One of the first symptoms of puerperal infection to assess for in the postpartum woman is:
Temperature of 38° C (100.4° F) or higher on postpartum day 2-3.
Profuse vaginal bleeding with ambulation.
Pain when passing stool.
Fatigue continuing for longer than 1 week.
The Correct Answer is A
Choice A rationale
A puerperal infection is a bacterial infection occurring after childbirth. A key diagnostic criterion is a temperature of 38° C (100.4° F) or higher, with the fever occurring on two separate occasions during the first 10 days postpartum, excluding the first 24 hours. The temperature elevation is a primary systemic sign of an underlying inflammatory or infectious process, often originating from the reproductive tract.
Choice B rationale
Profuse vaginal bleeding with ambulation, also known as secondary postpartum hemorrhage, can be a symptom of a subinvolution of the uterus, which can be caused by a retained placental fragment or a uterine infection. However, this is not one of the first and most specific signs of puerperal infection. A fever is a more definitive initial indicator.
Choice C rationale
Pain when passing stool is a common postpartum complaint related to perineal trauma, hemorrhoids, or a tear from childbirth. While it can be uncomfortable, it is not a direct symptom of a puerperal infection, which typically manifests with fever, malaise, abdominal pain, and foul-smelling lochia.
Choice D rationale
Fatigue is a universal and expected symptom for all new mothers, especially in the first week postpartum, due to the physical and emotional demands of childbirth and newborn care. It is a non-specific symptom and is not considered a primary indicator for a puerperal infection
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
A three-month follow-up visit is not the standard of care for an uncomplicated postpartum recovery. The typical recommendation for the first postpartum check-up is much earlier. The three-month timeframe would be too late to address common postpartum issues, such as lochia, uterine involution, perineal healing, or potential signs of postpartum depression, which need to be assessed and managed earlier.
Choice B rationale
The standard of care for a woman who has had an uncomplicated spontaneous vaginal delivery is to have her first postpartum follow-up visit with her OBGYN at six weeks postpartum. By this time, the uterus should have returned to its pre-pregnancy size and position, lochia should have ceased, and perineal healing should be complete. This visit is crucial for assessing physical recovery, discussing contraception, and screening for postpartum depression.
Choice C rationale
A one-week follow-up visit is typically too early for a routine postpartum check for a patient with an uncomplicated recovery. This timeframe is usually reserved for patients with complications, such as postpartum hemorrhage, infection, or preeclampsia, who require closer monitoring. For a healthy woman, waiting one week is not necessary to assess her recovery progress, as most significant changes occur over a longer period.
Choice D rationale
A two-week follow-up visit is earlier than the standard of care for an uncomplicated postpartum recovery. While some providers may see patients at this time, it is not the universally accepted first follow-up. The six-week visit is considered the benchmark because it allows for adequate time for the body to complete the major physiological changes of the puerperium, ensuring a comprehensive assessment of the patient’s physical and mental health. *.
Correct Answer is C
Explanation
Choice A rationale
Topical anesthetic creams, such as lidocaine, are not. typically recommended for routine use to reduce swelling and discomfort in the. perineum immediately postpartum. They can provide temporary relief from pain but. do not address the underlying swelling and may not be necessary. Their use is. often reserved for severe pain or specific indications like sutured lacerations,. and they don't have a broad application for discomfort and swelling.
Choice B rationale
Doing nothing is not a recommended intervention for perineal. swelling and discomfort. Providing care and comfort measures is a fundamental. aspect of postpartum nursing. Without intervention, swelling can worsen,. increasing pain and potentially delaying healing. Simple and effective measures. exist to alleviate these symptoms, promoting the patient's well-being and recovery. after a vaginal delivery.
Choice C rationale
Ice packs are the most effective and universally recommended. intervention for reducing perineal swelling and discomfort in the immediate. postpartum period. The cold temperature causes vasoconstriction, which decreases. blood flow to the area, thereby minimizing edema and inflammation. It also. provides a numbing effect, which helps to alleviate pain. The packs should be. applied for 15-20 minutes at a time.
Choice D rationale
Warm packs are not recommended for use in the first 24 hours. postpartum. Heat promotes vasodilation, which would increase blood flow to the. perineum, exacerbating swelling and discomfort. While warm compresses or sitz. baths can be beneficial for healing and pain relief after the initial 24 hours. have passed, their application in the immediate postpartum period is. contraindicated for the purpose of reducing edema.
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