Which condition seen in the postpartum period is likely to require careful medical assessment?

Headaches

Varicosities of the legs

Carpal tunnel syndrome

Periodic numbness and tingling of the fingers

Answer and Explanation

The Correct Answer is A

Choice a) Headaches is correct because this is a condition that can indicate a serious problem in the postpartum period and may require careful medical assessment. Headaches are common in the first few weeks after giving birth, but they can also be a sign of complications such as preeclampsia, eclampsia, cerebral venous thrombosis, meningitis, or aneurysm. Preeclampsia and eclampsia are conditions that cause high blood pressure, proteinuria, and seizures in pregnant or postpartum women. Cerebral venous thrombosis is a blood clot in the brain that can cause stroke-like symptoms. Meningitis is an infection of the membranes that cover the brain and spinal cord. Aneurysm is a bulge or rupture in a blood vessel that can cause bleeding in the brain. These conditions can be life-threatening and require immediate treatment. Therefore, women who experience severe, persistent, or unusual headaches in the postpartum period should seek medical attention as soon as possible.

Choice b) Varicosities of the legs is incorrect because this is not a condition that usually requires careful medical assessment in the postpartum period. Varicosities are enlarged or swollen veins that appear blue or purple under the skin. They are common in pregnancy due to increased blood volume, hormonal changes, and pressure from the growing uterus. They usually improve after delivery, but may persist or worsen in some women. Varicosities are usually harmless and do not cause any symptoms, but they may cause cosmetic concerns, discomfort, itching, or bleeding. They can also increase the risk of superficial thrombophlebitis, which is inflammation of a vein near the skin surface. However, these complications are rare and mild, and can be managed with conservative measures such as compression stockings, elevation of the legs, exercise, and painkillers. Therefore, women who have varicosities of the legs in the postpartum period do not need to worry too much, unless they have signs of infection or deep vein thrombosis, which is a more serious condition that involves a blood clot in a deep vein that can travel to the lungs and cause pulmonary embolism.

Choice c) Carpal tunnel syndrome is incorrect because this is not a condition that typically requires careful medical assessment in the postpartum period. Carpal tunnel syndrome is a condition that causes numbness, tingling, pain, or weakness in the hand and wrist due to compression of the median nerve that runs through a narrow passage called the carpal tunnel. It can occur in pregnancy due to fluid retention, hormonal changes, or repetitive movements. It usually resolves after delivery, but may persist or recur in some women. Carpal tunnel syndrome is usually mild and does not cause any serious complications, but it may interfere with daily activities or quality of life. It can be treated with conservative measures such as splinting, icing, massage, stretching, or painkillers. In severe cases, surgery may be needed to release the pressure on the nerve. Therefore, women who have carpal tunnel syndrome in the postpartum period do not need to seek medical attention urgently, unless they have signs of nerve damage or infection.

Choice d) Periodic numbness and tingling of the fingers is incorrect because this is not a condition that generally requires careful medical assessment in the postpartum period. Periodic numbness and tingling of the fingers can be caused by various factors such as cold exposure, poor circulation, nerve compression, vitamin deficiency, or anxiety.

It can also occur in pregnancy due to fluid retention or hormonal changes. It usually goes away after delivery, but may linger or come back in some women. Periodic numbness and tingling of the fingers is usually harmless and does not indicate any serious problem, but it may cause discomfort or annoyance. It can be relieved with simple measures such as warming up, moving around, shaking out the hands, taking supplements, or relaxing. Therefore, women who experience periodic numbness and tingling of the fingers in the postpartum period do not need to worry too much, unless they have signs of infection or neurological disorder.

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Correct Answer is D

Explanation

Choice A) Weight gain of 0.5 kg during the past 2 weeks: This is a normal weight gain for a pregnant woman and does not indicate preeclampsia.

Choice B) Pitting pedal edema at the end of the day: This is a common symptom of pregnancy and does not necessarily indicate preeclampsia. It can be relieved by elevating the legs and wearing compression stockings.

Choice C) Blood pressure increase to 138/86 mm Hg: This is a mild elevation of blood pressure and does not meet the criteria for preeclampsia, which is defined as a systolic blood pressure of 140 mm Hg or higher or a diastolic blood pressure of 90 mm Hg or higher on two occasions at least four hours apart.

Choice D) Dipstick value of 3+ for protein in her urine: This is a sign of significant proteinuria, which is one of the main features of preeclampsia. Proteinuria is defined as a urinary protein excretion of 300 mg or more in 24 hours or a dipstick reading of 1+ or higher. A dipstick value of 3+ indicates severe proteinuria and requires immediate attention and treatment. This woman has the highest risk of developing complications from preeclampsia, such as eclampsia, HELLP syndrome, placental abruption, or fetal growth restriction . Therefore, she should be seen by the nurse first.

A. A phase of the female menstrual cycle that involves the release of an egg (ovum) from one of the ovaries. B. A female reproductive organ in which ova or eggs are produced. C. The regular discharge of blood and mucosal tissue from the inner lining of the uterus through the vagina. D. One-sided, lower belly pain associated with normal ovulation. Usually occurs about 14 days before the next menstrual period.

Correct Answer is D

Explanation

Choice a) A phase of the female menstrual cycle that involves the release of an egg (ovum) from one of the ovaries is incorrect because this is not the definition of Mittelschmerz, but rather the definition of ovulation. Ovulation is the process by which one or more eggs are released from the ovaries and travel to the fallopian tubes, where they can be fertilized by sperm. Ovulation usually occurs around the middle of the menstrual cycle, which is typically 28 days long, but can vary from person to person. Ovulation can be detected by changes in basal body temperature, cervical mucus, or hormone levels. Therefore, this response is inaccurate and misleading.

Choice B) A female reproductive organ in which ova or eggs are produced is incorrect because this is not the definition of Mittelschmerz, but rather the definition of ovary. The ovary is a paired organ that is located on either side of the uterus in the lower abdomen. The ovary contains thousands of follicles, which are sacs that contain immature eggs. Each month, one or more follicles mature and release an egg during ovulation. The ovary also produces hormones such as estrogen and progesterone, which regulate the menstrual cycle and pregnancy. Therefore, this response is irrelevant and inaccurate.

Choice C) The regular discharge of blood and mucosal tissue from the inner lining of the uterus through the vagina is incorrect because this is not the definition of Mittelschmerz, but rather the definition of menstruation. Menstruation is the process by which the endometrium, which is the tissue that lines the uterus and prepares for implantation of a fertilized egg, is shed and expelled through the vagina if pregnancy does not occur. Menstruation usually occurs once a month and lasts for about 3 to 7 days, but can vary from person to person. Menstruation can be accompanied by symptoms such as cramps, bloating, mood swings, or headaches. Therefore, this response is irrelevant and inaccurate.

Choice D) One-sided, lower belly pain associated with normal ovulation. Usually occurs about 14 days before the next menstrual period is correct because this is the definition of Mittelschmerz. Mittelschmerz is a German word that means "middle pain". It refers to a mild to moderate pain or discomfort that some women experience in their lower abdomen around the time of ovulation. The pain may last for a few minutes to a few hours and may switch sides from month to month depending on which ovary releases an egg. The pain may be caused by irritation or stretching of the ovarian or abdominal wall by the maturing follicle or by fluid or blood released during ovulation.

Mittelschmerz is not a sign of any disease or problem and does not require any treatment. However, it can be confused with other conditions that cause pelvic pain, such as appendicitis, ectopic pregnancy, or ovarian cysts. Therefore, women who have severe or persistent pain should consult their doctor for diagnosis and treatment. Therefore, this response is clear and accurate.

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Which condition seen in the postpartum period is likely to require careful medical assessment?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is D

Explanation

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