Nokea
The nurse should warn a client who is about to receive Methergine (ergonovine) of which of the following side effects?
- A. Headache.
- B. Nausea.
- C. Cramping.
- D. Fatigue.
Correct Answer: A
Rationale: Methergine is used to prevent postpartum hemorrhage, but it can cause side effects such as headache, nausea, and cramping. The nurse should inform the client about these possible side effects to promote informed decision-making.
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A woman who has recently given birth complains of pain and tenderness in her leg. On physical examination, the nurse notices warmth and redness over an enlarged, hardened area. Which condition should the nurse suspect, and how will it be confirmed?
- A. Disseminated intravascular coagulation (DIC); asking for laboratory tests
- B. von Willebrand disease (vWD); noting whether bleeding times have been extended
- C. Thrombophlebitis; using real-time and color Doppler ultrasound
- D. Idiopathic or immune thrombocytopenic purpura (ITP); drawing blood for laboratory analysis
Correct Answer: C
Rationale: The correct answer is C: Thrombophlebitis; using real-time and color Doppler ultrasound. Thrombophlebitis is the inflammation of a vein with the formation of a blood clot. In this scenario, the woman's symptoms of pain, tenderness, warmth, redness, and an enlarged, hardened area in her leg are indicative of thrombophlebitis. Using real-time and color Doppler ultrasound will confirm the diagnosis by visualizing the blood clot in the affected vein. This diagnostic method is effective in detecting thrombosis and determining the extent of the clot, guiding appropriate treatment.
Incorrect choices:
A: Disseminated intravascular coagulation (DIC) is a systemic process causing widespread clotting in small blood vessels, leading to bleeding. Asking for laboratory tests wouldn't be the appropriate way to confirm thrombophlebitis.
B: von Willebrand disease (vWD) is a genetic bleeding disorder, and checking
The nurse is assessing the laboratory report on a 2-day postpartum G1 P1001. The woman had a normal postpartum assessment this morning. Which of the following results should the nurse report to the primary health care provider?
- A. White blood cells, 12,500 cells/mm3.
- B. Red blood cells, 4,500,000 cells/mm3.
- C. Hematocrit, 26%.
- D. Hemoglobin, 11 g/dL
Correct Answer: C
Rationale: A hematocrit of 26% indicates possible anemia, and it should be reported to the healthcare provider for further evaluation.
What important assessment should the nurse perform on all postpartum persons?
- A. Screen for PPD with the EPDS.
- B. Screen for drug use with a urine drug screen.
- C. Screen for breast-feeding failure.
- D. Screen for contraception contraindications.
Correct Answer: A
Rationale: Screening for PPD is essential during postpartum care.
What is a risk factor for PPH found in the prenatal record?
- A. primipara
- B. rubella nonimmune
- C. von Willebrand disorder
- D. history of appendectomy
Correct Answer: C
Rationale: The correct answer is C: von Willebrand disorder. This is a risk factor for postpartum hemorrhage (PPH) as it can lead to abnormal bleeding during and after childbirth. von Willebrand disorder is a hereditary bleeding disorder that affects the blood's ability to clot properly. This can increase the likelihood of excessive bleeding during delivery, putting the mother at risk for PPH.
Choice A: primipara is incorrect, as being a first-time mother (primipara) is not a direct risk factor for PPH.
Choice B: rubella nonimmune is incorrect, as rubella immunity status is not directly related to the risk of PPH.
Choice D: history of appendectomy is incorrect, as a previous appendectomy is not a known risk factor for PPH.
In summary, the presence of von Willebrand disorder in the prenatal record is a significant risk factor for PPH due to its impact on blood clotting ability during childbirth.
What postpartum infection is caused by STIs and chorioamnionitis?
- A. mastitis
- B. pneumonia
- C. cesarean wound infection
- D. postpartum endometritis
Correct Answer: D
Rationale: The correct answer is D, postpartum endometritis. This infection is commonly caused by sexually transmitted infections (STIs) and chorioamnionitis. Endometritis is inflammation of the endometrium lining the uterus after childbirth. Mastitis (A) is a breast infection, pneumonia (B) is a lung infection, and cesarean wound infection (C) is an infection at the site of the cesarean incision. These options are incorrect as they do not specifically relate to the postpartum infection caused by STIs and chorioamnionitis.