Nokea
Which of the following laboratory values would the nurse expect to see in a normal postpartum woman?
- A. Hematocrit, 39%.
- B. White blood cell count, 16,000 cells/mm3.
- C. Red blood cell count, 5 million cells/mm3.
- D. Hemoglobin, 15 grams/dL.
Correct Answer: B
Rationale: A slightly elevated white blood cell count is common postpartum due to the physiological stress of delivery and recovery.
You may also like to solve these questions
The nurse is collecting information during a follow-up OB appointment with a patient who delivered 3 months ago. The patient reports her partner has become cynical, irritable, and verbally abusive. The nurse will screen for which risks related to paternal postnatal depression (PPND)? Select all that apply.
- A. The father exhibited depression during the pregnancy
- B. The birth of this fourth child was unexpected and unplanned
- C. The father expresses feeling bored and underappreciated in his job
- D. The father is recently estranged from his parents and siblings
Correct Answer: B
Rationale: The correct answer is B. The birth of a fourth child being unexpected and unplanned can be a risk factor for paternal postnatal depression (PPND) due to increased stress and pressure. Choice A is incorrect because past depression during pregnancy doesn't directly correlate with PPND. Choice C is incorrect as feeling bored and underappreciated at work is not a direct risk factor for PPND. Choice D is incorrect as being recently estranged from family members doesn't directly relate to PPND.
The nurse is admitting a 38-year-old patient to triage in early labor with ruptured membranes. Her history includes a previous vaginal delivery 4 years ago and the presence of a uterine fibroid. What interventions are appropriate based on the hemorrhage risk for this patient?
- A. The patient is a moderate hemorrhage risk, so a type and screen should be ordered.
- B. The patient is a high hemorrhage risk, so 4 units of packed red blood cells should be ordered.
- C. The patient is a low hemorrhage risk, so a hold tube should be drawn.
- D. The patient is a moderate hemorrhage risk, but blood is not drawn at this time.
Correct Answer: A
Rationale: Step 1: The patient is in early labor with ruptured membranes, which increases the risk of hemorrhage.
Step 2: The presence of a uterine fibroid also contributes to the hemorrhage risk.
Step 3: Previous vaginal delivery 4 years ago does not significantly alter the hemorrhage risk.
Step 4: Ordering a type and screen will allow for rapid access to blood products if needed in case of hemorrhage.
Step 5: This is a moderate hemorrhage risk situation, warranting the need for preparing for potential blood transfusion.
Summary:
- Choice B is incorrect as ordering 4 units of packed red blood cells is excessive for a moderate hemorrhage risk.
- Choice C is incorrect as a hold tube will not provide immediate access to blood products in case of hemorrhage.
- Choice D is incorrect as blood should be drawn to be prepared for potential hemorrhage in a moderate risk situation.
A 2-day postpartum mother, G2 P2002, states that her 2-year-old daughter at home is very excited about taking 'my baby sister ' home. Which of the following is an appropriate response by the nurse?
- A. It 's always nice when siblings are excited to have the babies go home.
- B. Your daughter is very advanced for her age. She must speak very well.
- C. Your daughter is likely to become very jealous of the new baby.
- D. Older sisters can be very helpful. They love to play mother.
Correct Answer: C
Rationale: It is common for older siblings to feel jealousy when a new baby arrives. Preparing the child for the changes can help manage these feelings.
The nurse notices the uterus is boggy and the bladder is full. What intervention should the nurse perform next?
- A. Call for help.
- B. Start IV bolus.
- C. Get the person out of bed to walk to restroom.
- D. Massage the fundus and assess the lochia.
Correct Answer: D
Rationale: Step-by-step rationale:
1. A boggy uterus indicates uterine atony, a common cause of postpartum hemorrhage.
2. A full bladder can prevent the uterus from contracting effectively.
3. Massaging the fundus helps stimulate contractions to prevent further bleeding.
4. Assessing lochia provides information on the amount and type of bleeding.
5. This intervention addresses the underlying issue and promotes uterine contraction, reducing the risk of hemorrhage.
Other choices are incorrect:
A: Calling for help is not the immediate intervention needed to address the uterine atony and full bladder.
B: Starting an IV bolus may be necessary later but is not the priority in this situation.
C: Getting the person out of bed is not appropriate when managing postpartum hemorrhage; addressing uterine atony is crucial.
A woman is 1 hour postcesarean delivery with nausea and an estimated blood loss of 1,200 mL. She is currently experiencing heavy vaginal bleeding and has a uterus that firms with massage. She has a history of asthma with a current O2 saturation of 89%. The licensed provider has ordered Cytotec 800 mcg and Methergine 0.2 mg. What collaborative communication should occur between the nurse and provider?
- A. Since the total blood loss is under 1,500 mL, Cytotec and Methergine administration could be delayed for a time.
- B. Cytotec should be given rectally because the patient is already nauseated, and the Methergine route should be ordered.
- C. Recommend that the abdominal dressing be removed to inspect for incisional bleeding.
- D. Recommend that the patient not get Methergine because she has a history of asthma.
Correct Answer: D
Rationale: Given the patient’s asthma, Methergine should not be administered and alternative treatments should be discussed.