A patient, one day postpartum, is being monitored carefully after a significant postpartum hemorrhage. Which of the following should the nurse report to the obstetrician?
Urine output of 40 mL in the last 8 hours.
Drop in hematocrit of 2% since admission.
Weight decrease of 2 lbs since delivery.
Pulse rate of 68 beats per minute.
The Correct Answer is A
Choice A rationale
Urine output of 40 mL in 8 hours indicates oliguria, suggesting inadequate renal perfusion. Normal urine output is 30 mL/hour or greater. This could signify hypovolemia or renal compromise post-hemorrhage.
Choice B rationale
A drop in hematocrit of 2% may be expected postpartum and is not immediately concerning unless accompanied by hemodynamic instability or symptoms of anemia like dizziness or fatigue.
Choice C rationale
A 2 lb weight decrease postpartum is normal due to fluid shifts and diuresis. It does not indicate an emergent condition requiring immediate reporting to the obstetrician.
Choice D rationale
A pulse rate of 68 beats per minute is within the normal adult range of 60 to 100 beats per minute and is not typically concerning post-delivery.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","C"]
Explanation
Choice A rationale
Providing family support is crucial as preterm birth can cause significant emotional distress. Education and involvement aid understanding of interventions and foster a supportive environment for both the neonate and family.
Choice B rationale
Strict handwashing and sterile technique prevent infection in preterm neonates, whose immature immune systems make them highly susceptible to sepsis, a leading cause of morbidity in NICUs.
Choice C rationale
Creating a womb-like state through dim lighting, limited noise, and careful positioning supports neurodevelopment and mimics the intrauterine environment, promoting growth and stability.
Choice D rationale
Frequent diaper changes may disturb thermoregulation and disrupt the neonate's limited energy reserves, as preterm infants require an environment that minimizes stress and conserves energy.
Correct Answer is D
Explanation
Choice A rationale
Preterm neonates lack developed mechanisms to shiver for thermogenesis, relying instead on non-shivering thermogenesis primarily through brown fat metabolism, which is underdeveloped in preterm infants.
Choice B rationale
The fetal position does not significantly affect heat retention in preterm neonates, as their thermoregulatory mechanisms depend on adequate fat stores and skin coverage.
Choice C rationale
Blood vessels in preterm neonates are closer to the skin's surface, increasing heat loss due to greater exposure and lack of insulating subcutaneous fat.
Choice D rationale
Preterm neonates have minimal body fat, impeding insulation and heat retention, leading to rapid heat loss, necessitating external warming measures like incubators or radiant warmers.
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