A patient had a vaginal birth 4 hours ago. Her hematocrit of 35% on admission for labor. Her current hematocrit is 25% which of the following statements by the nurse might best explain that

“Because you're not eating enough iron-rich foods like meat."

"Because you are hemoconcentrated the hematocrit dropped after delivery."

"Because your blood volume has doubled, your hematocrit is lower."

"This change in hematocrit indicates a postpartum hemorrhage."

Answer and Explanation

The Correct Answer is C

A. A decrease in hematocrit after delivery is more likely due to physiological changes rather than dietary factors alone, though iron intake is important for overall recovery.

B. Hemoconcentration refers to an increase in hematocrit due to a decrease in plasma volume, but this is not the reason for a decreased hematocrit postpartum.

C. During pregnancy, blood volume increases to support both the mother and fetus. After delivery, plasma volume returns to pre-pregnancy levels, which can cause a relative decrease in hematocrit.

D. A significant drop in hematocrit could indicate postpartum hemorrhage, but a slight drop can be expected as part of normal post-delivery physiology.

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Correct Answer is ["A","C"]

Explanation

A. Maternal hypotension is a common side effect of epidural anesthesia, which can reduce uteroplacental blood flow and lead to late decelerations in the fetal heart rate.

B. Maternal tachycardia is not typically associated with late decelerations; it is more often seen with early decelerations or fetal distress.

C. An IV bolus prior to the epidural helps maintain blood volume and prevent hypotension. Without it, the risk of hypotension and subsequent late decelerations increases.

D. Placenta previa typically causes painless vaginal bleeding and may lead to abnormal FHR patterns, but it is not a direct cause of late decelerations post-epidural.

A. Administer oxygen via mask B. Reposition the woman C. Document and continue monitoring D. Apply a fetal scalp electrode.

Correct Answer is C

Explanation

A. Administering oxygen via mask is indicated when there is concern for fetal hypoxia, such as late decelerations or variable decelerations.

B. Repositioning the woman may be appropriate if fetal heart rate patterns are concerning, but in this case, the decelerations are likely to be normal variable decelerations.

C. This is a pattern of early decelerations, which is typically benign and reflects fetal head compression. The appropriate action is to document and continue monitoring.

D. Applying a fetal scalp electrode is not indicated unless there is difficulty obtaining an accurate fetal heart rate on external monitoring.

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A patient had a vaginal birth 4 hours ago. Her hematocrit of 35% on admission for labor. Her current hematocrit is 25% which of the following statements by the nurse might best explain that

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Naxlex Comprehensive Predictor Exams

Your patient received an epidural approximately 30 minutes ago. You notice late decelerations while evaluating the FHR tracing, Which of the following might be reasons that late decelerations occurring? (Select all that apply).

Correct Answer is ["A","C"]

Explanation

The fetal heart rate decelerates from baseline mirroring the uterine contractions and then returns to baseline by the end of the contraction. What action by the nurse is indicated?

Correct Answer is C

Explanation

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