A nurse is reviewing the laboratory data for a client who is at her first prenatal visit. The client is at 10 weeks of gestation. Which of the following manifestations should the nurse report to the provider?

2+ ketonuria

1.030 urine specific gravity

Hct 38%

Fasting blood glucose 70 mg/dL

Answer and Explanation

The Correct Answer is A

A.   2+ ketonuria indicates an elevated level of ketones in the urine, which can be a sign of inadequate nutrition or metabolism. This should be reported to the provider for further evaluation.
B.   A urine specific gravity of 1.030 is within normal range during pregnancy.
C.   A hematocrit (Hct) of 38% is within the normal range for a pregnant individual.
D.   A fasting blood glucose level of 70 mg/dL is within the normal range.

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Correct Answer is D

Explanation

A. administering misoprostol, may be indicated in postpartum care, but it is not the first priority in this situation. The immediate concern is excessive bleeding, which should be addressed first.
B. increasing maintenance IV fluid, is not the first action to take. While fluid management is important, it is not the priority when the client is experiencing excessive postpartum bleeding.
C. performing perineal hygiene, is important for overall hygiene, but it is not the first action to take when the client is experiencing excessive bleeding. Controlling bleeding takes precedence.
D. performing fundal assessment and massage, is the first priority. This helps assess for uterine atony (failure of the uterus to contract), a common cause of postpartum hemorrhage. Massage can stimulate uterine contractions and help control bleeding.

A. Positive Homans' sign B. Full, firm breasts C. Firm fundus at midline D. Lochia serosa

Correct Answer is C

Explanation

A. Homans' sign is a test for deep vein thrombosis and is not a normal postpartum finding.
B. Full, firm breasts typically occur a few days after delivery when milk production begins, not at 20 hours postpartum.
C. A firm fundus at the midline is an expected finding in the immediate postpartum period, indicating that the uterus is contracting and involuting properly.
D. Lochia serosa (pinkish-brown discharge) is a normal finding around 3 to 10 days postpartum, but it is not typically present at 20 hours postpartum.

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A nurse is reviewing the laboratory data for a client who is at her first prenatal visit. The client is at 10 weeks of gestation. Which of the following manifestations should the nurse report to the provider?

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