Complications of Postpartum

Complications of Postpartum Related

Review Complications of Postpartum related questions and content

A postpartum cesarean patient comes into the rural health clinic at 1 week postdelivery for an incision check by the nurse. The vital signs reveal a temperature of 100.5°F, and the patient reports moderate foul-smelling lochia. The nurse determines that the skin incision is healing normally, but when palpating the uterus, she discovers the patient to have uterine and pelvic tenderness. What are the most appropriate nursing actions?

  • A. Explain to the patient that she may have an infection of her uterus, and blood will need to be drawn to determine if this is the cause of her pain and excess bleeding.
  • B. Explain that the client should rest more to help the bleeding slow and that she should return to the clinic if she isn’t feeling better in a few days.
  • C. Explain to the patient that she is experiencing normal postoperative pain and bleeding and to come back for her scheduled 6-week postpartum checkup.
  • D. Explain to the patient that the incision appears to be healing nicely. Have her take Tylenol for the elevated temperature and continue with the ordered pain medication until her next visit.
Correct Answer: D

Rationale: Step 1: The nurse's assessment reveals signs of infection (fever, foul-smelling lochia, uterine, and pelvic tenderness).
Step 2: The nurse should address the immediate concerns - fever and pain. Tylenol helps reduce fever and pain.
Step 3: The incision healing well indicates no immediate surgical intervention required.
Step 4: Continuing pain medication ensures comfort until next visit.
Step 5: Blood tests for infection are not urgent; they can be done at the next visit if symptoms persist.
Summary:
A: Immediate blood draw is not necessary without a clear indication of sepsis.
B: Resting more won't address the infection; waiting a few days can worsen the condition.
C: Normal postoperative pain doesn't include fever and foul-smelling lochia; waiting for the 6-week checkup is risky.

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Which classification of placental separation is not recognized as an abnormal adherence pattern?

  • A. Placenta accreta
  • B. Placenta increta
  • C. Placenta percreta
  • D. Placenta abruptio
Correct Answer: D

Rationale: The correct answer is D: Placenta abruptio. Placenta abruptio is not a type of abnormal adherence pattern; instead, it refers to the premature detachment of a normally implanted placenta. Placenta accreta, increta, and percreta are abnormal adherence patterns where the placenta attaches too deeply into the uterine wall. Accreta is when it attaches but does not penetrate, increta is when it penetrates into the myometrium, and percreta is when it penetrates through the myometrium. Therefore, Placenta abruptio is the correct answer as it does not fall under the category of abnormal adherence patterns like the other choices.

Which of the following complementary therapies can a nurse suggest to a multiparous woman who is complaining of severe afterbirth pains?

  • A. Lie prone with a small pillow cushioning her abdomen.
  • B. Contract her abdominal muscles for a count of ten.
  • C. Slowly ambulate in the hallways.
  • D. Drink ice tea with lemon or lime.
Correct Answer: A

Rationale: Afterbirth pains are caused by uterine contractions. Lying prone with a pillow can help reduce discomfort by applying pressure and providing support to the abdomen. Ambulating or contracting the abdominal muscles is not generally recommended in this scenario.

Choose the best independent nursing action to aid episiotomy healing in the woman who is 24 hours postpartum.

  • A. Apply antibiotic cream to the area three times each day.
  • B. Squirt warm water over the perineum after voiding or stooling.
  • C. Maintain cold packs to the area at all times for the first 3 days.
  • D. Check the leukocyte level daily and report changes.
Correct Answer: B

Rationale: Squatting warm water over the perineum after voiding or stooling helps to soothe and cleanse the area, promoting healing.

The nurse continues to monitor a patient after a vaginal delivery with an estimated blood loss of 1,000 mL. Which assessment finding does the nurse recognize as requiring Stage 3 hemorrhage protocol?

  • A. Increased patient restlessness.
  • B. Manifestations of severe pain.
  • C. Development of abnormal vital signs.
  • D. Patient requests water for extreme thirst.
Correct Answer: C

Rationale: Vital signs will remain normal during Stages 1 and 2. The evidence of abnormal vital signs is one indicator of Stage 3 hemorrhage.

The nurse is collecting information during a follow-up OB appointment with a patient who delivered 3 months ago. The patient reports her partner has become cynical, irritable, and verbally abusive. The nurse will screen for which risks related to paternal postnatal depression (PPND)? Select all that apply.

  • A. The father exhibited depression during the pregnancy
  • B. The birth of this fourth child was unexpected and unplanned
  • C. The father expresses feeling bored and underappreciated in his job
  • D. The father is recently estranged from his parents and siblings
Correct Answer: B

Rationale: Exhibiting paternal depression during the pregnancy can be a risk factor for the development of PPND. An unexpected or unplanned pregnancy can be a risk factor for the development of PPND. The father’s estrangement from his parents and siblings can be a stressful life event and/or indicate a lack of social support.

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