Author Question: A nurse is delegating care of postpartum clients to a licensed vocational nurse (LVN). Which ... (Read 89 times)

magmichele12 · **on:** Jun 27, 2018

A nurse is delegating care of postpartum clients to a licensed vocational nurse (LVN). Which postpartum client is at the greatest risk for postpartum bleeding from uterine atony, and should not be delegated to an LVN's care?

1. A breastfeeding postpartum client
2. A postpartum client who began early ambulation
3. The client who delivered vaginally after a prolonged labor
4. A primiparous client

Question 2

A woman is 10 weeks pregnant. Her initial prenatal laboratory screening test for rubella showed an antibody titer of less than 1:6. The woman calls the clinic and tells the nurse that she has been exposed to measles.

The nurse's best response is: 1. Since you are in your first trimester of pregnancy, this is not likely to be a problem.
2. Would you like to see a counselor to talk about your options for the remainder of your pregnancy?
3. You should come to the clinic in the next day or two for further evaluation.
4. You need to have a rubella vaccination immediately. Can you get a ride to the clinic today?

zogaridan · **Reply #1 on:** Jun 27, 2018

Answer to Question 1

3
Rationale:
1. A breastfeeding client would be at less risk for postpartum hemorrhage, and would be appropriate to delegate to an LVN's care.
2. A postpartum client who ambulates early would be at less risk for postpartum hemorrhage, and would be appropriate to delegate to an LVN's care.
3. The client at greatest risk for postpartum hemorrhage because of uterine atony is the client who had a prolonged labor. Other factors that slow uterine involution and could interfere with contraction of the uterus during the postpartum period include anesthesia or excessive analgesia, difficult birth, grand multiparity, a full bladder, and incomplete expulsion of all of the placenta or fragments of the membranes.
4. A primiparous client would be at less risk for postpartum hemorrhage, and would be appropriate to delegate to an LVN's care.

Answer to Question 2

3
Rationale:
1. Exposure to rubella in the first trimester has the greatest risk for causing congenital anomalies.
2. It is nontherapeutic to send the client to a counselor.
3. Exposure to rubella in the first trimester has the greatest risk for causing congenital anomalies. So the best advice for the client would be to come to the clinic in the next day or two to talk with the nurse and physician about her options.
4. Clients are not vaccinated during the pregnancy.