A new mother is questioning the nurse about the newborn's urinary ...

[SO00]

A new mother is questioning the nurse about the newborn's urinary output, which is infrequent and scanty.
 
  The nurse recognizes this pattern as normal, and knows that contributing factors include which of the following? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. The infant's glomerular filtration rate is high in comparison with the adult rate.
  2. Full-term newborns are less able than are adults to concentrate urine because the tubules are short and narrow.
  3. The ability to concentrate urine fully is developed at the age of 1 year.
  4. Feeding practices can affect the osmolarity of the urine, but have limited effect on concentration of the urine.
  5. The newborn kidney is limited in its dilutional capacity.

Question 2

The nurse is assessing a patient who has been diagnosed with an early postpartum hemorrhage. Which findings would the nurse expect? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
 
  Select all that apply. 1. A boggy fundus that does not respond to massage
  2. Small clots and a moderate amount of lochia rubra on the pad
  3. Decreased pulse and increased blood pressure
  4. Hematoma formation or bulging/shiny skin in the perineal area
  5. Rise in the level of the fundus of the uterus

[nhea]

Answer to Question 1

2,4,5
Rationale 1: The infant's glomerular filtration rate is low in comparison with the adult rate.
Rationale 2: The reduced ability to concentrate urine is caused by the limited tubular reabsorption of water and limited excretion of solutes.
Rationale 3: The ability to concentrate urine fully is developed by 3 months of age.
Rationale 4: Newborns who do not void by 48 hours should be assessed for adequate fluid intake.
Rationale 5: Concentrating and dilutional limitations of renal function are important considerations in monitoring fluid therapy to avoid dehydration and overhydration.

Answer to Question 2

1,4,5
Rationale 1: A boggy fundus indicates that the uterus is not contracted and will continue to bleed.
Rationale 2: These are normal findings in the postpartal period.
Rationale 3: Increasing pulse and decreasing blood pressure are detected when the patient is bleeding.
Rationale 4: Shiny or bulging skin could indicate the presence of a hematoma.
Rationale 5: The uterine cavity can distend with up to 1000 ml or more of blood, causing the fundus to rise.

[SO00]

TYSM

[aliotak]

Gracias!