A patient who has been on prolonged bedrest for bleeding associated with placenta previa was taken to the operating room for an emergency cesarean delivery. Sixteen hours postoperatively, the patient complains that her left leg is hurting. The nurse finds that the entire left leg is swollen and has pitting edema, while the right leg appears to be normal. Which order does the nurse anticipate when paging the health care provider to the room?

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Ultrasound of the leg. The patient's presentation of unilateral leg swelling and pitting edema raises suspicion for deep vein thrombosis (DVT), a common complication postpartum, especially in women who have been on prolonged bedrest. An ultrasound of the leg is the most appropriate diagnostic test to confirm the presence of DVT. Option A) White blood cell count (WBC) is unlikely to be the priority in this case as the patient's symptoms are more suggestive of a vascular issue rather than an infectious process. Option C) X-ray of the leg is not the preferred initial imaging modality for evaluating DVT. Ultrasound is more sensitive and specific for detecting DVT. Option D) Serum creatinine is not relevant to the patient's presentation of unilateral leg swelling and pitting edema. It is more indicative of renal function and not the primary concern in this context. From an educational perspective, it is crucial for healthcare providers to recognize the signs and symptoms of DVT in postpartum patients, as prompt diagnosis and treatment are essential to prevent serious complications such as pulmonary embolism. Understanding the appropriate diagnostic approach in such cases is vital for providing safe and effective care to this patient population.

Correct Answer: B

Rationale: In the scenario of suspected pulmonary embolism in a postpartum patient, the nurse's initial response should be to raise the head of the bed and administer oxygen (Option B). This action is crucial as it helps to improve oxygenation and perfusion to vital organs, which is essential in managing a potential pulmonary embolism. Raising the head of the bed promotes optimal lung expansion and ventilation, while administering oxygen supports adequate oxygenation. These interventions are fundamental in stabilizing the patient's condition and preventing further complications related to hypoxia or respiratory distress. The other options are incorrect for several reasons: A) Starting a second IV line and preparing for transfusion is not the priority in a suspected pulmonary embolism. Immediate respiratory support takes precedence over initiating additional IV access. C) Inserting a catheter to monitor urine output is not the most urgent action in this critical situation. Monitoring urine output is important for assessing renal function but is not the primary intervention needed for a suspected pulmonary embolism. D) Lowering the head of the bed and elevating the legs is contraindicated in a suspected pulmonary embolism as it can further compromise oxygenation by impeding venous return to the heart, potentially exacerbating the embolism and leading to hemodynamic instability. In an educational context, understanding the prioritization of interventions in emergencies like pulmonary embolism is essential for nurses to provide safe and effective care. Critical thinking skills and quick decision-making are crucial in such situations to ensure the best outcomes for patients.

Correct Answer: C

Rationale: In postpartum teaching related to urinary health, emphasizing the importance of cleansing the perineum in a front-to-back direction (Option C) is crucial. This practice helps prevent the introduction of harmful bacteria from the rectal area to the urinary tract, reducing the risk of urinary tract infections (UTIs) and other complications. Option A, drinking any type of fluid whenever thirsty, is a general recommendation for overall hydration but not specifically related to urinary health postpartum. Option B, allowing the bladder to fill to promote emptying, is incorrect as frequent emptying of the bladder is important to prevent UTIs. Option D, eating two servings of acidic fruits or vegetables each day, is not directly related to perineal hygiene or urinary health. In an educational context, teaching postpartum individuals about proper perineal care is essential for their overall well-being and to prevent complications such as UTIs. Emphasizing the correct technique of cleansing from front to back can empower individuals to take proactive steps in maintaining their urinary health during the postpartum period.

Correct Answer: A

Rationale: In this scenario, the correct response is option A: Emptying the breast is important to prevent an abscess. This is the best nursing response because continuing to empty the breast through breastfeeding or pumping is crucial in treating mastitis and preventing the development of an abscess. Option B is incorrect because using a tight breast binder or bra can actually worsen engorgement and impede milk flow, exacerbating the mastitis. Option C is incorrect as there is no direct correlation between drinking extra fluids and weaning during mastitis treatment. Option D is incorrect because breastfeeding should not be resumed solely based on normal temperature; it is essential to ensure proper treatment and resolution of the infection. From an educational perspective, it is important for healthcare providers to understand the significance of breast emptying in managing mastitis. By continuing to breastfeed or pump, the mother can promote drainage of the infected milk ducts, alleviate symptoms, and prevent complications like abscess formation. Educating mothers on the importance of breast emptying can help them make informed decisions regarding breastfeeding even in the presence of mastitis.

Correct Answer: A

Rationale: In postpartum pharmacology, understanding the types of lochia and their characteristics is crucial for providing appropriate care to postpartum mothers. In this case, the correct answer is A) rubra, which is bright to dark red and occurs on days 1-3 postpartum. Rubra is the initial discharge after childbirth, consisting of blood, decidual tissue, and mucus. Option B) serosa is typically pinkish or brownish and occurs from days 4-10 postpartum, as it transitions from the initial rubra discharge. Option C) placental would not be a correct answer as it does not describe a specific type of lochia. Option D) alba is a whitish discharge occurring around days 10-14 postpartum, signaling the final stages of lochia. Educationally, understanding the progression of lochia helps healthcare providers assess the normal postpartum recovery process and identify any abnormal bleeding or complications. This knowledge is essential for providing quality care to postpartum women and ensuring their overall well-being during this critical period.