Two days after an uncomplicated vaginal birth, the nurse notes ...

[student77]

Two days after an uncomplicated vaginal birth, the nurse notes that the patient's hemoglobin is 13 mg/dL and the hematocrit is 48. What does the nurse conclude about these values?
 
  A.
  Patient is dehydrated
  B.
  Needs further assessment
  C.
  Normal for this situation
  D.
  Serious anemia

Question 2

A woman is 10 hours postpartum after an uncomplicated vaginal birth. She has voided four times, and each time the volume is less than 100 mL. What action by the nurse is best?
 
  A.
  Ask the woman to keep a voiding log for 24 hours.
  B.
  Palpate the fundus and assess the amount of lochia present.
  C.
  Request an order for a straight catheterization.
  D.
  Run the water in the bathroom faucet during voiding attempts.

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Answer to Question 1

ANS: C
After a vaginal birth, the hemoglobin can drop about 1 gram, or 2 grams following a cesarean birth (normal for women is 12.1-15.1 mg/dL). Due to diuresis, hemoconcentration can occur, resulting in a rise in the hematocrit (normal in women is 36.1-44.3). Therefore, these findings are normal after an uncomplicated vaginal birth.

Answer to Question 2

ANS: B
Women who have recently given birth are at risk for urinary stasis and retention, which can lead to a boggy uterus and increased lochia. Frequently voiding 150 mL or less is a sign of urinary stasis and retention. The nurse should assess these factors first. The woman may need assistance when ambulating to the bathroom, or the nurse may need to run the water in the bathroom faucet during voiding attempts. A last resort is straight catheterization for severe urinary retention. Because the woman should be on intake and output assessments, a voiding log will not be helpful.

[student77]

Excellent

[shewald78]

Gracias!