A client who is two weeks postpartum calls her obstetrician’s nurse and states that she has had a white discharge for about a week but today she is bleeding and saturating one pad about every 30 minutes. Which of the following is the appropriate response from the nurse?
“That is normal; you may have loosened your stitches.”.
“You may be starting to menstruate again.”.
“Go to the emergency department.”.
“You should stay on complete bed rest until the bleeding subsides.”.
The Correct Answer is C
Choice A rationale
Stating the bleeding is normal and linking it to stitches being loosened downplays the severity. Postpartum bleeding that saturates one pad in 30 minutes requires urgent evaluation to prevent complications like hypovolemic shock.
Choice B rationale
Menstruation typically resumes several weeks to months postpartum, depending on lactation. Heavy bleeding in this scenario is unlikely to be menstrual and requires medical attention to rule out hemorrhage or uterine atony.
Choice C rationale
Significant postpartum bleeding exceeding normal lochia patterns suggests a possible hemorrhage or retained products of conception, warranting immediate emergency department evaluation for prompt treatment and stabilization.
Choice D rationale
Bed rest is not appropriate in this case, as the heavy bleeding could indicate a life-threatening condition that demands immediate medical intervention rather than conservative management like rest.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
Feeling tired and wanting to sleep longer postpartum is common due to disrupted sleep from infant care, but it doesn't specifically indicate postpartum depression, which involves significant mood and emotional changes.
Choice B rationale
Occasional headaches postpartum can result from hormonal changes or stress, resolving with analgesics like Tylenol, and are not indicative of postpartum depression without associated mood disturbances like sadness or crying episodes.
Choice C rationale
Persistent crying and daily sadness are hallmark signs of postpartum depression, linked to hormonal imbalances, disrupted serotonin regulation, and social or emotional factors affecting maternal mental health postpartum.
Choice D rationale
Restlessness may be attributed to anxiety, but it alone doesn't conclusively diagnose postpartum depression, which involves deeper and more pervasive mood changes such as sadness or emotional withdrawal.
Correct Answer is C
Explanation
Choice A rationale
Retained placental fragments lead to delayed, not immediate, postpartum hemorrhage as they prevent complete uterine contraction over time.
Choice B rationale
Vaginal hematomas cause concealed, localized bleeding with minimal external blood loss, differing from profuse hemorrhage presentations.
Choice C rationale
Uterine atony, the most common cause, occurs when the uterus fails to contract effectively, leading to uncontrolled and excessive bleeding.
Choice D rationale
Uterine inversion, though serious, is rare and typically accompanied by visible uterine prolapse, not commonly causing profuse bleeding in the immediate postbirth period.
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