A client who delivered vaginally 18-hours ago develops a slight fever. The delivery record shows spontaneous rupture of membranes (SROM) for 36 hours prior to delivery and labor lasting 24 hours. An epidural was placed during labor, and the client experienced a third-degree perineal laceration.
The practical nurse (PN) should recognize which information poses the greatest risk for developing postpartum endometritis?
Epidural anesthesia.
SROM for 36 hours.
Third-degree perineal laceration.
Labor lasting for 24 hours.
The Correct Answer is B
The information that poses the greatest risk for developing postpartum endometritis in this situation is that the client experienced spontaneous rupture of membranes (SROM) for 36 hours prior to delivery. SROM for an extended period of time increases the risk of infection, including postpartum endometritis, which is an infection of the uterus. The practical nurse (PN) should recognize this risk factor and monitor the client closely for signs of infection. The other information listed may also be important to consider, but SROM for 36 hours poses the greatest risk for developing postpartum endometritis in this situation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
The first action the PN should take is to obtain a point-of-care glucose test. This will provide immediate information about the patient's blood sugar level and help guide further interventions.
Option A, reviewing prior insulin prescriptions, is important but not the first priority.
Option B, checking blood pressure, is also important but not the most immediate concern.
Option D, assessing urine for ketones, can provide useful information about the presence of ketones in the urine, which can indicate diabetic ketoacidosis, but it is not the first action that should be taken.
Correct Answer is D
Explanation
Gestational diabetes mellitus (GDM) is a type of diabetes that occurs during pregnancy. If euglycemia, or normal blood glucose levels, is not maintained during pregnancy, the fetus can be at risk for a number of complications. The greatest risk to the fetus in this situation is the development of a macrosomic newborn, or a newborn that is significantly larger than average. This occurs because the excess glucose in the mother's bloodstream is passed on to the fetus, leading to excessive fetal growth.
Macrosomia can lead to complications during delivery, such as shoulder dystocia, and can increase the risk of injury to both the mother and the baby. While low birth weight and preterm birth are also potential complications of GDM, macrosomia is considered the greatest risk to the fetus if euglycemia is not maintained. Cleft palate is not typically associated with GDM.
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