The nurse reviews clinical data for a client 24 hours postpartum following a vaginal delivery.
Which of the following findings would require follow-up by the nurse?
The nurse reviews clinical data for a client 24 hours postpartum following a vaginal delivery.
Which of the following findings would require follow-up by the nurse?
A. Hematocrit 46% (0.46 L/L) [>33%, >.33L/L]
[2%]
B. Creatinine 1.0 mg/dL (88.4 µmol/L) [0.5–1.1 mg/dL, 44–97 µmol/L]
[1%]
C. Platelets 90 mm3 (90 x 10⁹/L) [150-400 mm3, 150–400 × 10⁹/L]
[71%]
D. White blood cell 17 mm3 (17 x 10⁹/L) [5-10 mm3, 5-10 × 10⁹/L]
[26%]
Statistics
Subject/Lesson
Subject
Maternal & Newborn Health
Lesson
Postpartum
Client Need
Test Plan
Health Promotion and Maintenance
Related Topic
Ante/Intra/Postpartum and Newborn Care
Item Type
Item Type
Analysis
Explanation
Choice C is correct. The platelet count is low and requires follow-up and notification to the primary healthcare provider (PHCP). The normal platelet count is 150-400 mm3, 150-400 × 10⁹/L. Causes of postpartum thrombocytopenia include exposure to certain medications, HELLP syndrome, preeclampsia, or disseminated intravascular coagulopathy. Thrombocytopenia can lead to an increased risk of bleeding, which is a concern postpartum, especially after a vaginal delivery.
Choice A is incorrect. The hematocrit level is within the normal range (greater than 33% or 0.33 L/L) and does not require immediate follow-up.
Choice B is incorrect. The creatinine level is within the normal range (0.5-1.1 mg/dL, 44–97 µmol/L) and does not require immediate follow-up.
Choice D is incorrect. The white blood cell count is elevated, but can be a normal response to the stress of delivery. However, it should be monitored for signs of infection. It does not necessarily require immediate follow-up unless there are other concerning symptoms.
Related Videos
2 Key Topics
HELLP Syndrome
28.5 Infection & Complication Risks
Additional Info
✓ Normal postpartum findings include -
- A urinary output of up to 3000 mL/day may occur, especially on days 2 through 5 postpartum.
- Diaphoresis is a common postpartum finding
- White blood cell (WBC) count increases to as high as 30,000/mm3 during labor and the immediate postpartum period
- The hematocrit returns to normal limits 4 to 6 weeks postpartum
- The first stool usually occurs within 2 to 3 days postpartum. Constipation is common during the first bowel movement.
- Approximately 4.5 to 5.8 kg (10 to 13 lb) is lost during childbirth. This includes the weight of the fetus, placenta, amniotic fluid and blood lost during the birth
- An additional 2.3 to 3.6 kilograms (kg) (5 to 8 lb) are lost as a result of diuresis and 0.9 kg to 1.4 kg (2 to 3 lb) from involution and lochia by the end of the first week
✓ In the first 24 hours after childbirth, a woman's body begins the process of physical recovery. The uterus starts to contract back to its pre-pregnancy size, which can cause discomfort and cramping known as afterpains. The healthcare team monitors the woman's vital signs, bleeding, and uterine contractions to ensure her body is healing properly.
✓ The first 24 hours after childbirth are crucial for bonding between the mother and the newborn. Skin-to-skin contact is encouraged, which helps regulate the baby's body temperature and promotes breastfeeding.
