Which of the following findings should alert a nurse assessing a client who is 8 hr postpartum and multiparous?

Fundus three fingerbreadths above the umbilicus.

Moderate lochia rubra.

Blood pressure 130/84 mm Hg.

Moderate swelling of the labia.

Answer and Explanation

The Correct Answer is A

Choice A rationale
A fundus that is three fingerbreadths above the umbilicus 8 hours postpartum is a sign of urinary retention, which can displace the uterus and inhibit uterine contraction, leading to postpartum hemorrhage.
Choice B rationale
Moderate lochia rubra, or bloody discharge, is normal within the first few days after childbirth.
Choice C rationale
A blood pressure of 130/84 mm Hg is within the normal range for a postpartum woman.
Choice D rationale
Moderate swelling of the labia can be a normal finding after a vaginal birth.

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Correct Answer is A

Explanation

Choice A rationale
The client’s symptoms and lab results are consistent with HELLP Syndrome, a severe form of preeclampsia. HELLP stands for Hemolysis, Elevated Liver enzymes, and Low Platelet count. The client’s elevated liver enzymes and low platelets, along with the reported symptoms, are indicative of this condition.
Choice B rationale
While the client’s high blood pressure could suggest Postpartum hypertension, the presence of severe headaches, visual disturbances, right upper quadrant pain, and abnormal lab results point more towards HELLP Syndrome.
Choice C rationale
Hypertension in pregnancy could be a possibility, but it does not explain all of the client’s symptoms and lab results, particularly the elevated liver enzymes and low platelets.
Choice D rationale

Superimposed preeclampsia is a condition where a pregnant woman with chronic hypertension develops preeclampsia. However, the client’s severe symptoms and lab results are more indicative of HELLP Syndrome.

A. Hypomagnesemia B. Hypocalcemia C. Hyperbilirubinemia D. Hypoglycemia

Correct Answer is D

Explanation

Choice A rationale

Hypomagnesemia is not typically a primary concern for newborns of mothers with diabetes mellitus. While it can occur in newborns, it is not directly related to macrosomia or maternal diabetes.
Choice B rationale
Hypocalcemia can occur in newborns, especially preterm infants, infants of diabetic mothers, and those with perinatal asphyxia. However, it is not the primary concern in this scenario.
Choice C rationale
Hyperbilirubinemia can occur in newborns for a variety of reasons, including prematurity, blood group incompatibility, and other factors. While infants of diabetic mothers may have an increased risk of jaundice, it is not the primary concern in this scenario.
Choice D rationale
Hypoglycemia is the correct answer. Infants of diabetic mothers are at risk for hypoglycemia after birth. During pregnancy, the fetus produces extra insulin in response to the mother’s high blood glucose levels. After birth, the newborn continues to produce extra insulin for a short time until it adjusts to normal glucose-insulin balance. This can lead to hypoglycemia, which is a primary concern and requires immediate attention.

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Which of the following findings should alert a nurse assessing a client who is 8 hr postpartum and multiparous?

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Naxlex Comprehensive Predictor Exams

Correct Answer is A

Explanation

A nurse is caring for a newborn who has macrosomia and whose mother has diabetes mellitus. The nurse should recognize which of the following complications as the priority focus of care?

Correct Answer is D

Explanation

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