The nurse is making a follow-up home visit to a woman who is 12 days postpartum. Which finding would the nurse expect when assessing the client's fundus?

2 cm below the umbilicus

cannot be palpated

6 cm below the umbilicus

halfway below the umbilicus

Answer and Explanation

The Correct Answer is A

A. By 12 days postpartum, the fundus should be about 2 cm below the umbilicus, as the uterus is returning to its pre-pregnancy size. This is a normal finding at this stage of postpartum recovery.
B. At 12 days postpartum, the fundus should still be palpable, though it will be much lower than in the immediate postpartum period.
C. This is too low for 12 days postpartum. The fundus should not descend this far yet.
D. Halfway below the umbilicus would be expected around 7-10 days postpartum, but by 12 days, the fundus should be about 2 cm below the umbilicus, indicating more involution.

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Correct Answer is D

Explanation

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.

A. Strict intake and output monitoring B. Prepare for delivery of the fetus by cesarean section (C/S) C. Weekly monitoring of coagulation factors D. Complete bed rest for the remainder of the pregnancy

Correct Answer is B

Explanation

A. Strict intake and output monitoring is important for managing any patient with significant blood loss or who is at risk for complications, but it does not directly address the immediate needs of a client with abruptio placentae. The priority is stabilizing the mother and delivering the fetus safely.

B. Prepare for delivery of the fetus by cesarean section (C/S) is correct. Abruptio placentae (placental abruption) is a life-threatening condition where the placenta prematurely detaches from the uterine wall, leading to bleeding and potential fetal distress. Immediate delivery is often required, especially if there is significant bleeding or fetal compromise. A cesarean section is usually the preferred method of delivery in these cases to reduce the risk of maternal and fetal complications.

C. Weekly monitoring of coagulation factors is important for managing coagulopathies that might develop in the presence of placental abruption, but it is not the immediate action required. Immediate delivery is the priority.

D. Complete bed rest for the remainder of the pregnancy may be recommended for certain cases of placental abruption with mild symptoms, but in the presence of moderate vaginal bleeding and significant findings on ultrasound, immediate delivery (typically by C-section) is more urgent.

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The nurse is making a follow-up home visit to a woman who is 12 days postpartum. Which finding would the nurse expect when assessing the client's fundus?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is B

Explanation

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