A patient had a vaginal birth 4 hours ago. Her hematocrit of 35% on admission for labor. Her current hematocrit is 25% which of the following statements by the nurse might best explain that

“Because you're not eating enough iron-rich foods like meat."

"Because you are hemoconcentrated the hematocrit dropped after delivery."

"Because your blood volume has doubled, your hematocrit is lower."

"This change in hematocrit indicates a postpartum hemorrhage."

Answer and Explanation

The Correct Answer is C

A. A decrease in hematocrit after delivery is more likely due to physiological changes rather than dietary factors alone, though iron intake is important for overall recovery.

B. Hemoconcentration refers to an increase in hematocrit due to a decrease in plasma volume, but this is not the reason for a decreased hematocrit postpartum.

C. During pregnancy, blood volume increases to support both the mother and fetus. After delivery, plasma volume returns to pre-pregnancy levels, which can cause a relative decrease in hematocrit.

D. A significant drop in hematocrit could indicate postpartum hemorrhage, but a slight drop can be expected as part of normal post-delivery physiology.

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Correct Answer is A

Explanation

A. Abruptio placenta and preeclampsia are risk factors for DIC, a serious complication that can lead to bleeding and clotting issues, including petechiae and oozing from IV sites.

B. A 4100 gm baby (large baby) is not a risk factor for DIC in the immediate postpartum period.

C. Having five children does not increase the risk for DIC.

D. Hyperemesis gravidarum is not related to the development of DIC.

A. Genetic testing when the babies are delivered will need to be done to determine this. B. They are dizygotic because the ultrasound shows one is bigger than the other. C. The twins are dizygotic because they are not the same sex D. They are monozygotic because they are in different amniotic sacs.

Correct Answer is C

Explanation

A. Genetic testing is not necessary to determine if the twins are identical. Identical twins come from the same egg, while fraternal twins come from separate eggs.

B. The size difference alone does not determine whether twins are identical or fraternal.

C. Dizygotic twins (fraternal twins) are always of different sexes. This is because they are fertilized by two separate sperm and develop from two separate eggs.

D. Monozygotic twins (identical twins) occur when one fertilized egg splits into two embryos. The fact that they are different sexes rules out the possibility of monozygotic twins.

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A patient had a vaginal birth 4 hours ago. Her hematocrit of 35% on admission for labor. Her current hematocrit is 25% which of the following statements by the nurse might best explain that

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Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

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