A client who is 7 days postpartum calls the provider’s office and reports pain, swelling, and redness of her left calf.Besides the client seeing the provider, which of the following interventions should the nurse suggest?
Massage the area.
Elevate the leg.
Apply cold compresses.
Flex the knee while resting.
The Correct Answer is B
Choice A rationale
Massaging the area is not recommended as it can dislodge a clot and cause it to travel to the lungs, leading to a pulmonary embolism. This can be life-threatening and should be avoided.
Choice B rationale
Elevating the leg helps to reduce swelling and pain by promoting venous return. This is a standard intervention for managing symptoms of deep vein thrombosis (DVT) and helps prevent further complications.
Choice C rationale
Applying cold compresses is not effective for DVT. Cold compresses are generally used to reduce inflammation and pain in acute injuries, but they do not address the underlying issue of a blood clot.
Choice D rationale
Flexing the knee while resting can increase the risk of clot dislodgement and is not recommended. Keeping the leg straight and elevated is a safer approach to managing DVT symptoms.
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Correct Answer is A
Explanation
Choice A rationale
At 1 cm above the umbilicus is the expected position of the uterine fundus 12 hours postpartum. After delivery, the fundus is typically at the level of the umbilicus and then descends approximately 1 cm per day. At 12 hours postpartum, it is normal for the fundus to be slightly above the umbilicus.
Choice B rationale
One fingerbreadth above the symphysis pubis is not the expected position of the fundus 12 hours postpartum. This position is more typical several days postpartum as the uterus continues to involute and return to its pre-pregnancy size.
Choice C rationale
To the right of the umbilicus is not a normal finding and may indicate a full bladder, which can displace the uterus. The nurse should assist the client to void and then reassess the fundal position.
Choice D rationale
Three fingerbreadths above the umbilicus is not expected 12 hours postpartum. This position may indicate uterine atony or subinvolution, which requires further assessment and intervention.
Correct Answer is B
Explanation
Choice A rationale
Fungal infections typically present with itching, redness, and a thick, white discharge resembling cottage cheese. The yellow-white vaginal drainage described is more consistent with lochia alba, the final stage of lochia, which is a normal postpartum discharge.
Choice B rationale
Lochia alba is the final stage of lochia, occurring around 10 to 14 days postpartum and lasting up to six weeks. It is characterized by a yellowish-white discharge, indicating the end of the postpartum bleeding process.
Choice C rationale
Retained placenta can cause prolonged bleeding and infection, but it is usually associated with heavy bleeding and not a yellow-white discharge. The presence of lochia alba suggests normal postpartum progression.
Choice D rationale
Bacterial infections often present with a foul-smelling discharge, pain, and fever. The yellow-white discharge described is more indicative of lochia alba, a normal postpartum occurrence.