A postpartum client with a history of lupus develops a flare-up 2 weeks after birth. The nurse understands this occurs because:
Pregnancy causes permanent immune suppression.
Breastfeeding suppresses immune function.
Estrogen levels rise after birth, triggering autoimmune reactions.
The rebound of the immune system postpartum may reactivate autoimmune conditions.
The Correct Answer is D
Choice A reason: Pregnancy does not cause permanent immune suppression. Immune suppression occurs temporarily during pregnancy to protect the fetus but resolves postpartum.
Choice B reason: Breastfeeding does not suppress immune function. It primarily affects hormonal balance and lactation but does not directly trigger autoimmune flare-ups.
Choice C reason: Estrogen levels do not rise after birth; they actually decline. Therefore, this is not the cause of lupus flare-ups postpartum.
Choice D reason: The immune system rebounds after delivery, returning to its pre-pregnancy state. This rebound can reactivate autoimmune conditions such as lupus, leading to flare-ups.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Intermittent fetal heart auscultation is appropriate when contractions are infrequent and the fetal heart rate is reassuring. It allows monitoring without continuous electronic fetal monitoring, especially in low-risk cases.
Choice B reason: Nipple stimulation is a natural method to promote uterine contractions by stimulating endogenous oxytocin release. However, in this case, contractions are already present, and nipple stimulation is not contraindicated.
Choice C reason: Administration of IV fluids is safe and often necessary to maintain hydration, support uteroplacental perfusion, and prevent maternal hypotension.
Choice D reason: Vaginal examinations every hour are contraindicated because the client has had ruptured membranes for 18 hours. Frequent vaginal exams increase the risk of ascending infection (chorioamnionitis). Vaginal exams should be minimized and performed only when clinically indicated.
Correct Answer is A
Explanation
Choice A reason: A fundus above the umbilicus and deviated to the right indicates bladder distention. Encouraging the client to void relieves bladder pressure, allowing the uterus to contract normally and return to midline.
Choice B reason: Fundal massage is indicated for uterine atony, not bladder distention. Massage will not correct displacement caused by a full bladder.
Choice C reason: Immediate notification of the provider is not necessary until nursing interventions fail. Voiding is the first-line intervention.
Choice D reason: Retained placental fragments cause uterine atony and abnormal bleeding, not fundal deviation. The clinical picture here is consistent with bladder distention.
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