A nurse massages the uterus of a postpartum woman after making a hypothesis of uterine atony.
Which of the following outcomes would indicate that the client's condition had improved?
Decreased pain level.
Stable blood pressure.
Fundus firm at or below the umbilicus.
Reduced lochial flow.
The Correct Answer is C
Choice A rationale
Decreased pain level can be an effect of addressing the cause of pain, but it doesn't indicate improved uterine tone or resolution of atony.
Choice B rationale
Stable blood pressure is important, but it is not the direct outcome of improved uterine tone or the resolution of uterine atony.
Choice C rationale
A firm fundus at or below the umbilicus indicates successful contraction of the uterus, resolving uterine atony and reducing bleeding.
Choice D rationale
Reduced lochial flow can indicate decreased bleeding, but it does not directly indicate improved uterine tone or resolution of uterine atony.
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Correct Answer is D
Explanation
Choice A rationale
Placental abruption involves the detachment of the placenta from the uterine wall before delivery, causing bleeding, abdominal pain, and uterine tenderness. It does not typically cause dyspnea, hypotension, frothy sputum, or loss of consciousness.
Choice B rationale
Uterine rupture is a tear in the uterine wall, often in a scarred uterus. Symptoms include severe abdominal pain, abnormal fetal heart rate, and vaginal bleeding. It can cause shock, but not frothy sputum or sudden dyspnea.
Choice C rationale
Uterine inversion occurs when the uterus turns inside out, often during placental delivery. It leads to pain, hemorrhage, and shock. Like uterine rupture, it does not cause frothy sputum or sudden dyspnea.
Choice D rationale
Anaphylactoid syndrome (amniotic fluid embolism) occurs when amniotic fluid enters the maternal circulation, causing an anaphylactic reaction. Symptoms include sudden dyspnea, hypotension, frothy sputum, and loss of consciousness, fitting the scenario described.
Correct Answer is C
Explanation
Choice A rationale
While intravenous antibiotics are given during labor to prevent GBS transmission to the baby, it is not administered at home but in the hospital when labor begins.
Choice B rationale
GBS does not significantly increase the risk of intrauterine infection that requires daily temperature checks; it primarily poses a risk of neonatal infection during delivery.
Choice C rationale
GBS bacteria reside in the vagina and can be transmitted to the baby during delivery. Administering antibiotics during labor helps protect the baby from serious GBS-related illnesses.
Choice D rationale
GBS does not cause scarlet fever or the symptoms described; those are caused by different bacteria, namely Streptococcus pyogenes. .