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 ["A","C","D"]
Explanation
Choice A rationale
Postpartum hemorrhage may occur weeks after delivery due to subinvolution of the uterus or retained placental fragments. Educating about late risks ensures patients monitor symptoms and seek timely care.
Choice B rationale
Breastfeeding is encouraged even after postpartum hemorrhage as it helps stimulate uterine contractions, reducing bleeding risk. Recommending avoidance could delay recovery and is scientifically unsupported unless contraindicated.
Choice C rationale
Oxytocin may be prescribed for ongoing uterine atony or to prevent late postpartum hemorrhage. It is essential to educate patients about its purpose and correct administration for safety and effectiveness.
Choice D rationale
Saturating a peri-pad within 1 hour may indicate active bleeding. Reporting this promptly ensures swift intervention to prevent further complications, aligning with standard postpartum care protocols.
Choice E rationale
Postpartum hemorrhage is not limited to 24–48 hours after birth; late-onset hemorrhage, occurring up to weeks later, is a known complication. Misleading patients with this incorrect timeframe can delay critical interventions.
Correct Answer is C
Explanation
Choice A rationale
Respiratory depression is less common in myelomeningocele unless secondary to severe neurological anomalies. It is not the primary risk mediator in this congenital condition.
Choice B rationale
Decreased cardiac output is not directly associated with myelomeningocele. This condition primarily affects the spinal cord and surrounding tissues rather than cardiovascular function.
Choice C rationale
Infection risk is high due to exposed neural tissue, making it the most significant concern. Infection can lead to meningitis, sepsis, and neurological deterioration if not properly managed.
Choice D rationale
Neurological damage is inherent to myelomeningocele but does not act as an external risk mediator. The focus is on preventing additional risks like infections to improve outcomes.
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