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A nurse is caring for a client who is 18 hours postpartum. Which finding should alert the nurse to the possibility of a postpartum complication?

A.

Heart rate 125 bpm.

B.

Fundus palpable at the umbilicus.

C.

Urine output of 3,000 mL in 24 hr.

D.

Orthostatic hypotension.

Answer and Explanation

The Correct Answer is A

Choice A rationale

 

A heart rate of 125 bpm is significantly elevated and may indicate a postpartum complication such as infection, hemorrhage, or other underlying conditions. Tachycardia in the postpartum period warrants further assessment and intervention to identify and address the cause.

 

Choice B rationale

 

The fundus being palpable at the umbilicus is normal for 18 hours postpartum. The uterus gradually descends into the pelvis over the postpartum period, and its position at the umbilicus at this stage is expected.

 

Choice C rationale

 

A urine output of 3,000 mL in 24 hours is within the normal range for postpartum diuresis. Increased urine output is common as the body eliminates excess fluid accumulated during pregnancy.

 

Choice D rationale

 

Orthostatic hypotension can occur in the postpartum period due to blood volume changes and fluid shifts. While it requires monitoring, it is not as immediately concerning as tachycardia, which may indicate a more serious complication.

 


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View Related questions

Correct Answer is D

Explanation

Choice A rationale

Swelling in both breasts is more indicative of engorgement rather than mastitis. Mastitis typically affects only one breast.

Choice B rationale

A white patch on a nipple is more likely a sign of a yeast infection (thrush) rather than mastitis.

Choice C rationale

Cracked and bleeding nipples can be a risk factor for mastitis but are not a definitive sign of the condition.

Choice D rationale

A red and painful area in one breast is a classic sign of mastitis. This condition is often accompanied by flu-like symptoms such as fever and malaise.

Correct Answer is C

Explanation

Choice A rationale

Asking the client to rate her pain is important for assessing discomfort, but it does not address the immediate issue of a deviated fundus. A deviated fundus often indicates a full bladder, which can impede uterine contraction and increase the risk of postpartum hemorrhage.

Choice B rationale

Encouraging the client to perform Kegel exercises is beneficial for pelvic floor strengthening but does not address the immediate concern of a deviated fundus. The priority is to ensure the uterus can contract properly.

Choice C rationale

Assisting the client to the bathroom to void is the correct action. A full bladder can displace the uterus, preventing it from contracting effectively and increasing the risk of hemorrhage. Voiding helps the uterus return to its proper position and function.

Choice D rationale

Encouraging the client to move to the left lateral position may provide comfort but does not address the underlying issue of a full bladder causing uterine displacement.

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