The nurse is closely monitoring a patient who is postpartum and at risk for PPH. Which assessment finding will cause the nurse to contact the primary care provider immediately?

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Peripad weighs 100 g within 15 minutes. This finding indicates excessive postpartum bleeding, which is a significant concern as it suggests a risk of postpartum hemorrhage (PPH). Immediate notification of the primary care provider is crucial to initiate prompt interventions and prevent further complications. Option A) The uterus is displaced may indicate a full bladder or uterine atony, which are important to address but do not represent an immediate threat as much as severe bleeding does. Option B) The uterine fundus is boggy suggests uterine atony, a common cause of PPH, but it does not indicate active bleeding as directly as option D. Option C) Small clots being expressed with massage are a normal finding in the immediate postpartum period and do not necessarily indicate significant bleeding. In an educational context, understanding the assessment findings and interventions for postpartum complications like PPH is crucial for nurses caring for postpartum patients. Recognizing early signs of PPH and knowing when to escalate care are essential skills to ensure the safety and well-being of the mother. Regular simulation training and case studies can help reinforce this knowledge and enhance clinical decision-making in these critical situations.

Correct Answer: B

Rationale: In this scenario, the correct answer is option B) Information applicable to medication therapy. The rationale behind this is that when a postpartum patient is experiencing signs and symptoms of an episiotomy infection and is on oral antibiotic therapy, it is crucial to provide education on medication therapy for pain management. It is important for the nurse to ensure the patient understands the prescribed pain medication regimen, including dosage, timing, potential side effects, and interactions with antibiotics. Option A) Application of hot packs to the perineal area may provide temporary relief but does not address the underlying issue of infection or provide effective pain management in this case. Option C) Instructions to improve circulation by ambulating is important for overall recovery but may not directly address the pain associated with the episiotomy infection. Option D) Medicating for pain above level 4 on a 0 to 10 scale is vague and does not provide specific guidance on pain management tailored to the patient's condition and medication regimen. In an educational context, understanding the rationale behind pain management strategies in postpartum patients with complications is essential for nurses to provide safe and effective care. By teaching medication therapy specifics, nurses empower patients to manage their pain effectively, promoting better outcomes and patient satisfaction.

Correct Answer: C

Rationale: In the context of postpartum psychosis, the correct medical management for a patient exhibiting symptoms is immediate hospitalization in a psychiatric unit (Option C). This option is the most appropriate because postpartum psychosis is a serious condition that requires close monitoring, specialized care, and often pharmacological intervention to ensure the safety of both the mother and the newborn. Option A (Prescriptions for antidepressant/antipsychotic drugs) is a common treatment approach for postpartum depression but may not be sufficient for the acute presentation of postpartum psychosis. Option B (Discharge to home with 24-hour observation in place) is not appropriate as postpartum psychosis necessitates a higher level of care than can be provided at home. Option D (Prescribed neonate visits during in-patient treatment) is not the priority in this situation as the immediate focus should be on addressing the mother's acute psychiatric needs. Educationally, understanding the urgency and severity of postpartum psychosis is crucial for nurses caring for postpartum patients. Recognizing the signs and symptoms early, knowing the appropriate interventions, and understanding the importance of prompt and specialized care can help prevent adverse outcomes for both the mother and the newborn. Nurses should be prepared to advocate for the appropriate level of care and treatment in these situations to ensure the best possible outcomes for the patient.

Correct Answer: A

Rationale: In this scenario, the correct response is option A) Foul-smelling lochia. This is a sign of a potential infection, such as endometritis, which can be a serious complication postpartum. It is crucial for the nurse to instruct the patient to contact their primary care provider immediately if they notice foul-smelling lochia as this requires prompt medical attention to prevent further complications. Option B) Hot, red, painful breasts could indicate mastitis, which is a common postpartum complication. While this is a concern, it is not as urgent as foul-smelling lochia. The nurse should educate the patient about managing mastitis but does not need to contact the primary care provider immediately unless symptoms worsen. Option C) Mild headache is a common postpartum symptom and is usually not a cause for immediate concern. However, persistent or severe headaches should be reported to the primary care provider as they could indicate more serious issues like preeclampsia. Option D) Not sleeping well is a common issue postpartum due to the demands of caring for a newborn. While sleep deprivation can impact the mother's health, it is not typically a reason to contact the primary care provider unless it is severe and affecting the mother's ability to function. In an educational context, it is important for nurses to understand the potential complications that can arise in the postpartum period and to educate patients on when to seek medical help. By prioritizing and differentiating between symptoms that require immediate attention versus those that can be managed with home care, nurses can help ensure the well-being of postpartum patients and their infants.

Correct Answer: C

Rationale: In the context of postpartum care after a cesarean delivery, it is crucial for nurses to be able to recognize signs of wound infection promptly. Option C, increased margins of incisional redness, is the correct answer in this scenario. This finding indicates a spreading infection that needs immediate attention. Option A, a mild increase in temperature, could be a normal postpartum finding or result from other causes, so it is not a definitive sign of wound infection. Option B, incisional tenderness with palpation, can be expected as part of normal wound healing and may not necessarily indicate infection unless accompanied by other signs. Option D, notably warm skin around the incision, could be attributed to localized inflammation or increased blood flow to the area as part of the healing process, rather than a clear indicator of infection. Educationally, understanding the subtle differences in postpartum assessments is essential for nurses to provide safe and effective care. Recognizing the specific signs of wound infection helps in timely intervention and prevention of complications for the mother. This case highlights the importance of thorough assessment and clinical judgment in postpartum care, ensuring optimal outcomes for both the mother and the newborn.