G1P1, 37 weeks' gestation patient with a scheduled nonstress test (NST)

Complete the following sentence using the drop-down options.

The nurse's greatest concern is the client's risk of developing
i_
and related to
ii__
and
_iii____
.

Answer and Explanation

The Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"B","dropdown-group-3":"C"}

Correct answers: The nurse's greatest concern is the client's risk of developing HELLP syndrome and related to thrombocytopenia and elevated liver enzymes.

Rationale:

I. HELLP syndrome (Hemolysis, Elevated Liver Enzymes, and Low Platelets) is a severe form of preeclampsia that can lead to life-threatening complications.

Ii. Thrombocytopenia (low platelets) (120,000) increases the risk of bleeding.

Iii. Elevated liver enzymes (ALT 75, AST 78, Alkaline Phosphatase 184) suggest liver involvement, which is a hallmark of HELLP syndrome.

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Correct Answer is []

Explanation

Condition: Postpartum Hemorrhage (PPH)

Postpartum hemorrhage is defined as blood loss ≥ 500 mL after vaginal delivery or ≥ 1000 mL after cesarean delivery. In this case, the client has heavy bleeding, large clots, and lightheadedness, which are key indicators of excessive postpartum blood loss.

Risk Factors

1. Fetal Macrosomia: The baby weighs 9 lbs 4 oz (4196 grams), which is considered macrosomia (birth weight > 4000 g). Large fetal size increases the risk of uterine overdistension, which can impair uterine contractions and lead to uterine atony, the most common cause of postpartum hemorrhage.

2. Uterine Atony: The nurse initially noted a boggy uterus that required massage to become firm. Uterine atony occurs when the uterus fails to contract effectively after delivery, leading to excessive bleeding. This is the leading cause of PPH.

3. Prolonged Labor: A prolonged labor can cause uterine fatigue, reducing the uterus's ability to contract properly after delivery, thereby increasing the risk of uterine atony and PPH.

Assessment Findings

1. Heavy vaginal bleeding: The client has heavy bleeding with three quarter-sized clots, which is abnormal postpartum and indicates excessive blood loss.

2. Blood pressure: The client’s BP is 150/86 mmHg, which may indicate compensatory vasoconstriction due to ongoing blood loss. If hemorrhage continues, hypotension may develop.

3. Urine output: The client did not feel the urge to void, and catheterization drained 450 mL of urine. A full bladder can prevent proper uterine contraction, worsening uterine atony and bleeding.

A. "There is an increased risk of introducing infection." B. "There is an increased risk of rupture of the membranes." C. "This could result in profound bleeding." D. "This could initiate preterm labor."

Correct Answer is C

Explanation

A. "There is an increased risk of introducing infection." – While infections can occur, the primary concern with internal examinations in placenta previa is hemorrhage rather than infection.

B. "There is an increased risk of rupture of the membranes." – While membrane rupture is a risk with any vaginal examination, it is not the primary concern in placenta previa.

C. "This could result in profound bleeding." – With placenta previa, the placenta partially or completely covers the cervix. Digital or speculum exams can disrupt the placenta, causing significant hemorrhage, which is why they are contraindicated.

D. "This could initiate preterm labor." – While stimulation of the cervix could lead to contractions, the primary risk with an internal exam in placenta previa is significant bleeding, not preterm labor.

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G1P1, 37 weeks' gestation patient with a scheduled nonstress test (NST) Complete the following sentence using the drop-down options. The nurse's greatest concern is the client's risk of developing __i_____ and related to __ii____ and ___iii____.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

35-year-old postpartum client. Select the condition, risk factors and assessment findings that the client may be experiencing.

Correct Answer is []

Explanation

A nurse is caring for a client who is at 37 weeks of gestation and has placenta previa. The client asks the nurse why the provider does not do an internal examination. Which of the following explanations of the primary reason should the nurse provide?

Correct Answer is C

Explanation

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G1P1, 37 weeks' gestation patient with a scheduled nonstress test (NST)

Complete the following sentence using the drop-down options.

The nurse's greatest concern is the client's risk of developing
i_
and related to
ii__
and
_iii____
.