The laboratory results for a postpartum woman are as follows:

blood type: A +

rubella: non-immune

hematocrit: 30%

GBS: negative
How would the nurse best interpret these data?

A rubella injection is advised

A blood transfusion is advised

The nurse should contact the provider for an antibiotic order an

RhoGAM injection should be administered within 72 hours

Answer and Explanation

The Correct Answer is A

A) A rubella injection is advised:
Since the rubella titer is non-immune, the woman is not protected against rubella, which is important to address during the postpartum period. The rubella vaccine is typically given to women who are non-immune to rubella after childbirth, but it is contraindicated during pregnancy because it is a live vaccine. The best action in this case would be to administer the rubella vaccine to the postpartum woman before discharge, with instructions to avoid becoming pregnant for at least 28 days after vaccination to prevent harm to a future fetus.

B) A blood transfusion is advised:
The hematocrit of 30% indicates that the woman has mild anemia, but it does not require immediate intervention like a blood transfusion. Normal hematocrit levels for postpartum women typically range between 32% and 42%. A transfusion would be indicated if the hematocrit were much lower (usually below 20-25%) or if there were symptoms of significant blood loss, which are not indicated in this case.

C) The nurse should contact the provider for an antibiotic order:
There is no indication from the provided laboratory results or the scenario that the woman requires antibiotics. Group B Streptococcus (GBS) was negative, which eliminates the need for prophylactic antibiotics. There is no mention of any infection risk requiring an antibiotic prescription, and since her GBS result is negative, antibiotics are not warranted.

D) RhoGAM injection should be administered within 72 hours:
RhoGAM (Rh immunoglobulin) is typically administered to a woman with Rh-negative blood who has given birth to an Rh-positive baby to prevent Rh sensitization in future pregnancies. In this case, the woman has an Rh-positive blood type (A+), so she does not need RhoGAM. RhoGAM would only be necessary if the woman had an Rh-negative blood type, which she does not.

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Correct Answer is A

Explanation

A) Prolactin:
Prolactin is the primary hormone responsible for stimulating milk production in the postpartum period. In breastfeeding mothers, prolactin levels remain elevated, especially during the first few weeks after delivery, to support lactation. This hormone is released in response to suckling and is essential for maintaining a steady milk supply. Elevated prolactin levels help establish and maintain breastfeeding during the early postpartum period, even as other pregnancy-related hormones begin to decline.

B) Estrogen:
Estrogen levels drop sharply after childbirth, as the placenta is no longer present to produce this hormone. The decline in estrogen is one of the factors that helps initiate lactation. While estrogen rises later during the postpartum period as the body returns to its non-pregnant state, it is not elevated during the immediate postpartum period in breastfeeding women.

C) Progesterone:
Similar to estrogen, progesterone levels fall quickly after delivery. Progesterone is involved in maintaining pregnancy, and its levels decrease significantly once the placenta is delivered. A reduction in progesterone is one of the hormonal changes that triggers the onset of lactation. It does not remain elevated in the immediate postpartum period.

D) Human placental lactogen (hPL):
hPL is produced by the placenta during pregnancy to support fetal growth and prepare the breasts for lactation. However, after delivery, hPL levels decline rapidly because the placenta is expelled. It is not elevated in the immediate postpartum period.

E) Relaxin:
Relaxin is a hormone that helps to soften the cervix and relax the ligaments in preparation for childbirth. Its levels are elevated during pregnancy and drop significantly after delivery. It does not remain elevated in the postpartum period, particularly in breastfeeding women.

A. The vaccine is a live virus and may cause birth defects in the fetus. B. Tests to determine if the client developed immunity are not accurate for a month. C. She may have the virus and feel too sick to tolerate a pregnancy. D. Her body is not ready to nurture another pregnancy so quickly.

Correct Answer is A

Explanation

A) The vaccine is a live virus and may cause birth defects in the fetus:
The Rubella vaccine is a live attenuated virus, which means it contains a weakened form of the virus. Although this vaccine is safe for most adults, it can cause serious birth defects if a woman becomes pregnant within a 4-week period after receiving the vaccine. The live virus could potentially affect the developing fetus, causing congenital rubella syndrome (CRS), which can result in severe birth defects like heart defects, deafness, and cataracts. To prevent any risk to a future pregnancy, women are advised to wait at least 4 weeks after
vaccination before trying to conceive.

B) Tests to determine if the client developed immunity are not accurate for a month:
This is not accurate. While some tests for rubella immunity can be done soon after vaccination, the primary reason for delaying pregnancy is the live virus in the vaccine, not a delay in testing. The immune response to the vaccine typically develops within a few weeks, but the risk to a fetus comes from the live virus, not the testing process. The 4-week delay is to ensure that the virus has been cleared from the body before pregnancy is attempted.

C) She may have the virus and feel too sick to tolerate a pregnancy:
While the Rubella vaccine can cause mild side effects like fever, it does not typically cause significant illness that would prevent a woman from tolerating a pregnancy. The primary concern is the safety of the fetus, not the mother's symptoms, as any illness is generally mild and transient. The 4-week delay is to prevent potential harm to a fetus due to the live virus present in the vaccine.

D) Her body is not ready to nurture another pregnancy so quickly:
This rationale is not based on any medical guideline. There is no evidence to suggest that the body needs time to "recover" from the Rubella vaccine before becoming pregnant. The reason for the 4-week delay is to ensure that the live virus has been cleared from the body to avoid any risk to a potential pregnancy. The concern is not about the woman's ability to support another pregnancy, but about the potential for the live vaccine virus to harm a developing fetus.

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The laboratory results for a postpartum woman are as follows: blood type: A + rubella: non-immune hematocrit: 30% GBS: negative How would the nurse best interpret these data?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

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Correct Answer is A

Explanation

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The laboratory results for a postpartum woman are as follows:

blood type: A +

rubella: non-immune

hematocrit: 30%

GBS: negative
How would the nurse best interpret these data?