Complication Postpartum

Complication Postpartum Related

Review Complication Postpartum related questions and content

A woman who has recently given birth complains of pain and tenderness in her leg. On physical examination, the nurse notices warmth and redness over an enlarged, hardened area. Which condition should the nurse suspect, and how will it be confirmed?

  • A. Disseminated intravascular coagulation (DIC); asking for laboratory tests
  • B. von Willebrand disease (vWD); noting whether bleeding times have been extended
  • C. Thrombophlebitis; using real-time and color Doppler ultrasound
  • D. Idiopathic or immune thrombocytopenic purpura (ITP); drawing blood for laboratory analysis
Correct Answer: C

Rationale: Pain and tenderness in the extremities, which show warmth, redness, and hardness, is likely thrombophlebitis. A Doppler ultrasound examination is a common noninvasive way to confirm the diagnosis. A diagnosis of DIC is made according to clinical findings and laboratory markers. With DIC, a physical examination will reveal symptoms that may include unusual bleeding, petechiae around a blood pressure cuff on the woman’s arm, and/or excessive bleeding from the site of a slight trauma such as a venipuncture site. Symptoms of vWD, a type of hemophilia, include recurrent bleeding episodes, prolonged bleeding time, and factor VIII deficiency. A risk for PPH exists with vWD but does not exhibit a warm or reddened area in an extremity. ITP is an autoimmune disorder in which the life span of antiplatelet antibodies is decreased. Increased bleeding time is a diagnostic finding, and the risk of postpartum uterine bleeding is increase

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The nurse works in a labor and delivery facility with new protocols for estimating postpartum blood loss. Which method for estimating blood loss is implemented in the delivery room?

  • A. Ask the patient how many peripads she considered to be “soaked.”
  • B. Collect blood in calibrated, under-buttocks drapes for vaginal birth.
  • C. Place a basin at the foot of the delivery table to catch any blood.
  • D. Rely on the primary health care provider’s estimate of blood loss.
Correct Answer: B

Rationale: Collecting blood in calibrated, under-buttocks drapes for vaginal birth and then weighing the drapes is the easiest way to estimate blood loss in the delivery room.

The nurse educates the person with a newborn in the NICU. What guidance does the nurse provide?

  • A. Breast milk is not good for a premature baby.
  • B. Premature babies breast-feed easily.
  • C. Skin-to-skin contact helps both baby and breast-feeding person.
  • D. A bottle is recommended for all feedings.
Correct Answer: C

Rationale: Skin-to-skin contact is important for both mother and premature infant.

The nurse is assisting the primary care provider with the third stage of a vaginal delivery. The patient is multiparous, experienced a precipitous birth, and has a history of hypertension. Which medical prescription does the nurse anticipate for this patient?

  • A. Methylergonovine
  • B. Fresh frozen plasma
  • C. Carboprost-tromethamine
  • D. Magnesium sulfate
Correct Answer: C

Rationale: The correct answer is C: Carboprost-tromethamine. In the given scenario, the patient is multiparous, had a precipitous birth, and has a history of hypertension. Carboprost-tromethamine is typically administered in the third stage of labor to manage postpartum hemorrhage, which is a potential complication in this case due to the patient's history of hypertension. Methylergonovine (choice A) is contraindicated in patients with hypertension due to its vasoconstrictive effects. Fresh frozen plasma (choice B) is not typically indicated for postpartum hemorrhage. Magnesium sulfate (choice D) is commonly used for pre-eclampsia/eclampsia but not specifically for postpartum hemorrhage in this scenario.

The nurse is assisting the primary care provider with the third stage of a vaginal delivery. The patient is multiparous, experienced a precipitous birth, and has a history of hypertension. Which medical prescription does the nurse anticipate for this patient?

  • A. Methylergonovine
  • B. Fresh frozen plasma
  • C. Carboprost-tromethamine
  • D. Magnesium sulfate
Correct Answer: C

Rationale: Carboprost-tromethamine is classified as a prostaglandin and is prescribed to maintain contraction of the uterine muscles.

The nurse palpates a distended bladder on a woman who delivered vaginally 2 hours earlier. The woman refuses to go to the bathroom, 'I really don 't need to go. ' Which of the following responses by the nurse is appropriate?

  • A. Okay. I must be palpating your uterus.
  • B. I understand but I still would like you to try to urinate.
  • C. You still must be numb from the local anesthesia.
  • D. That is a problem. I will have to catheterize you.
Correct Answer: B

Rationale: A distended bladder can lead to complications such as uterine atony. The nurse should encourage the woman to attempt urination, but if she refuses, further action may be necessary.

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