Which instruction should be included in the discharge teaching plan to assist the patient in recognizing early signs of complications?
“Palpate the fundus daily to ensure it is soft.”.
“The passage of clots is expected.”.
“Report any decrease in the amount of brownish-red lochia.”.
“Notify the physician of any increase in the amount of lochia or a return to bright red bleeding.”.
The Correct Answer is D
Choice A rationale
A soft uterus indicates uterine atony, a complication rather than a normal finding. Daily fundal palpation ensures involution but should result in a firm, not soft, uterus.
Choice B rationale
Passage of clots is common postpartum, but ongoing monitoring for excessive clotting is crucial as it may indicate retained placental fragments or incomplete uterine involution.
Choice C rationale
Decreased lochia does not indicate complications unless it is completely absent, which may suggest uterine or cervical obstruction and warrants further evaluation.
Choice D rationale
Increased lochia or bright red bleeding signifies secondary postpartum hemorrhage, often caused by retained placental tissue or subinvolution, requiring immediate medical attention.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Narcan (naloxone) is contraindicated as it can precipitate acute withdrawal symptoms in neonates exposed to opioids in utero, leading to seizures and severe distress due to sudden opioid receptor blockade.
Choice B rationale
Phenobarbital is used to manage neonatal abstinence syndrome by reducing central nervous system hyperexcitability and seizures. It is not contraindicated as it provides symptomatic relief for withdrawal symptoms.
Choice C rationale
Methadone is used to treat neonatal abstinence syndrome by stabilizing opioid levels and preventing withdrawal symptoms. It is not contraindicated and helps manage symptoms effectively in opioid-exposed neonates.
Choice D rationale
Morphine is a first-line treatment for neonatal abstinence syndrome, reducing withdrawal symptoms by mimicking the effects of opioids. It is not contraindicated and is commonly used in neonatal care.
Correct Answer is A
Explanation
Choice A rationale
Postpartum depression with psychotic features may lead to suicidal ideation or infanticidal tendencies due to delusions or hallucinations. Ensuring safety is critical to prevent harm to both mother and infant.
Choice B rationale
Anger outbursts, though concerning, do not pose immediate threats like harm to self or infant. Addressing this behavior is secondary to prioritizing safety in severe postpartum psychosis cases.
Choice C rationale
Neglecting hygiene reflects depressive symptoms but does not indicate psychosis severity or imminent danger. Primary focus remains on managing safety risks to the mother and infant.
Choice D rationale
Losing trust in her husband is relevant to interpersonal stress but does not constitute a primary care concern. The immediate threat of harm takes precedence over marital dynamics.
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