A nurse is conducting a home visit on a client who is 5 weeks postpartum. The client says they are still experiencing a "yellow-ish white vaginal discharge.’’ What should the nurse include in the teaching to the client about this type of discharge?
A postpartum individual can have lochia rubra at 5 weeks postpartum.
A postpartum individual should not have any lochia at 5 weeks postpartum.
A postpartum individual can have lochia serosa up to 6 weeks postpartum.
A postpartum individual can have lochia alba ranging from 10 to 14 days and up to weeks postpartum.
The Correct Answer is D
A) A postpartum individual can have lochia rubra at 5 weeks postpartum:
Lochia rubra is the first stage of lochia, consisting of bright red blood and tissue, and is typically seen in the first 3-4 days postpartum. By 5 weeks postpartum, the lochia should no longer be in the rubra phase, and the discharge should have progressed to lochia serosa or alba. If the client is still experiencing lochia rubra at 5 weeks, this could indicate a problem, such as retained placental tissue or infection, and requires further evaluation.
B) A postpartum individual should not have any lochia at 5 weeks postpartum:
While it is true that lochia should be minimal or absent by 5 weeks postpartum, it is not uncommon for some women to still experience small amounts of lochia, particularly in the form of lochia alba, which can last up to 6 weeks. The type of discharge should be assessed, and if the discharge is abnormal (such as foul-smelling or accompanied by other symptoms), the nurse should investigate further. However, some amount of discharge, especially lochia alba, can be normal at this stage.
C) A postpartum individual can have lochia serosa up to 6 weeks postpartum:
Lochia serosa, which is pinkish or brownish in color and consists of blood, mucus, and uterine tissue, usually occurs between 4 to 10 days postpartum. It is not typically seen at 5 weeks postpartum unless there is a delay in the normal progression of lochia stages. By 5 weeks postpartum, lochia serosa should have already transitioned to lochia alba, a whitish or yellowish discharge.
D) A postpartum individual can have lochia alba ranging from 10 to 14 days and up to weeks postpartum:
Lochia alba is the final stage of lochia and typically starts around 10–14 days postpartum, lasting up to 6 weeks in some women. It consists mainly of leukocytes, epithelial cells, and mucus, and it is usually white or yellowish in color. This type of discharge is normal in the later weeks postpartum, and its presence at 5 weeks is considered a normal finding as long as it is not accompanied by foul odor, significant odor, or other signs of infection.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["C","E","H","I"]
Explanation
Findings that require follow-up:
Uterus boggy at 24 hr postpartum:
A boggy uterus indicates poor uterine contraction, which can lead to postpartum hemorrhage. Effective uterine contraction is crucial to prevent excessive bleeding after delivery, and this finding warrants immediate intervention, such as fundal massage or administering uterotonic medications.
Lochia rubra with foul odor:
Foul-smelling lochia is a sign of potential infection, often indicative of endometritis, which is an infection of the uterine lining. The presence of this odor requires prompt follow-up and possibly antibiotic treatment to prevent further complications.
Elevated temperature (38.3°C/100.9°F) at 24 hr postpartum:
A postpartum fever may indicate infection, such as endometritis or a urinary tract infection (UTI). This fever should be investigated further to determine the cause and appropriate treatment, as untreated infections can lead to serious complications.
Increased heart rate (105/min) at 24 hr postpartum:
Tachycardia in the postpartum period can be a sign of infection or early signs of hemodynamic instability, possibly due to blood loss or infection. Close monitoring is necessary, and the healthcare provider should be notified to evaluate the cause and initiate treatment if necessary.
Correct Answer is ["5"]
Explanation
Given:
Desired dose: Digoxin 0.25 mg PO daily
Available concentration: Digoxin 500 mcg/10 mL
To find:
Volume to administer (in mL)
Step 1: Convert desired dose to micrograms
We know that 1 milligram (mg) is equal to 1000 micrograms (mcg). Therefore, to convert the desired dose from mg to mcg, we multiply by 1000:
Desired dose (mcg) = Desired dose (mg)x 1000
Desired dose (mcg) = 0.25 mg x 1000 = 250 mcg
Step 2: Set up the proportion
We can use the following proportion to solve the problem:
(Desired dose) / (Available concentration) = Volume to administer
Step 3: Substitute the values
Plugging in the given values, we get:
(250 mcg) / (500 mcg/10 mL) = Volume to administer
Step 4: Simplify
To simplify, we can invert the denominator and multiply:
(250 mcg) x (10 mL / 500 mcg) = Volume to administer
The "mcg" units cancel out, leaving us with:
(250 x 10 mL) / 500 = Volume to administer
Step 5: Calculate
Performing the multiplication and division, we get:
2500/ 500 = Volume to administer
5 mL = Volume to administer
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