A nurse is collecting data from a client who is 2 days postpartum. Which of the following findings should alert the nurse to the possibility of a puerperal infection?
Upper abdominal pain
Bradycardia
Hypothermia
Foul-smelling lochia
The Correct Answer is D
A. Upper abdominal pain could indicate a variety of issues, including gastrointestinal upset or muscle soreness from labor, but it is not specific to a puerperal infection.
B. Bradycardia (slow heart rate) is not typically associated with a puerperal infection.
C. Hypothermia (low body temperature) is not a typical sign of a puerperal infection.
D. Foul-smelling lochia can be indicative of an infection, as an unpleasant odor may be associated with bacterial growth in the uterine cavity. This is a concerning sign and should be further evaluated.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. The suprapubic area is typically where the uterus can be palpated, but it's not the location for auscultating fetal heart tones at 12 weeks of gestation.
B. The umbilical area is not the optimal location at this stage; the fetal heart tones are generally not audible in this location until the uterus rises higher into the abdomen in later gestation.
C. At 12 weeks of gestation, the fetal heart tones are typically auscultated above the left iliac crest.
D. Below the liver border on the right abdomen is also not correct, as the fetal heart tones are unlikely to be found there at 12 weeks.
Correct Answer is B
Explanation
A. Applying an antiseptic after the puncture can be done to prevent infection, but it is not the initial step.
B. Warming the newborn's heel helps to increase blood flow, making the collection process more effective and less painful.
C. The puncture should be made on the outer aspect of the newborn's heel, where there is a good blood supply.
D. After the puncture, it is important to apply pressure to the site to stop bleeding, typically using a gauze pad or cotton ball.
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