A nurse is caring for a mother who delivered vaginally 2 hours ago.
Hemoglobin: 9 g/dL (11 to 14 g/dL). Hematocrit: 30% (36 to 43%). Platelets: 220,000/mm³ (150,000 to 400,000/mm³). WBC count: 12,000/mm³ (4,000 to 15,000/mm³). Temperature: 38.3°C (100.9°F). Select the 4 findings the nurse should report to the provider.
Respiratory assessment.
Hemoglobin level.
Heart rate.
Constant trickle of blood at the vagina.
Correct Answer : B,D
Choice A rationale
Respiratory assessment is important but not immediately concerning without specific abnormal findings.
Choice B rationale
Hemoglobin level of 9 g/dL is low and could indicate postpartum hemorrhage or anemia, warranting attention.
Choice C rationale
Heart rate abnormalities would be significant but are not provided in the data given.
Choice D rationale
Constant trickle of blood at the vagina suggests ongoing bleeding which could indicate a postpartum hemorrhage, requiring prompt intervention.
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Related Questions
Correct Answer is D
Explanation
Choice A rationale
Platelets at 140,000 mg are within the normal range and are not typically indicative of postpartum complications like a thrombus.
Choice B rationale
Hemoglobin at 7 mg/dl indicates anemia but is not directly related to the symptoms of pain and tenderness in the calf.
Choice C rationale
A WBC count of 15,000 could indicate an infection or inflammatory process but is not specific to deep vein thrombosis (DVT).
Choice D rationale
Fibrinogen at 600 mg/dl is elevated and can be a marker for increased coagulation activity, which is associated with an increased risk of thrombosis. .
Correct Answer is ["C","D","E"]
Explanation
Choice A rationale
A fundus midline and firm at the umbilicus is a normal postpartum finding and does not require reporting. It indicates that the uterus is contracting as expected to prevent postpartum hemorrhage.
Choice B rationale
Moderate lochia rubra without clots is expected in the immediate postpartum period and does not need to be reported. It is part of normal postpartum bleeding as the uterus sheds its lining.
Choice C rationale
A constant trickle of blood at the vagina postpartum could indicate a laceration or retained placental fragments and should be reported to the provider for further evaluation and management.
Choice D rationale
Hemoglobin levels can provide important information about the mother's blood loss during delivery. A low hemoglobin level could indicate significant blood loss and necessitates reporting.
Choice E rationale
An abnormal heart rate in a postpartum mother could be indicative of complications such as hemorrhage or infection and should be reported to the provider for further assessment.
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