Which condition seen in the postpartum period is likely to require careful medical assessment?
Headaches
Varicosities of the legs
Carpal tunnel syndrome
Periodic numbness and tingling of the fingers
The Correct Answer is A
Choice a) Headaches is correct because this is a condition that can indicate a serious problem in the postpartum period and may require careful medical assessment. Headaches are common in the first few weeks after giving birth, but they can also be a sign of complications such as preeclampsia, eclampsia, cerebral venous thrombosis, meningitis, or aneurysm. Preeclampsia and eclampsia are conditions that cause high blood pressure, proteinuria, and seizures in pregnant or postpartum women. Cerebral venous thrombosis is a blood clot in the brain that can cause stroke-like symptoms. Meningitis is an infection of the membranes that cover the brain and spinal cord. Aneurysm is a bulge or rupture in a blood vessel that can cause bleeding in the brain. These conditions can be life-threatening and require immediate treatment. Therefore, women who experience severe, persistent, or unusual headaches in the postpartum period should seek medical attention as soon as possible.
Choice b) Varicosities of the legs is incorrect because this is not a condition that usually requires careful medical assessment in the postpartum period. Varicosities are enlarged or swollen veins that appear blue or purple under the skin. They are common in pregnancy due to increased blood volume, hormonal changes, and pressure from the growing uterus. They usually improve after delivery, but may persist or worsen in some women. Varicosities are usually harmless and do not cause any symptoms, but they may cause cosmetic concerns, discomfort, itching, or bleeding. They can also increase the risk of superficial thrombophlebitis, which is inflammation of a vein near the skin surface. However, these complications are rare and mild, and can be managed with conservative measures such as compression stockings, elevation of the legs, exercise, and painkillers. Therefore, women who have varicosities of the legs in the postpartum period do not need to worry too much, unless they have signs of infection or deep vein thrombosis, which is a more serious condition that involves a blood clot in a deep vein that can travel to the lungs and cause pulmonary embolism.
Choice c) Carpal tunnel syndrome is incorrect because this is not a condition that typically requires careful medical assessment in the postpartum period. Carpal tunnel syndrome is a condition that causes numbness, tingling, pain, or weakness in the hand and wrist due to compression of the median nerve that runs through a narrow passage called the carpal tunnel. It can occur in pregnancy due to fluid retention, hormonal changes, or repetitive movements. It usually resolves after delivery, but may persist or recur in some women. Carpal tunnel syndrome is usually mild and does not cause any serious complications, but it may interfere with daily activities or quality of life. It can be treated with conservative measures such as splinting, icing, massage, stretching, or painkillers. In severe cases, surgery may be needed to release the pressure on the nerve. Therefore, women who have carpal tunnel syndrome in the postpartum period do not need to seek medical attention urgently, unless they have signs of nerve damage or infection.
Choice d) Periodic numbness and tingling of the fingers is incorrect because this is not a condition that generally requires careful medical assessment in the postpartum period. Periodic numbness and tingling of the fingers can be caused by various factors such as cold exposure, poor circulation, nerve compression, vitamin deficiency, or anxiety.
It can also occur in pregnancy due to fluid retention or hormonal changes. It usually goes away after delivery, but may linger or come back in some women. Periodic numbness and tingling of the fingers is usually harmless and does not indicate any serious problem, but it may cause discomfort or annoyance. It can be relieved with simple measures such as warming up, moving around, shaking out the hands, taking supplements, or relaxing. Therefore, women who experience periodic numbness and tingling of the fingers in the postpartum period do not need to worry too much, unless they have signs of infection or neurological disorder.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice a) Insert an indwelling urinary catheter is incorrect because this is not a priority action for a client who has a large amount of painless, bright red vaginal bleeding. This type of bleeding is suggestive of placenta previa, which is a condition where the placenta covers part or all of the cervix, preventing normal delivery. Inserting an indwelling urinary catheter can cause trauma to the cervix or the placenta, which can worsen the bleeding and endanger the mother and the fetus. Therefore, this action should be avoided unless absolutely necessary.
Choice b) Prepare the abdominal and perineal areas is incorrect because this is not a priority action for a client who has a large amount of painless, bright red vaginal bleeding. This type of bleeding is suggestive of placenta previa, which is a condition where the placenta covers part or all of the cervix, preventing normal delivery. Preparing the abdominal and perineal areas can be done before performing a cesarean section, which is usually the preferred mode of delivery for placenta previa. However, this action should be done after stabilizing the client's condition and obtaining informed consent for surgery.
Choice c) Witness the signature for informed consent for surgery is incorrect because this is not a priority action for a client who has a large amount of painless, bright red vaginal bleeding. This type of bleeding is suggestive of placenta previa, which is a condition where the placenta covers part or all of the cervix, preventing normal delivery.
Witnessing the signature for informed consent for surgery can be done before performing a cesarean section, which is usually the preferred mode of delivery for placenta previa. However, this action should be done after stabilizing the client's condition and explaining the risks and benefits of surgery.
Choice d) Initiate IV access is correct because this is the priority action for a client who has a large amount of painless, bright red vaginal bleeding. This type of bleeding is suggestive of placenta previa, which is a condition where the placenta covers part or all of the cervix, preventing normal delivery. Initiating IV access can help to restore fluid volume, prevent hypovolemic shock, administer medications such as oxytocin or blood products if needed, and prepare for emergency cesarean section if indicated. Therefore, this action should be done as soon as possible to save the life of the mother and the fetus.
Correct Answer is C
Explanation
Choice A) dilates the bronchioles, decreasing airway resistance: This is not the correct function of surfactant.
Surfactant is a substance that reduces the surface tension of the fluid that lines the alveoli, which are the tiny air sacs in the lungs where gas exchange occurs. Surfactant does not affect the diameter of the bronchioles, which are the small airways that branch from the bronchi. Bronchodilation and bronchoconstriction are regulated by the autonomic nervous system and various mediators, such as histamine, epinephrine, and acetylcholine.
Choice B) provides transportation for oxygen to enter the blood supply: This is not the correct function of surfactant. Surfactant does not transport oxygen or any other gas. Oxygen diffuses from the alveoli into the capillaries, where it binds to hemoglobin in the red blood cells. The red blood cells then transport oxygen to the tissues via the blood circulation. Surfactant does not play a role in this process.
Choice C) keeps the alveoli open during expiration: This is the correct function of surfactant. Surfactant prevents the alveoli from collapsing during expiration by lowering the surface tension of the fluid that lines them. This allows for easier breathing and better gas exchange. Without enough surfactant, the alveoli tend to collapse and stick together, causing atelectasis, which is a condition where some or all of a lung collapses. Atelectasis can lead to hypoxia, respiratory distress, and infection.
Choice D) causes increased permeability of the alveoli: This is not the correct function of surfactant. Surfactant does not increase or decrease the permeability of the alveoli, which is the ability of substances to pass through them.
Permeability of the alveoli depends on several factors, such as pressure gradients, solubility, molecular size, and membrane thickness. Increased permeability of the alveoli can occur in conditions such as acute respiratory distress syndrome (ARDS), where fluid leaks into the alveolar space and impairs gas exchange. Surfactant does not cause this condition, but it can be affected by it.
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