Which instruction should be included in the discharge teaching plan to assist the patient in recognizing early signs of complications?
“Palpate the fundus daily to ensure it is soft.”.
“The passage of clots is expected.”.
“Report any decrease in the amount of brownish-red lochia.”.
“Notify the physician of any increase in the amount of lochia or a return to bright red bleeding.”.
The Correct Answer is D
Choice A rationale
A soft uterus indicates uterine atony, a complication rather than a normal finding. Daily fundal palpation ensures involution but should result in a firm, not soft, uterus.
Choice B rationale
Passage of clots is common postpartum, but ongoing monitoring for excessive clotting is crucial as it may indicate retained placental fragments or incomplete uterine involution.
Choice C rationale
Decreased lochia does not indicate complications unless it is completely absent, which may suggest uterine or cervical obstruction and warrants further evaluation.
Choice D rationale
Increased lochia or bright red bleeding signifies secondary postpartum hemorrhage, often caused by retained placental tissue or subinvolution, requiring immediate medical attention.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","C"]
Explanation
Choice A rationale
Providing family support is crucial as preterm birth can cause significant emotional distress. Education and involvement aid understanding of interventions and foster a supportive environment for both the neonate and family.
Choice B rationale
Strict handwashing and sterile technique prevent infection in preterm neonates, whose immature immune systems make them highly susceptible to sepsis, a leading cause of morbidity in NICUs.
Choice C rationale
Creating a womb-like state through dim lighting, limited noise, and careful positioning supports neurodevelopment and mimics the intrauterine environment, promoting growth and stability.
Choice D rationale
Frequent diaper changes may disturb thermoregulation and disrupt the neonate's limited energy reserves, as preterm infants require an environment that minimizes stress and conserves energy.
Correct Answer is D
Explanation
Choice A rationale
Manually removing the placenta can introduce infection and cause uterine injury, which are not preventive measures for postpartum hemorrhage but treatments for retained placenta requiring sterile conditions and medical indication.
Choice B rationale
Administering antibiotics does not directly prevent postpartum hemorrhage, as it focuses on managing infections like endometritis. Hemorrhage prevention is better addressed by uterine tone management and avoiding excessive bleeding.
Choice C rationale
Applying pressure to the umbilical cord can lead to uterine inversion, worsening hemorrhage. Controlled cord traction during active management of the third stage is safer and reduces hemorrhage risk effectively.
Choice D rationale
Frequent urination prevents bladder distension, which enhances uterine contraction. A contracted uterus reduces hemorrhage risk by compressing blood vessels. Distended bladder inhibits proper uterine contraction, increasing hemorrhage likelihood.
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