A woman with placenta previa is being treated with expectant management. The woman and fetus are stable. The nurse is assessing the woman for possible discharge home. Which statement by the woman would suggest to the nurse that home care might be inappropriate?

I know to call my health care provider right away if I start to bleed again."

"My mother lives next door and can drive me here if necessary.”

“I realize the importance of following the instructions for my care.”

“I have a toddler and preschooler at home who need my attention."

Answer and Explanation

The Correct Answer is D

A. "I know to call my health care provider right away if I start to bleed again." This statement reflects the woman's understanding of the importance of monitoring for any complications such as bleeding and taking prompt action, which is appropriate for expectant management.

B. "My mother lives next door and can drive me here if necessary." This indicates that the woman has support at home, which is important for her ability to access care if needed. It suggests a good support system for managing the pregnancy.

C. "I realize the importance of following the instructions for my care." This shows that the woman understands the need for careful adherence to her care plan, which is a positive sign that she is well-informed and prepared for home care.

D. "I have a toddler and preschooler at home who need my attention." This statement raises concern because caring for young children at home might pose a risk to the woman’s health and safety. It can make it more challenging for her to adhere to the prescribed bed rest or reduced activity level needed for managing placenta previa, especially if she needs to be closely monitored for bleeding or complications. Therefore, this statement suggests that home care might not be appropriate in this situation.

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Correct Answer is A

Explanation

A. Temperature of 101° F (38.3° C) is concerning as it may indicate an infection, especially if it persists beyond the first 24 hours postpartum. A mild increase in temperature can be common during the first 24 hours after birth due to the physical stress of labor and delivery, but a temperature of 101° F is above the normal postpartum range and warrants further investigation for possible infection, such as endometritis or a urinary tract infection.

B. Respiratory rate of 16 breaths per minute is within the normal range for a postpartum woman, as normal respiratory rate is typically between 12 and 20 breaths per minute in adults. No immediate concerns are suggested by this finding.

C. Lochia rubra with a fleshy odor is a normal finding during the first few days postpartum. Lochia rubra, the initial discharge after childbirth, typically has a fleshy or musty odor and contains blood, mucus, and tissue from the uterine lining. A foul or offensive odor, however, would be indicative of infection, but a "fleshy" odor is normal.

D. Pain rating of 2 on a scale from 0 to 10 is within an acceptable range for postpartum pain. Mild discomfort is expected, especially around the perineum or from uterine contractions, and can usually be managed with over-the-counter pain relievers. A pain level of 2 suggests that the patient is coping well.

A. fluid replacement B. birth of the fetus C. oxygenation D. control of hypertension

Correct Answer is C

Explanation

A. Fluid replacement is important for maintaining maternal and fetal circulation, but it is not the priority immediately following a seizure. Oxygenation and stabilizing the mother’s condition are more critical in the acute phase.

B. Birth of the fetus may become necessary if the mother’s condition worsens, but the immediate priority is stabilizing the mother and ensuring proper oxygenation to prevent further complications for both the mother and fetus.

C. Oxygenation is the priority intervention after a seizure in eclampsia. Seizures can lead to a decrease in oxygen levels, and ensuring adequate oxygenation is crucial for both the mother and fetus. The nurse should administer oxygen to support breathing and prevent hypoxia.

D. Control of hypertension is essential in managing eclampsia, but the immediate focus should be on stabilizing the mother post-seizure, which includes ensuring adequate oxygenation first. Once stabilized, antihypertensive medications can be administered as necessary.

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A woman with placenta previa is being treated with expectant management. The woman and fetus are stable. The nurse is assessing the woman for possible discharge home. Which statement by the woman would suggest to the nurse that home care might be inappropriate?

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Correct Answer is A

Explanation

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Correct Answer is C

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