A client who is two weeks postpartum calls her obstetrician’s nurse and states that she has had a white discharge for about a week but today she is bleeding and saturating one pad about every 30 minutes. Which of the following is the appropriate response from the nurse?
“That is normal; you may have loosened your stitches.”.
“You may be starting to menstruate again.”.
“Go to the emergency department.”.
“You should stay on complete bed rest until the bleeding subsides.”.
The Correct Answer is C
Choice A rationale
Stating the bleeding is normal and linking it to stitches being loosened downplays the severity. Postpartum bleeding that saturates one pad in 30 minutes requires urgent evaluation to prevent complications like hypovolemic shock.
Choice B rationale
Menstruation typically resumes several weeks to months postpartum, depending on lactation. Heavy bleeding in this scenario is unlikely to be menstrual and requires medical attention to rule out hemorrhage or uterine atony.
Choice C rationale
Significant postpartum bleeding exceeding normal lochia patterns suggests a possible hemorrhage or retained products of conception, warranting immediate emergency department evaluation for prompt treatment and stabilization.
Choice D rationale
Bed rest is not appropriate in this case, as the heavy bleeding could indicate a life-threatening condition that demands immediate medical intervention rather than conservative management like rest.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Preterm neonates lack developed mechanisms to shiver for thermogenesis, relying instead on non-shivering thermogenesis primarily through brown fat metabolism, which is underdeveloped in preterm infants.
Choice B rationale
The fetal position does not significantly affect heat retention in preterm neonates, as their thermoregulatory mechanisms depend on adequate fat stores and skin coverage.
Choice C rationale
Blood vessels in preterm neonates are closer to the skin's surface, increasing heat loss due to greater exposure and lack of insulating subcutaneous fat.
Choice D rationale
Preterm neonates have minimal body fat, impeding insulation and heat retention, leading to rapid heat loss, necessitating external warming measures like incubators or radiant warmers.
Correct Answer is A
Explanation
Choice A rationale
Visual impairment, including retinopathy of prematurity, results from immature retinal vascularization and oxidative damage caused by prolonged oxygen therapy in premature infants, leading to neovascularization and potential retinal detachment.
Choice B rationale
Sensitivity to touch reflects neurologic immaturity or overstimulation in premature infants but is not directly associated with oxygen therapy. It stems from underdeveloped sensory pathways and an immature central nervous system.
Choice C rationale
Hyperbilirubinemia arises from excessive bilirubin production or impaired hepatic clearance in neonates, unrelated to oxygen therapy. Factors include hemolysis, immature liver enzyme systems, or delayed feeding initiation.
Choice D rationale
Cerebral palsy, a motor disorder due to non-progressive brain injury, can result from perinatal asphyxia or intracranial hemorrhage, but it is not a direct outcome of oxygen therapy in premature infants.
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