Editing Maternal and Newborn Nursing – LPN Practice Questions (section)

==Question 10==
An LPN is caring for postpartum clients on a mother-baby unit. Which findings should be reported to the registered nurse? '''Select all that apply.'''
# A client who saturated a perineal pad in 45 minutes
# A client with a pulse of 118 beats per minute and cool, clammy skin
# A client reporting severe, unrelieved rectal pressure and perineal pain
# A client with profuse sweating overnight who has voided large amounts
# A client reporting a severe headache with blurred vision
# A client with painful uterine cramping while breastfeeding

'''Answer:''' 1, 2, 3, 5 (A, B, C, E).

''Rationale:'' Saturating a perineal pad in an hour or less signals excessive bleeding. Tachycardia with cool, clammy skin is an early sign of hypovolemia, and blood pressure falls only late. Severe, unrelieved perineal or rectal pain suggests a '''hematoma''', which can conceal significant blood loss. Headache with visual changes raises concern for '''postpartum preeclampsia''', which can develop or worsen after birth and up to 6 weeks later. Option 4 describes normal postpartum diuresis and diaphoresis as the extra plasma volume of pregnancy is excreted. Option 6 describes afterpains, which are expected and are more intense in multiparas and during breastfeeding because oxytocin release stimulates contraction; these are treated with analgesia and reassurance.