When planning the care for a client during the first 24 hours postpartum, the nurse expects to monitor the client's pulse and blood pressure frequently based on the understanding that the client is at risk for which condition?

Thromboembolism

Cervical laceration

Hemorrhoids

Hemorrhage

Answer and Explanation

The Correct Answer is D

Hemorrhage. This is because postpartum hemorrhage (PPH) is severe bleeding and loss of blood after childbirth that can lead to death. The most common cause of PPH is the uterus not contracting properly after delivery. The nurse needs to monitor the client’s pulse and blood pressure frequently to detect signs of shock and blood loss.

Choice A is wrong because thromboembolism is a blood clot that blocks a blood vessel, not a complication of bleeding.

Choice B is wrong because cervical laceration is a tear in the cervix that can cause bleeding, but it is not a common cause of PPH.

Choice C is wrong because hemorrhoids are swollen veins in the anus or rectum that can cause bleeding, but they are not a common cause of PPH.

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Correct Answer is A

Explanation

To check for postpartum hemorrhage.

This is because postpartum hemorrhage is a serious and potentially life-threatening complication that can occur within 24 hours of birth or later. It is defined as a blood loss of more than 500 mL in a vaginal delivery or more than 1000 mL in a cesarean delivery. The most common cause of postpartum hemorrhage is uterine atony, which is the failure of the uterus to contract after delivery. Other causes include lacerations, retained placental fragments, coagulation disorders, and uterine rupture. Monitoring the vital signs, especially blood pressure, and pulse, can help detect signs of hypovolemia due to blood loss. Other signs include pale skin, cold and clammy extremities, delayed capillary refill, decreased urine output, and altered mental status.

Choice B is not correct because determining if the mother's milk is coming in is not the primary rationale for monitoring a new mother every 15 minutes for the first hour after delivery. Milk production usually begins around 48 to 72 hours after delivery and is influenced by hormonal changes, breastfeeding frequency, and maternal health. Although breastfeeding support is important for postpartum care, it is not a priority over checking for postpartum hemorrhage.

Choice C is not correct because monitoring the mother's blood pressure to note any elevations is not the primary rationale for monitoring a new mother every 15 minutes for the first hour after delivery. Elevated blood pressure can indicate gestational hypertension or preeclampsia, which are serious conditions that can affect postpartum women. However, these conditions are more likely to cause symptoms such as headache, blurred vision, epigastric pain, and proteinuria⁴.

Moreover, blood pressure may not be a sensitive indicator of blood loss and may remain normal until a significant amount of blood is lost¹.

Choice D is not correct because answering questions the new parents may have is not the primary rationale for monitoring a new mother every 15 minutes for the first hour after delivery. Although providing education and support to the new parents is an essential part of postpartum care, it is not a priority over checking for postpartum hemorrhage. The new parents may have questions about infant care, feeding, contraception, recovery, and other topics that can be addressed during the postpartum period.

A. Gentle massage of the affected leg B. Anticoagulants for 6 weeks C. Passive leg exercises twice a day D. Application of ice to the affected leg

Correct Answer is B

Explanation

Anticoagulants for 6 weeks. This is because the client’s symptoms suggest that she has deep vein thrombosis (DVT), which is a blood clot in a deep vein of the leg. DVT is a serious condition that can lead to pulmonary embolism, which is a blockage of a blood vessel in the lungs. The treatment for DVT involves anticoagulants, which are drugs that prevent blood clots from growing or forming new ones. The duration of anticoagulant therapy depends on the risk factors and severity of DVT, but it is usually at least 6 weeks.

Choice A is wrong because gentle massage of the affected leg can dislodge the clot and cause a pulmonary embolism.

Choice C is wrong because passive leg exercises can increase blood flow and worsen pain and swelling.

Choice D is wrong because the application of ice to the affected leg can reduce inflammation but does not treat the underlying clot.

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When planning the care for a client during the first 24 hours postpartum, the nurse expects to monitor the client's pulse and blood pressure frequently based on the understanding that the client is at risk for which condition?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

What is the primary rationale for monitoring a new mother every 15 minutes for the first hour after delivery?

Correct Answer is A

Explanation

During a postpartum assessment, a woman reports that her right calf is painful. The nurse observes edema and redness along the saphenous vein in the right lower leg. Based on this finding, the nurse explains that the probable treatment will involve:

Correct Answer is B

Explanation

The nurse is teaching a prenatal class and illustrating some of the basic events that will happen right after the birth. The nurse should point out which action will best help the infant maintain an adequate body temperature.

Five days after a spontaneous vaginal delivery, a woman comes to the emergency room because she has a fever and persistent cramping. The nurse recognizes that the cause of these signs and symptoms may be:

The nurse is conducting a prenatal class explaining the various activities that will occur within the first few hours after birth. The nurse determines the session is successful when the couples correctly choose which reason for the use of an antibiotic ointment.

A nurse is caring for a client who is 4 hr postpartum. The nurse finds a small amount of lochia rubra on the client's perineal pad. The fundus is midline and firm at the umbilicus. Which of the following actions should the nurse take?

A first-time mother reports that she is experiencing difficulty breastfeeding her newborn. The neonatal reflex that the nurse would teach the mother to elicit, in order to facilitate breastfeeding is:

A nurse is collecting data from a postpartum client and finds a large amount of lochia rubra with several clots on the client's perineal pad. Which of the following actions should the nurse take first?

The 1-day postpartum patient shows a temperature elevation, cough, and slight shortness of breath on exertion. Based on these symptoms, the nurse should: