A nurse is reviewing the laboratory results of a client who had a postpartum hemorrhage due to placenta accreta.
The nurse notes that the client’s platelet count is 80,000/mm3, fibrinogen level is 150 mg/dL, and prothrombin time is 18 seconds.
What is the most appropriate interpretation of these findings?
The client has normal coagulation parameters
The client has mild coagulation impairment
The client has moderate coagulation impairment
The client has severe coagulation impairment
The Correct Answer is D
The client has severe coagulation impairment.
This is because the client’s platelet count, fibrinogen level, and prothrombin time are all significantly abnormal compared to the normal ranges.
• The normal platelet count is 150,000 to 450,000/mm3.
A platelet count of 80,000/mm3 indicates thrombocytopenia, which is a low number of platelets that can impair clotting and cause bleeding.
• The normal fibrinogen level is 200 to 400 mg/dL.
A fibrinogen level of 150 mg/dL indicates hypofibrinogenemia, which is a low level of fibrinogen that can impair clotting and cause bleeding.
• The normal prothrombin time is 11 to 13.5 seconds.
A prothrombin time of 18 seconds indicates a prolonged clotting time that can impair clotting and cause bleeding.
Choice A is wrong because the client does not have normal coagulation parameters.
All three tests are abnormal and indicate a severe coagulation impairment.
Choice B is wrong because the client does not have mild coagulation impairment.
The degree of abnormality in the test results is too high to be considered mild.
Choice C is wrong because the client does not have moderate coagulation impairment.
The degree of abnormality in the test results is too high to be considered moderate.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Oxytocin is the most effective medication for preventing and treating postpartum hemorrhage caused by uterine atony, which is the failure of the uterus to contract after delivery.Oxytocin stimulates uterine contractions and reduces bleeding.
Choice A is wrong because methylergonovine maleate (Methergine) is a second-line uterotonic drug that can cause hypertension and should not be used in women with high blood pressure.
Choice B is wrong because magnesium sulfate (MgSO4) is used to prevent seizures in women with preeclampsia or eclampsia, not to treat postpartum hemorrhage.
Choice D is wrong because carboprost tromethamine (Hemabate) is another second-line uterotonic drug that can cause severe diarrhea and bronchospasm and should not be used in women with asthma.
Correct Answer is A
Explanation
Perineal hematoma.A perineal hematoma is a collection of blood in the soft tissues of the perineum that can result from trauma during delivery, such as vacuum-assisted birth.The client may present with a large, tense, bluish bulge on the perineum and severe pain in the area.
Choice B. Vulvar varicosity is wrong because it is a condition where the veins in the vulva become enlarged and swollen due to increased blood flow and pressure during pregnancy.It usually appears as bluish or purple veins on the vulva and may cause discomfort, itching, or heaviness in the area.
It is not related to vacuum-assisted birth or prolonged labor.
Choice C. Rectocele is wrong because it is a condition where the rectum bulges into the vagina due to weakening of the pelvic floor muscles and connective tissue.
It may cause symptoms such as difficulty with bowel movements, a feeling of pressure or fullness in the vagina, or sexual dysfunction.
It is not related to vacuum-assisted birth or prolonged labor.
Choice D. Episiotomy is wrong because it is a surgical incision made in the perineum to enlarge the vaginal opening during delivery.
It may be done to facilitate delivery, prevent severe tearing, or protect the baby’s head from trauma.
It is not a diagnosis but a procedure that may be performed during vacuum-assisted birth or normal vaginal delivery.
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