A nurse is caring for the client.

Exhibits

Select the 5 findings that indicate the client's condition has improved.

Heart rate

Temperature

Lochia

Hgb

WBC count

Fundal height

Answer and Explanation

Correct Answer : A,B,C,E,F

A. Heart rate. The client’s heart rate decreased from 110/min on postpartum day 3 to 78/min on day 5, returning to normal resting range, which suggests improvement in systemic inflammation or infection, and better overall hemodynamic stability.
B. Temperature. The temperature has decreased from 38.6° C (101.5° F) to 37.1° C (98.9° F), which is within normal limits. This reduction is a key indicator of resolving infection or inflammation, especially considering the earlier febrile response.
C. Lochia. Lochia has improved from a moderate, foul-smelling, dark brown discharge to a small amount of brownish-red lochia with no odor, which suggests infection resolution and appropriate progression of postpartum uterine involution.
D. Hgb. The client’s hemoglobin dropped from 11.1 g/dL to 10 g/dL, which is below the normal postpartum range. This is likely due to ongoing recovery, recent surgery, and fluid shifts, but it does not indicate improvement and may require continued monitoring.
E. WBC count. The WBC count normalized from a significantly elevated 33,000/mm³ to 10,000/mm³, which is within the normal reference range. This is a strong sign that the infection or inflammatory response is resolving.
F. Fundal height. The fundus has decreased from 1 cm above the umbilicus on day 3 to 4 cm below on day 5, which is consistent with normal involution of the uterus during the postpartum period and is a positive sign of recovery.

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Correct Answer is C

Explanation

A. Apply the largest cuff available. Using a cuff that is too large can result in falsely low readings. Cuff size should match the client’s arm circumference to ensure accuracy, but simply switching to the largest cuff does not resolve difficulty in auscultation.
B. Deflate the cuff quickly. Rapid deflation can cause the nurse to miss the systolic and diastolic sounds, making it harder to obtain an accurate reading. The cuff should be deflated at a steady rate of 2–3 mmHg per second.
C. Use the palpatory method to determine blood pressure. When sounds are difficult to auscultate, the palpatory method is a reliable alternative. This involves palpating the radial pulse while inflating the cuff to estimate systolic pressure, which helps guide a more accurate auscultatory attempt.
D. Place the arm above the level of the client's heart. Elevating the arm above heart level can lower the pressure artificially, resulting in an inaccurate measurement. For correct results, the arm should be supported at heart level.

A. Schedule the client for an aPTT test. B. Collect a blood sample from the client for a direct Coombs test. C. Monitor the client for uterine contractions. D. Administer Rho(D) Immune globulin if the client is Rh positive.

Correct Answer is C

Explanation

A. Schedule the client for an aPTT test. An aPTT (activated partial thromboplastin time) test is used to monitor heparin therapy and is not relevant following an amniocentesis unless the client has a known bleeding disorder, which is not indicated here.
B. Collect a blood sample from the client for a direct Coombs test. The direct Coombs test is typically performed on newborns, not the mother, to detect antibodies attached to red blood cells. It is not a routine part of post-amniocentesis care.
C. Monitor the client for uterine contractions. After an amniocentesis, it is essential to monitor for signs of preterm labor, including uterine contractions. The procedure can irritate the uterus and potentially trigger contractions, especially at 34 weeks gestation.
D. Administer Rho(D) Immune globulin if the client is Rh positive. Rho(D) Immune globulin is given to Rh-negative clients after procedures like amniocentesis to prevent isoimmunization. It is not indicated for Rh-positive individuals.

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A nurse is caring for the client. Exhibits Select the 5 findings that indicate the client's condition has improved.

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A nurse is caring for the client.

Exhibits

Select the 5 findings that indicate the client's condition has improved.