A nurse is planning care for a client who is 1 hour postpartum and has peripartum cardiomyopathy.

Which of the following actions should the nurse plan to take?

Administer an IV bolus of lactated Ringer’s.

Assess blood pressure twice daily.

Restrict daily oral fluid intake.

Obtain a prescription for misoprostol.

Answer and Explanation

The Correct Answer is C

Choice A rationale
Administering an IV bolus of lactated Ringer’s is not the best action for a client with peripartum cardiomyopathy. This condition is a form of heart failure that occurs during the last month of pregnancy or up to five months postpartum. It can lead to fluid overload, so giving an IV bolus of lactated Ringer’s could exacerbate the client’s condition.
Choice B rationale
Assessing blood pressure twice daily is important for any postpartum client, but it is not the most critical action for a client with peripartum cardiomyopathy. This condition can lead to fluid overload and heart failure, so while monitoring blood pressure is important, it is not the primary intervention.
Choice C rationale
Restricting daily oral fluid intake is the correct action. Peripartum cardiomyopathy can lead to fluid overload and heart failure. Restricting fluid intake can help manage the client’s fluid status and prevent exacerbation of heart failure.
Choice D rationale
Obtaining a prescription for misoprostol is not relevant in this context. Misoprostol is a medication used to prevent stomach ulcers in patients taking NSAIDs and to induce labor or cause an abortion. It has no role in the management of peripartum cardiomyopathy.

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Correct Answer is B

Explanation

Choice A rationale
A heart rate of 89/min is within the normal range for an adult, and would not typically be a cause for concern.
Choice B rationale
Cool, clammy skin can be a sign of shock or other serious conditions such as hypoperfusion or inadequate blood flow, which could be a sign of hemorrhage or other circulatory issues. This is a significant finding that should be reported to the provider immediately. Hypoperfusion can lead to inadequate oxygen supply to the body’s organs and tissues, which can result in organ failure and other serious complications. Therefore, any signs of hypoperfusion, including cool, clammy skin, should be reported to the provider immediately for further evaluation and treatment.
Choice C rationale
A blood pressure of 120/70 mm Hg is within the normal range for an adult, and would not typically be a cause for concern.
Choice D rationale
Moderate lochia serosa is a normal finding in a woman who is 3 days postpartum. Lochia serosa is the term for the pink or brownish discharge that occurs after lochia rubra, the bright red discharge that occurs immediately after childbirth. Lochia serosa typically begins about 3- 4 days after delivery and can continue for up to 10 days postpartum.

A. “Thick, white vaginal discharge.”. B. “Vulva lesions.”. C. “Malodorous discharge.”. D. “Urinary frequency.”.

Correct Answer is C

Explanation

Choice A rationale
A thick, white vaginal discharge is more commonly associated with a yeast infection, not trichomoniasis.
Choice B rationale
Vulva lesions are not a typical symptom of trichomoniasis. They can be associated with other conditions such as herpes.
Choice C rationale
Trichomoniasis is a sexually transmitted infection caused by a parasite. One of the common symptoms in women is a foul-smelling vaginal discharge, which can be clear, white, yellowish, or greenish.
Choice D rationale
While urinary frequency can occur with trichomoniasis, it is not as specific or common as malodorous discharge.

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A nurse is planning care for a client who is 1 hour postpartum and has peripartum cardiomyopathy. Which of the following actions should the nurse plan to take?

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A nurse is planning care for a client who is 1 hour postpartum and has peripartum cardiomyopathy.

Which of the following actions should the nurse plan to take?