The nurse is assessing the laboratory report on a 2-day postpartum G1P1001. The woman had a normal postpartum assessment this morning. Which of the following results should the nurse report to the primary health care provider?

Correct Answer: C

Rationale: In this scenario, the correct answer is option C) Hematocrit - 26%. The nurse should report this result to the primary health care provider because a hematocrit level of 26% in a 2-day postpartum patient is indicative of potential postpartum hemorrhage, which is a serious complication that requires immediate attention and intervention. A hematocrit level of 26% is below the normal range, suggesting a decrease in red blood cell volume and potential blood loss. Option A) White blood cells - 12,500 cells/mm3 and option B) Red blood cells - 4,500,000 cells/mm3 are within normal ranges and do not indicate an immediate concern related to postpartum complications like hemorrhage. Therefore, these results do not warrant immediate reporting to the primary health care provider. Educationally, understanding the significance of laboratory values in postpartum care is crucial for nurses providing care to women during this vulnerable period. Recognizing abnormal values and knowing when to escalate concerns to the healthcare provider can help prevent and manage complications effectively, ensuring the safety and well-being of postpartum patients.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Dizziness. When a gravid at 36 weeks gestation lies flat on her back, she may experience supine hypotensive syndrome due to compression of the inferior vena cava by the weight of the uterus. This can lead to decreased blood flow returning to the heart, resulting in symptoms like dizziness. A) Hypertension is unlikely in this context as lying flat on the back would not typically cause hypertension. C) Rales (abnormal crackling sounds heard on auscultation of the lungs) are not directly related to the position of the gravid lying flat on her back. D) Chloasma (skin discoloration often seen in pregnant women) is a cosmetic concern and not a direct result of lying on the back. Educationally, it is important for nurses caring for pregnant individuals to understand the physiological changes that occur during pregnancy and how certain positions or actions can impact both the mother and the fetus. This knowledge helps in providing safe and effective care to prevent complications such as supine hypotensive syndrome.

Correct Answer: B

Rationale: In the context of perinatal loss nursing care, it is crucial for educators to ensure that clients have a clear understanding of the role of amniotic fluid and the amniotic sac in pregnancy. Option B, "Fetal nutrients are provided by the amniotic fluid," is the correct answer that indicates the need for further teaching. While amniotic fluid serves various functions, such as providing a cushion against impact and helping regulate fetal temperature, it does not serve as the primary source of fetal nutrients. Fetal nutrients are primarily derived from the placenta through the umbilical cord. Option A, "The amniotic fluid helps to dilate the cervix once labor begins," is incorrect because the amniotic fluid does not play a direct role in cervical dilation. Cervical dilation is primarily influenced by uterine contractions during labor. Option C, "Amniotic fluid provides a cushion against the impact of the abdominal wall," is incorrect because this statement is accurate. Amniotic fluid does act as a cushion, protecting the fetus from external pressure or impact. Option D, "The amniotic sac helps regulate fetal temperature," is incorrect as well. The amniotic sac helps to maintain a stable environment for the fetus by providing protection and space but does not play a significant role in regulating fetal temperature. In an educational context, it is essential to clarify misconceptions and provide accurate information to clients to support their understanding of the physiological processes during pregnancy. By addressing misunderstandings and reinforcing correct information, educators can empower clients to make informed decisions and feel confident in their knowledge about perinatal care.

Correct Answer: B

Rationale: In the context of advocating for improved prenatal care services in the community, the most important information to include is the infant mortality rate (Option B). Infant mortality rate reflects the number of deaths of infants under one year of age per 1,000 live births. This rate is a critical indicator of the overall health and well-being of a population, including the impact of prenatal care on infant outcomes. The other options are not as directly relevant to the need for improved prenatal care services in the community. Maternal mortality rate (Option A) focuses on the deaths of mothers related to childbirth, which while important, may not directly reflect the need for improved prenatal care services. Perinatal mortality rate (Option C) includes stillbirths and early neonatal deaths, which are also important but may not convey the specific impact of prenatal care on infant survival. Neonatal mortality rate (Option D) specifically looks at deaths that occur within the first 28 days of life, which is important but does not capture the broader impact of prenatal care on overall infant health outcomes. Educationally, understanding the nuances of different mortality rates can help nurses and healthcare providers advocate for targeted interventions and resources to improve perinatal outcomes. By focusing on the infant mortality rate, healthcare professionals can better identify areas for improvement in prenatal care services to ultimately reduce infant deaths in the community.

Correct Answer: C

Rationale: The priority nursing diagnosis for a woman like G10P6226 who experienced a significant postpartum hemorrhage after a spontaneous vaginal delivery is "Fluid volume deficit related to blood loss" (Option C). This is the most critical issue to address first because postpartum hemorrhage can lead to severe hypovolemia and shock if not managed promptly. Replacing lost fluids and blood is essential to stabilize the patient's condition and prevent further complications. Option A, "Alteration in comfort related to afterbirth pains," is not the priority in this situation because the patient's physiological stability takes precedence over pain management. Option B, "Risk for altered parenting related to grand multiparity," is not an immediate concern when the patient is experiencing a life-threatening complication like fluid volume deficit. Option D, "Risk for sleep deprivation related to mothering role," is also not the priority as it is a long-term concern compared to the urgent need to address the fluid volume deficit. Educationally, understanding the concept of prioritizing nursing diagnoses based on the patient's immediate needs is crucial in providing effective and safe patient care. Nurses need to be able to recognize and address life-threatening conditions first before addressing other less urgent issues. This case highlights the importance of quick assessment and intervention in managing postpartum complications.