Complications of Postpartum

Complications of Postpartum Related

Review Complications of Postpartum related questions and content

A patient who has been on prolonged bedrest for bleeding associated with placenta previa was taken to the operating room for an emergency cesarean delivery. Sixteen hours postoperatively, the patient complains that her left leg is hurting. The nurse finds that the entire left leg is swollen and has pitting edema, while the right leg appears to be normal. Which order does the nurse anticipate when paging the health care provider to the room?

  • A. White blood cell count (WBC)
  • B. Ultrasound of the leg
  • C. X-ray of the leg
  • D. Serum creatinine
Correct Answer: B

Rationale: The correct answer is B: Ultrasound of the leg. In this scenario, the patient is at risk for deep vein thrombosis (DVT) due to prolonged bedrest and recent surgery. The symptoms of leg pain, swelling, and pitting edema raise suspicion for DVT. An ultrasound of the leg is the most appropriate diagnostic test to confirm the presence of a blood clot. This test is non-invasive, highly sensitive, and specific for detecting DVT. It allows for prompt diagnosis and initiation of appropriate treatment such as anticoagulation therapy to prevent potential complications like pulmonary embolism.

Summary:
- A: White blood cell count (WBC) is not indicated for evaluating leg pain and swelling in this context.
- C: X-ray of the leg is not useful for diagnosing DVT, as it primarily shows bones and is not sensitive for detecting blood clots.
- D: Serum creatinine is a test for kidney function and is not relevant for assessing

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A client, G1 P0101, postpartum 1 day, is assessed. The nurse notes that the client 's lochia rubra is moderate and her fundus is boggy 2 cm above the umbilicus and deviated to the right. Which of the following actions should the nurse take first?

  • A. Notify the woman 's primary health care provider.
  • B. Massage the woman 's fundus.
  • C. Escort the woman to the bathroom to urinate.
  • D. Check the quantity of lochia on the peripad.
Correct Answer: B

Rationale: A boggy fundus can indicate uterine atony, which can lead to postpartum hemorrhage. The first step is to massage the fundus to stimulate uterine contraction.

Which of the following laboratory values would the nurse expect to see in a normal postpartum woman?

  • A. Hematocrit, 39%.
  • B. White blood cell count, 16,000 cells/mm3.
  • C. Red blood cell count, 5 million cells/mm3.
  • D. Hemoglobin, 15 grams/dL.
Correct Answer: B

Rationale: A slightly elevated white blood cell count is common postpartum due to the physiological stress of delivery and recovery.

A postpartum patient calls the clinic 4 days after the birth of her newborn because she is extremely tired and her vaginal bleeding is heavier. Which does the nurse anticipate when advising her to come in to the office right now?

  • A. A hematocrit will be drawn, and the licensed provider will check for retained placental fragments.
  • B. Her stress level and sleep deprivation will be evaluated, and a prescription for sleeping medication will be given.
  • C. The perineum will be evaluated for lacerations that were missed.
  • D. Reassure the client that this is all normal and provide a prescription for slow-release iron tablets.
Correct Answer: A

Rationale: The correct answer is A. The nurse anticipates that a hematocrit will be drawn and the provider will check for retained placental fragments because heavy vaginal bleeding and extreme fatigue could indicate postpartum hemorrhage due to retained placental tissue. This is a serious complication that requires immediate medical attention to prevent further complications such as infection or hemorrhagic shock.

Choice B is incorrect because prescribing sleeping medication does not address the underlying cause of the symptoms. Choice C is incorrect because lacerations would typically have been evaluated and repaired during delivery, and would not likely be missed. Choice D is incorrect because reassuring the client without further evaluation could lead to potential serious consequences if the underlying issue of retained placental fragments is not addressed promptly.

The nurse is closely monitoring a patient who is postpartum and at risk for PPH. Which assessment finding will cause the nurse to contact the primary care provider immediately?

  • A. The uterus is displaced.
  • B. The uterine fundus is boggy.
  • C. Small clots are expressed with massage.
  • D. Peripad weighs 100 g within 15 minutes.
Correct Answer: D

Rationale: The nurse will monitor the amount and characteristics of each patient’s lochia. If bleeding seems excessive, the nurse will weigh peripads to ascertain the amount of blood loss.

What postpartum infection is caused by STIs and chorioamnionitis?

  • A. mastitis
  • B. pneumonia
  • C. cesarean wound infection
  • D. postpartum endometritis
Correct Answer: D

Rationale: Postpartum endometritis can result from untreated STIs and chorioamnionitis and typically presents as fever and uterine tenderness.

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