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A nurse is assisting a client out of bed for the first time since delivery.The client becomes frightened when she passes a large amount of lochia.Which of the following responses should the nurse make?

A.

Urinary tract infections are associated with increased lochia.

B.

Lochia can pool in the vagina while you lie in bed.

C.

You might have retained fragments of your placenta.

D.

The amount of lochia increases during the postpartum period.

Answer and Explanation

The Correct Answer is B

Choice A rationale

 

Urinary tract infections (UTIs) are not typically associated with increased lochia. UTIs usually present with symptoms such as burning during urination, frequent urination, and lower abdominal pain.

 

Choice B rationale

 

Lochia can pool in the vagina while lying in bed, leading to a larger amount being expelled upon standing. This is a normal occurrence and not a cause for concern.

 

Choice C rationale

 

Retained fragments of the placenta can cause heavy bleeding and infection, but the sudden expulsion of a large amount of lochia upon standing is more likely due to pooling rather than retained placenta.

 

Choice D rationale

 

The amount of lochia typically decreases over time during the postpartum period. An increase in lochia is not expected and should be evaluated for other causes.


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Correct Answer is B

Explanation

Choice B rationale

A heart rate of 110/min is a sign of tachycardia, which can indicate a postpartum complication such as infection, hemorrhage, or other underlying conditions. Tachycardia requires immediate assessment and intervention.

Choice A rationale

Chills shortly following delivery can be a normal response to the body’s adjustment after childbirth and do not necessarily indicate a complication.

Choice C rationale

Urinary output of 3,000 mL/12 hr is high but can be a normal part of postpartum diuresis as the body eliminates excess fluid accumulated during pregnancy.

Choice D rationale

The fundus at the umbilicus level is a normal finding in the immediate postpartum period and does not indicate a complication.

Correct Answer is D

Explanation

Choice A rationale

Rho(D) immune globulin is not indicated if both the client and the newborn are Rh positive. There is no risk of Rh incompatibility in this scenario.

Choice B rationale

Similarly, if both the client and the newborn are Rh positive, there is no need for Rho(D) immune globulin.

Choice C rationale

If both the client and the newborn are Rh negative, there is no risk of Rh incompatibility, and Rho(D) immune globulin is not needed.

Choice D rationale

Rho(D) immune globulin is indicated when the client is Rh negative and the newborn is Rh positive. This prevents the development of Rh antibodies in the client, which could affect future pregnancies.

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