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A client who experienced a severe postpartum hemorrhage following the vaginal birth of twins is transferred to the postpartum unit.
The nurse knows that assessment for which complication is the highest priority for this client?

A.

Disseminated intravascular coagulation (DIC).

B.

Postpartum psychosis.

C.

Hard, painful uterine afterpains.

D.

Placenta accreta.

E.

Placenta accreta.

Answer and Explanation

The Correct Answer is A

Choice A rationale

Disseminated intravascular coagulation (DIC) is a serious complication that can occur after severe postpartum hemorrhage. It involves an abnormal activation of the clotting cascade, leading to the formation of small blood clots in the vessels and can result in organ damage.

Choice B rationale

Postpartum psychosis is a rare psychiatric emergency that typically presents with delirium and mood disturbances, and it is not directly related to postpartum hemorrhage.

Choice C rationale

While hard, painful uterine afterpains can occur after childbirth, they are not the highest priority for assessment in a client who experienced a severe postpartum hemorrhage.

Choice D rationale

Placenta accreta is a condition where the placenta attaches too deeply into the uterine wall. However, it is typically identified during pregnancy or at the time of delivery, not after a postpartum hemorrhage.


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Related Questions

Correct Answer is B

Explanation

Choice A rationale
While protein is an essential nutrient for overall health and wellbeing, increasing protein intake alone is unlikely to significantly improve hemoglobin levels. Hemoglobin is a protein in red blood cells that carries oxygen, and its production depends on having enough iron, vitamin B12, and folic acid, not just protein.
Choice B rationale
During pregnancy, the volume of blood in a woman’s body increases to support the growing fetus. This increase in blood volume can dilute the blood, which can lead to a decrease in the concentration of red blood cells and hemoglobin, a condition known as physiological anemia of pregnancy. This is a normal part of pregnancy and is typically not a cause for concern.
Choice C rationale
While it’s true that many women experience changes in their hemoglobin levels during pregnancy, it’s not accurate to say that almost all women at 28-weeks gestation have anemia. Anemia is defined as a level of hemoglobin that’s lower than normal, and the normal range can vary. However, it’s important to note that the normal range for hemoglobin does decrease during pregnancy.
Choice D rationale
Iron is a key component of hemoglobin, and iron deficiency is a common cause of anemia. If a pregnant woman’s hemoglobin levels are low, taking an iron supplement might help increase these levels. However, it’s important to talk to a healthcare provider before starting any new medication or supplement.

Correct Answer is C

Explanation

Choice A rationale
A heart rate of 58 beats/minute is within the normal range for adults, including those who have recently given birth. Therefore, there is no need to report this to the healthcare provider.
Choice B rationale
While assessing for excessive lochia is important in postpartum care, there is no indication from the given vital signs that this is necessary.
Choice C rationale
The vital signs provided are all within normal ranges for a postpartum patient. Therefore, the appropriate action would be to document these findings in the patient’s record.
Choice D rationale
There is no indication from the given vital signs that the patient has a fever or pain, so administering a PRN dose of acetaminophen is not necessary.

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