The nurse is providing discharge teaching for a client who is 24 hours postpartum. The nurse explains to the client that her vaginal discharge will change from red to pink and then to white. The client asks, 'What if I start having red bleeding after it changes?' What should the nurse instruct the client to do?

Correct Answer: A

Rationale: The correct answer is A) Reduce activity level and notify the healthcare provider. This response is appropriate because red bleeding after the initial postpartum discharge signifies fresh bleeding and could indicate a potential issue such as hemorrhage or infection. Instructing the client to reduce activity level helps minimize further bleeding, while notifying the healthcare provider promptly allows for timely intervention and assessment. Option B) Go to bed and assume a knee-chest position is incorrect as it does not address the potential underlying cause of the red bleeding and may delay necessary medical evaluation. Option C) Massage the uterus and go to the emergency room is also incorrect as massaging the uterus without proper assessment could be harmful, and going to the emergency room should be guided by healthcare provider instructions. Option D) Do not worry as this is a normal occurrence is incorrect because red bleeding after the initial postpartum period should not be dismissed as normal without proper evaluation to rule out complications. In an educational context, it is crucial for nurses to be able to provide accurate and timely information to postpartum clients regarding expected changes and potential warning signs after childbirth. This scenario emphasizes the importance of postpartum monitoring and the need for appropriate intervention in case of abnormal signs or symptoms to ensure the well-being of both the mother and the newborn.

Correct Answer: C

Rationale: In the case of a client admitted with total placenta previa, the most critical finding for the nurse to report to the healthcare provider immediately is the onset of uterine contractions (Option C). This is because in placenta previa, where the placenta partially or completely covers the cervix, uterine contractions can lead to severe bleeding due to the detachment of the placenta from the uterine wall. This situation can rapidly escalate into a life-threatening emergency for both the mother and the fetus. Option A, a heart rate of 100 beats/minute, though abnormal, may not be as urgent in this scenario as the risk of hemorrhage from uterine contractions. Option B, variable fetal heart rate, while concerning, is not as immediate a concern as uterine contractions leading to potential hemorrhage. Option D, burning urination, is unrelated to the diagnosis of placenta previa and does not pose an immediate threat to the client's life. Educationally, understanding the priority of reporting critical findings in obstetric emergencies like placenta previa is crucial for nurses caring for pregnant clients. This question highlights the importance of recognizing potentially life-threatening situations and acting promptly to ensure the safety and well-being of both the mother and the baby.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) 200 ml/hr. The rationale behind this is that the nurse needs to administer cefazolin 2 grams IV over 30 minutes. The medication is available in a concentration of 2 grams/100 ml. Therefore, to deliver 2 grams of cefazolin, the nurse needs to infuse 100 ml of the medication. Since the infusion is to be completed over 30 minutes, which is half an hour, the nurse should calculate the infusion rate in ml/hour. Option A) 100 ml/hr is incorrect because this rate would deliver only half of the required dose in the specified time frame. Option C) 6 ml/hr and Option D) 1.6 ml/hr are also incorrect as they do not provide the necessary infusion rate to deliver the full 2 grams of cefazolin over 30 minutes. Educationally, this question assesses the nurse's understanding of medication administration and infusion rate calculations, which are crucial skills in providing safe and effective care to maternity patients. Nurses must be competent in calculating correct infusion rates to ensure that patients receive the prescribed medication in the appropriate dosage and time frame. Mastery of these calculations is essential for patient safety and quality care delivery in maternity settings.

Correct Answer: A

Rationale: The correct answer is A) That's called caput succedaneum. It will absorb and cause no problems. Caput succedaneum is a common condition in newborns characterized by swelling on the baby's head due to pressure during birth. It typically resolves on its own without intervention. Option B is incorrect because a cephalohematoma, not caput succedaneum, is a collection of blood between the skull and periosteum. Unlike caput succedaneum, a cephalohematoma may take weeks to months to resolve as the body reabsorbs the blood. Option C is incorrect because cephalohematoma does not directly cause jaundice. Jaundice is usually a result of elevated bilirubin levels and is not directly related to a cephalohematoma. Option D is incorrect because caput succedaneum does not require drainage. It is a self-limiting condition that resolves as the baby's body reabsorbs the excess fluid. In an educational context, it is crucial for nurses to be able to differentiate between common newborn conditions like caput succedaneum and cephalohematoma to provide accurate information and reassurance to new parents. Understanding these conditions helps nurses promote parental education and alleviate unnecessary concerns regarding their newborn's health.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) The client reports feeling a flushing sensation. - **Explanation of Correct Answer (D):** A flushing sensation is a common side effect of magnesium sulfate therapy. It indicates that the drug level has reached a therapeutic range for treating PIH. This symptom suggests vasodilation, which helps in controlling hypertension in the client. - **Explanation of Incorrect Answers:** - A) The client being oriented to date, time, and place is unrelated to the therapeutic level of magnesium sulfate. - B) Respiratory rate of 14 breaths per minute is within normal limits and does not directly indicate the achievement of therapeutic drug level. - C) Urinary output of 30 ml per hour is a concerning finding in a pregnant client and may indicate inadequate kidney perfusion, but it does not specifically indicate the therapeutic level of magnesium sulfate. - **Educational Context:** Understanding the assessment findings related to medication therapy is crucial for nurses caring for pregnant clients with complications like PIH. Recognizing the signs of therapeutic drug levels helps in providing safe and effective care to improve maternal and fetal outcomes. Educating nursing students on these assessment skills prepares them to deliver quality care in obstetric settings.