A 25-year-old client who had a severe postpartum hemorrhage following the vaginal birth of twins is transferred to the postpartum unit. The nurse knows that assessment for what complication has the highest priority for this client?

Placenta accreta

Hard, painful uterine afterpains.

Postpartum psychosis.

Disseminated intravascular coagulation

Answer and Explanation

The Correct Answer is D

A. Placenta accreta: Placenta accreta is a condition where the placenta attaches too deeply into the uterine wall. While this can be a concern, the client in this scenario has already given birth, so this may not be the highest priority at this moment.

B. Hard, painful uterine afterpains: Afterpains are common in the postpartum period, especially in women who have given birth to multiples. While they can be uncomfortable, they are generally expected and not considered a severe complication.

C. Postpartum psychosis: Postpartum psychosis is a serious mental health condition that can occur after childbirth. It is characterized by symptoms such as hallucinations, delusions, and severe mood disturbances. While it is a serious concern, it might not be the immediate priority in a client who has had a severe postpartum hemorrhage.

D. Disseminated intravascular coagulation (DIC): This is a life-threatening condition where there is widespread activation of clotting factors, leading to excessive blood clotting followed by bleeding. Given the history of severe postpartum hemorrhage, DIC is a significant concern, and prompt assessment and intervention are crucial.

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Correct Answer is B

Explanation

A. Document the findings in the record: Documenting the findings is important, but it doesn't address the potential issue of hypoglycemia.

B. Obtain a heel stick blood glucose level: This is the most appropriate action given the signs presented. A low blood glucose level can be a critical issue in newborns and requires prompt evaluation and management.

C. Place a pulse oximeter on the heel: While oxygen saturation monitoring is valuable in certain situations, it may not be the priority in this case where hypoglycemia is suspected.

D. Swaddle the infant in a warm blanket: While maintaining warmth is important, especially if the baby is hypothermic, addressing the potential hypoglycemia takes precedence.

A. Unilateral lower leg pain. B. Soft, spongy fundus C. Saturating two perineal pads per hour. D. Pulse rate of 56 beats/minute

Correct Answer is D

Explanation

A. Unilateral lower leg pain:
Unilateral lower leg pain can be a symptom of deep vein thrombosis (DVT), which is a serious condition. It requires further assessment and intervention.

B. Soft, spongy fundus:
A soft, spongy fundus is not a normal finding 12 hours postpartum. The fundus should be firm and well-contracted. A soft fundus could indicate uterine atony, a potential cause of postpartum hemorrhage.

C. Saturating two perineal pads per hour:
Saturating two perineal pads per hour is not a normal finding and may indicate excessive bleeding, which is concerning for postpartum hemorrhage. This requires immediate attention.

D. Pulse rate of 56 beats/minute:
A pulse rate of 56 beats per minute can be within the normal range, especially if the client is at rest. However, it's essential to consider the overall clinical picture and whether there are any signs of distress or symptoms associated with a low pulse rate.

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A 25-year-old client who had a severe postpartum hemorrhage following the vaginal birth of twins is transferred to the postpartum unit. The nurse knows that assessment for what complication has the highest priority for this client?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is B

Explanation

Which physical assessment data should the nurse consider a normal finding for a primigravida client who is 12 hours postpartum?

Correct Answer is D

Explanation

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