a patient wishes to begin breastfeeding. The nurse assists the client by:
- A. Positioning the infant to grasp the nipple to express milk.
- B. Giving the infant a bottle first to evaluate the baby's ability to suck
- C. Leaving them alone and allowing the infant to nurse as long as desired
- D. Touching the infant's cheek adjacent to the nipple to elicit the rooting reflex
Correct Answer: A
Rationale: Positioning the infant to grasp the nipple to express milk is an essential step in helping the patient begin breastfeeding successfully. As a nurse, it is crucial to ensure that the infant is properly latched onto the breast to facilitate effective feeding and milk transfer. This involves positioning the infant in a way that allows them to effectively grasp the nipple, promoting proper suckling and milk production. By assisting the patient in positioning the infant correctly, the nurse is supporting the establishment of successful breastfeeding and ensuring optimal nutrition for the baby.
The nurse is performing an assessment of a postpartum client. Which finding requires immediate action?
- A. Temperature of 100.4°F.
- B. Foul-smelling lochia.
- C. Fundus firm and midline.
- D. Breast tenderness on palpation.
Correct Answer: B
Rationale: Foul-smelling lochia may indicate an infection and requires prompt medical evaluation.
A nurse is teaching a client who is 28 weeks of gestation and not up-to date on current immunization. Which of the following immunizations should the nurse inform the client to anticipate receiving following birth?
- A. Pneumococcal
- B. Hepatitis
- C. Human papillomavirus
- D. Rubella
Correct Answer: D
Rationale: The CDC recommends that women who are not up-to-date with the MMR (measles, mumps, rubella) vaccine should receive it immediately postpartum. Rubella, also known as German measles, is particularly important during pregnancy because contracting rubella during pregnancy can lead to serious complications in the baby, such as birth defects and miscarriage. By ensuring the client receives the MMR vaccine postpartum, it helps protect both the mother and any future pregnancies from the risk of rubella infection.
A patient who has an LNG-IUC in place calls the office and states she just took a pregnancy test, and it is positive. She comes in for a visit, and the nurse does another pregnancy test, which is positive. What does the nurse know that the clinician will inform the patient regarding the IUC?
- A. Removing the IUC may increase the chance of infertility.
- B. The fetus is at risk for congenital defects.
- C. The IUC needs to be removed regardless of the plans for this pregnancy.
- D. There is no risk to the fetus if the IUC is left in place.
Correct Answer: D
Rationale: The correct statement the nurse knows that the clinician will inform the patient regarding the LNG-IUC is that there is no risk to the fetus if the IUC is left in place. The LNG-IUC (levonorgestrel-releasing intrauterine system) is a highly effective form of contraception that works by releasing progesterone locally in the uterus. The hormonal effect of the LNG-IUC is mostly limited to the uterus and very little of it circulates systemically. Therefore, there is no known increased risk of congenital defects or harm to the fetus if the IUC is left in place during pregnancy. The IUC can be left in place if the patient chooses to continue the pregnancy, provided there are no signs of infection or other complications that would necessitate its removal.