A perinatal nurse receives reports from the nurse aide on four ...

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A perinatal nurse receives reports from the nurse aide on four patients who all gave birth within the last 4 hours. Which patient should the nurse assess first?
 
  A.
  Blood loss of 850 mL during cesarean birth
  B.
  Exhausted mother wanting only to rest after childbirth
  C.
  Pulse consistently ranges from 82 to 90 beats/minute
  D.
  Systolic blood pressure change from 132 to 110 mm Hg

Question 2

A patient has been transferred to an intensive care unit (ICU) after experiencing a pulmonary embolus. The patient is stable 24 hours later, but will remain in the unit for another day or two.
 
  At this time, the priority for the perinatal nurse is to provide the family with information about infant care and what other action?
  A.
  Advocate for infant visitation and breast pumping in the ICU if desired by the patient.
  B.
  Give the family information about the hospital policies and procedures, including visiting hours.
  C.
  Provide information about follow-up with her family physician after discharge from the hospital.
  D.
  Educate the family and patient about the patient's risk for future deep vein thrombosis.

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Answer to Question 1

ANS: D
A drop in blood pressure by 15, maternal heart rate over 110 beats/minute, or an oxygen saturation less than 95 may indicate a postpartum hemorrhage. The nurse should assess the woman whose blood pressure has changed more than 15. Blood loss of 850 mL during cesarean birth is not considered excessive. A pulse under 100 beats/minute is normal. A mother may well be exhausted and need to rest, particularly if her birthing experience was difficult or traumatic.

Answer to Question 2

ANS: A
Any postpartum complication can psychosocially affect a patient and her family. Prolonged treatment or hospitalization may create financial hardships, negatively impact family relationships and attachment with the infant, or result in psychological-emotional or spiritual crises. Because the patient is now stable, the perinatal nurse should advocate for the patient to have a postpartum experience that is as normal as possible. Visiting hours in the ICU are best explained by the ICU staff. It is too early to provide specific information about follow-up. Teaching the family and patient about future risks is important, but is not as high of a priority as is seeing to the patient's psychosocial needs and infant bonding in the ICU.