The nurse receives a newborn within the first minutes after a vaginal delivery and intervenes to establish adequate respirations. What priority issue should the nurse address to ensure the newborn's survival?

Bleeding tendencies

Heat loss

Hypoglycemia

Fluid balance

Answer and Explanation

The Correct Answer is B

A. Bleeding tendencies:
Bleeding tendencies are not typically a priority immediately after birth unless there is a specific indication. Newborns are not at immediate risk for bleeding unless there are underlying conditions.

B. Heat loss:
Heat loss is a significant concern for newborns. Maintaining an adequate temperature is crucial to prevent hypothermia, which can lead to complications.

C. Hypoglycemia:
While monitoring blood glucose is important in the newborn, it may not be the most immediate concern within the first minutes after delivery. Stabilizing the newborn's temperature and initiating breathing are usually higher priorities.

D. Fluid balance:
Fluid balance is essential, but the initial focus is often on establishing respirations and maintaining temperature. Fluids may be administered as needed based on the clinical assessment.

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Correct Answer is D

Explanation

A. Placenta accreta: Placenta accreta is a condition where the placenta attaches too deeply into the uterine wall. While this can be a concern, the client in this scenario has already given birth, so this may not be the highest priority at this moment.

B. Hard, painful uterine afterpains: Afterpains are common in the postpartum period, especially in women who have given birth to multiples. While they can be uncomfortable, they are generally expected and not considered a severe complication.

C. Postpartum psychosis: Postpartum psychosis is a serious mental health condition that can occur after childbirth. It is characterized by symptoms such as hallucinations, delusions, and severe mood disturbances. While it is a serious concern, it might not be the immediate priority in a client who has had a severe postpartum hemorrhage.

D. Disseminated intravascular coagulation (DIC): This is a life-threatening condition where there is widespread activation of clotting factors, leading to excessive blood clotting followed by bleeding. Given the history of severe postpartum hemorrhage, DIC is a significant concern, and prompt assessment and intervention are crucial.

A. Notify the healthcare provider of the complaint B. Recommend an over-the-counter yeast medication C. Inform her that this is a normal physiological change. D. Prepare the client for a sterile speculum exam

Correct Answer is C

Explanation

A. Notify the healthcare provider of the complaint: While it's important for the healthcare provider to be aware of any changes or symptoms the client is experiencing, the described discharge is commonly associated with normal physiological changes in pregnancy.

B. Recommend an over-the-counter yeast medication: The characteristics of the discharge described (white, thin, and watery) are not typical of a yeast infection. Using over-the-counter medications without proper assessment can lead to unnecessary treatment.

C. Inform her that this is a normal physiological change: This is the most appropriate action. Increased vaginal discharge, often described as leukorrhea, is a common and normal change during pregnancy. It's generally thin, white, and watery.

D. Prepare the client for a sterile speculum exam: A sterile speculum exam may be indicated if there are other concerning symptoms or if the discharge changes in color, consistency, or if there is associated itching or foul odor. However, based on the information provided, it's not the first-line action.

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The nurse receives a newborn within the first minutes after a vaginal delivery and intervenes to establish adequate respirations. What priority issue should the nurse address to ensure the newborn's survival?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A 25-year-old client who had a severe postpartum hemorrhage following the vaginal birth of twins is transferred to the postpartum unit. The nurse knows that assessment for what complication has the highest priority for this client?

Correct Answer is D

Explanation

During a routine first trimester prenatal exam, a pregnant client tells the nurse that she has noticed an increase in vaginal discharge that is white, thin, and watery. Which action should the nurse implement?

Correct Answer is C

Explanation

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