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 D
Explanation
Choice D rationale
Using a postpartum depression-screening tool with the client is the first action the nurse should take. This tool helps to assess the severity of the client’s symptoms and determine the appropriate level of care. Early identification and intervention are crucial in managing postpartum depression effectively.
Choice A rationale
Arranging for counseling to help the client cope with the stress of being a parent is important, but it is not the first action. Counseling can be part of the treatment plan after the initial assessment using the screening tool.
Choice B rationale
Reinforcing teaching about ways to increase rest and sleep is beneficial for the client’s overall well-being, but it does not address the immediate need to assess the severity of the client’s depressive symptoms.
Choice C rationale
Requesting a prescription for an antidepressant medication may be necessary, but it should be based on the results of the screening tool and a thorough assessment by a healthcare provider.