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 C
Explanation
Choice A rationale
Advising about birth defects without offering compassionate support can intensify parental grief and fails to acknowledge the significance of their emotional trauma, worsening their psychological response after a stillbirth.
Choice B rationale
Discouraging naming deters parental acknowledgment of their baby's existence, which disrupts grieving processes. Recognizing their loss helps families process grief healthily and facilitates emotional closure.
Choice C rationale
Giving mementos and allowing holding the baby fosters parental bonding and validates their loss. These actions are supported by bereavement care guidelines promoting emotional processing, acceptance, and closure after stillbirth.
Choice D rationale
Immediate morgue transport disregards the psychological needs of grieving parents and deprives them of opportunities to spend time with their baby, essential for acknowledging their loss and beginning grief processing.
Correct Answer is C
Explanation
Choice A rationale
Retained placental fragments lead to delayed, not immediate, postpartum hemorrhage as they prevent complete uterine contraction over time.
Choice B rationale
Vaginal hematomas cause concealed, localized bleeding with minimal external blood loss, differing from profuse hemorrhage presentations.
Choice C rationale
Uterine atony, the most common cause, occurs when the uterus fails to contract effectively, leading to uncontrolled and excessive bleeding.
Choice D rationale
Uterine inversion, though serious, is rare and typically accompanied by visible uterine prolapse, not commonly causing profuse bleeding in the immediate postbirth period.
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