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Which of the following laboratory tests should the nurse report to the obstetrician when monitoring a client who is one day postpartum and has experienced significant postpartum hemorrhage?

Urine output 200 mL for the past 8 hours

Weight decrease of 2 pounds since delivery

Hemoglobin, which is an indicator of the number of RBCs and decreases during hypovolemia and hemorrhage

Hematocrit, which is the percent of RBCs in the total blood volume, and decreases during hypovolemia.

Answer and Explanation

The Correct Answer is C

Hemoglobin, which is an indicator of the number of RBCs and decreases during hypovolemia and hemorrhage.

Hemoglobin is a protein that carries oxygen in the blood and is measured in grams per deciliter (g/dL).

A normal range for hemoglobin is 12 to 16 g/dL for women.

A low hemoglobin level indicates anemia, which can be caused by blood loss or other factors.

A postpartum hemorrhage is a loss of more than 500 mL of blood after delivery, which can lead to hypovolemia (low blood volume) and shock.

Choice A is wrong because urine output 200 mL for the past 8 hours is within the normal range for a postpartum woman.

The kidneys may retain fluid during pregnancy and release it after delivery, resulting in increased urine output.

A normal urine output is 30 to 50 mL per hour.

Choice B is wrong because weight decrease of 2 pounds since delivery is expected for a postpartum woman.

The weight loss reflects the loss of fluid, blood, and placental tissue during delivery.

A normal weight loss after delivery is 10 to 12 pounds.

Choice D is wrong because hematocrit, which is the percent of RBCs in the total blood volume, and decreases during hypovolemia, may not reflect the true extent of blood loss in a postpartum hemorrhage.

Hematocrit is measured as a percentage and a normal range for hematocrit is 37 to 47% for women.

However, hematocrit may be falsely elevated due to hemoconcentration (increased concentration of blood cells) caused by fluid loss.

Hematocrit may take several days to reflect the actual blood loss.

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Correct Answer is B

Explanation

This is because a boggy uterus that is displaced to the right of midline indicates that the bladder is full and pushing the uterus out of place.A full bladder can prevent the uterus from contracting effectively after delivery, leading to excessive bleeding and postpartum hemorrhage (PPH).

Emptying the bladder can help the uterus return to its normal position and tone.

Choice A is wrong because applying ice packs to the perineum may help reduce swelling and pain, but it will not address the underlying cause of the boggy uterus.

Choice C is wrong because increasing the rate of IV fluids may worsen the bleeding by diluting the blood and reducing its clotting ability.

Choice D is wrong because administering carboprost, a medication that stimulates uterine contractions, may be indicated if other measures fail to restore uterine tone, but it is not the first action to take.Carboprost also has side effects such as fever, nausea, vomiting, and diarrhea.

Normal ranges for uterine size and position after delivery are:

• Immediately after delivery: at or slightly below the level of the umbilicus (navel)

• 6 hours after delivery: 1 fingerbreadth above the umbilicus

• 12 hours

A. Early B. Late C. Chronic D. Acute

Correct Answer is A

Explanation

Early postpartum hemorrhage occurs within the first 24 hours after delivery.The client has saturated two perineal pads in 15 minutes, which indicates severe bleeding and a possible complication of the third stage of labor.

Choice B is wrong because late postpartum hemorrhage occurs 24 hours to 12 weeks postpartum.This type of hemorrhage is usually caused by retained placental fragments or infection.

Choice C is wrong because chronic postpartum hemorrhage is not a recognized term.

Postpartum hemorrhage is an acute condition that requires immediate attention.

Choice D is wrong because acute postpartum hemorrhage is not a specific type of hemorrhage, but a general term for any excessive bleeding after childbirth.Postpartum hemorrhage can be classified into mild, moderate, or severe based on the amount of blood loss.

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Which of the following laboratory tests should the nurse report to the obstetrician when monitoring a client who is one day postpartum and has experienced significant postpartum hemorrhage?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who delivered vaginally 4 hours ago and has a boggy uterus that is displaced to the right of midline. Which of the following actions should the nurse take first?

Correct Answer is B

Explanation

A nurse is caring for a client who delivered vaginally 4 hours ago and has saturated two perineal pads in 15 minutes. The nurse identifies this as which of the following types of postpartum hemorrhage?

Correct Answer is A

Explanation

What is the most common cause of late postpartum hemorrhage?

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Which of the following is a nursing intervention for postpartum hemorrhage?