A woman who gave birth 24 hours ago tells the nurse, "I've been urinating so much over the past several hours.". Which response by the nurse would be most appropriate?
A) "You must have an infection, so let me get a urine specimen.".
B) "Your body is undergoing many changes that cause your bladder to fill quickly.".
C) "Your uterus is not contracting as quickly as it should.".
D) "The anesthesia that you received is wearing off and your bladder is working again.".
B
Feedback:
Postpartum diuresis occurs as a result of several mechanisms: the large amounts of IV fluids given during labor, a decreasing antidiuretic effect of oxytocin as its level declines, the buildup and retention of extra fluids during pregnancy, and a decreasing production of aldosterone—the hormone that decreases sodium retention and increases urine production. All these factors contribute to rapid filling of the bladder within 12 hours of birth. Diuresis begins within 12 hours after childbirth and continues throughout the first week postpartum. Rapid bladder filling, possible infection, or effects of anesthesia are not involved.
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