A charge nurse is recommending postpartum clients for discharge following a local disaster. Which of the following clients should the nurse recommend for discharge first?
A client who had an emergency cesarean birth 1 day ago
A client who had a precipitous birth 36 hr ago and has a second-degree perineal laceration
A client who has preeclampsia and a blood pressure of 166/110 mm Hg
A client who received 2 units of packed RBCs 6 hr ago for a postpartum hemorrhage
The Correct Answer is B
A. A client 1 day post-cesarean birth is still at risk for postoperative complications (e.g., infection, bleeding, pain, immobility). This client requires ongoing hospital monitoring.
B. A client who delivered vaginally 36 hours ago and has only a second-degree laceration is generally stable and can safely be discharged home with proper instructions for perineal care.
C. The client with preeclampsia and severe hypertension (166/110 mm Hg) is at high risk for seizures, stroke, and organ complications. This client must remain hospitalized for stabilization and management.
D. A client recently transfused after postpartum hemorrhage needs continued monitoring for recurrent bleeding and transfusion reactions. Discharging this client would be unsafe.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Tenting of the skin suggests dehydration, not fluid overload.
B. A respiratory rate of 30/min indicates tachypnea, which can occur due to pulmonary congestion and decreased gas exchange from fluid overload. Other signs may include crackles, dyspnea, elevated blood pressure, and jugular vein distension.
C. A heart rate of 60/min is normal; fluid overload typically causes tachycardia as the body compensates for increased volume and decreased oxygenation.
D. Warm, dry skin is a normal finding and does not indicate excess fluid volume.
Correct Answer is C
Explanation
A. This describes blood pressure measurement, not pulse deficit assessment.
B. Comparing carotid pulses in different positions is used to assess for orthostatic changes, not pulse deficit.
C. A pulse deficit is the difference between the apical pulse (central) and radial pulse (peripheral). This measurement helps identify conditions like atrial fibrillation where some heartbeats fail to produce peripheral perfusion.
D. Assessing both radial pulses simultaneously checks for pulse equality between limbs, not for pulse deficit.
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