A nurse is caring for a client who is 5 hr postpartum following a vaginal birth of a newborn weighing 11 lb 6 oz. (5160 g). The nurse should recognize that this client is at risk for which of the following postpartum complications?
Thrombophlebitis
Retained placental fragments
Puerperal infection
Uterine atony
The Correct Answer is D
Choice A reason: Thrombophlebitis is a condition where a blood clot forms in a vein and causes inflammation and pain. The risk factors for thrombophlebitis include immobility, dehydration, obesity, smoking, and cesarean birth. This client is not at increased risk for thrombophlebitis based on the information given.
Choice B reason: Retained placental fragments are pieces of the placenta that remain in the uterus after delivery and can cause bleeding, infection, or uterine subinvolution. The risk factors for retained placental fragments include placenta previa, placenta accreta, manual removal of the placenta, and incomplete separation of the placenta. This client is not at increased risk for retained placental fragments based on the information given.
Choice C reason: Puerperal infection is an infection of the reproductive tract that occurs within six weeks after delivery and can cause fever, malaise, abdominal pain, and foul-smelling lochia. The risk factors for puerperal infection include prolonged rupture of membranes, prolonged labor, multiple vaginal examinations, operative delivery, and retained placental fragments. This client is not at increased risk for puerperal infection based on the information given.
Choice D reason: Uterine atony is a condition where the uterus fails to contract and retract after delivery and can cause excessive bleeding, hypovolemic shock, and hemorrhage. The risk factors for uterine atony include overdistension of the uterus, prolonged labor, oxytocin use, anesthesia, and trauma. This client is at increased risk for uterine atony due to the large size of the newborn, which can overstretch the uterus and impair its ability to contract.
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Naxlex Comprehensive Predictor Exams
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Correct Answer is D
Explanation
Choice A reason: Calcium carbonate is not the compound that the nurse should have readily available, as it is an antacid that neutralizes stomach acid and relieves heartburn. Calcium carbonate is not used to treat severe preeclampsia or magnesium sulfate toxicity, which are the conditions that the client may have.
Choice B reason: Potassium chloride is not the compound that the nurse should have readily available, as it is an electrolyte supplement that replenishes potassium levels and prevents hypokalemia. Potassium chloride is not used to treat severe preeclampsia or magnesium sulfate toxicity, which are the conditions that the client may have.
Choice C reason: Ferrous sulfate is not the compound that the nurse should have readily available, as it is an iron supplement that prevents or treats iron deficiency anemia. Ferrous sulfate is not used to treat severe preeclampsia or magnesium sulfate toxicity, which are the conditions that the client may have.
Choice D reason: Calcium gluconate is the compound that the nurse should have readily available, as it is an antidote that reverses the effects of magnesium sulfate and restores calcium levels and neuromuscular function. Calcium gluconate is used to treat severe preeclampsia or magnesium sulfate toxicity, which are the conditions that the client may have.
Correct Answer is C
Explanation
Choice A reason: Disseminated intravascular coagulation (DIC) syndrome is not the correct answer, as it is a coagulation disorder that causes widespread clotting and bleeding in the body. DIC can occur as a complication of severe preeclampsia, but it is not indicated by the laboratory results. DIC would cause a low platelet count, but also a prolonged prothrombin time (PT) and activated partial thromboplastin time (aPTT), and a low fibrinogen level.
Choice B reason: Eclampsia is not the correct answer, as it is a seizure disorder that occurs in clients with severe preeclampsia. Eclampsia can occur as a complication of severe preeclampsia, but it is not indicated by the laboratory results. Eclampsia would cause a high blood pressure, but also a proteinuria, edema, and hyperreflexia.
Choice C reason: Hemolysis, elevated liver enzyme levels, and low platelet levels (HELLP) syndrome is the correct answer, as it is a variant of severe preeclampsia that affects the blood and the liver. HELLP syndrome is indicated by the laboratory results, as it causes a low platelet count, an elevated AST level, and a falling hematocrit. HELLP syndrome would also cause a high blood pressure, a proteinuria, and a right upper quadrant pain.
Choice D reason: Idiopathic thrombocytopenia is not the correct answer, as it is an autoimmune disorder that causes the destruction of platelets by antibodies. Idiopathic thrombocytopenia can affect pregnant women, but it is not related to severe preeclampsia or the laboratory results. Idiopathic thrombocytopenia would cause a low platelet count, but not an elevated AST level or a falling hematocrit.
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