Nokea
Hemabate has been ordered for a postpartum patient who has uncontrolled bleeding and uterine atony. Which is the appropriate nursing action?
- A. Check the patient’s vital signs first for hypotension, and lower the head of the bed.
- B. Check the patient’s blood glucose and increase the IV fluid rate.
- C. Check the patient’s record for a history of asthma, and ask the licensed provider for an order of an antidiarrheal medication.
- D. Check the patient’s record for a history of hypothyroid, and ask the licensed provider to order something for nausea.
Correct Answer: C
Rationale: The correct answer is C. The rationale is as follows:
1. Hemabate is a medication used to treat postpartum hemorrhage due to uterine atony.
2. Checking the patient's record for a history of asthma is crucial as Hemabate can exacerbate asthma symptoms.
3. Asking the provider for an antidiarrheal medication is appropriate to manage potential side effects of Hemabate.
4. Checking vital signs for hypotension (Choice A) is important but not the immediate nursing action.
5. Checking blood glucose and increasing IV fluids (Choice B) are not directly related to the administration of Hemabate.
6. Checking for a history of hypothyroid and asking for anti-nausea medication (Choice D) is irrelevant to Hemabate administration.
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The nurse is developing a standard care plan for postpartum clients who have had midline episiotomies. Which of the following interventions should be included in the plan?
- A. Assist with stitch removal on third postpartum day.
- B. Administer analgesics every four hours per doctor 's orders.
- C. Teach client to contract her buttocks before sitting.
- D. Irrigate incision twice daily with antibiotic solution
Correct Answer: C
Rationale: Teaching clients to contract their buttocks before sitting helps to relieve pressure on the episiotomy site and promote healing.
A breastfeeding woman, 1 1/2 months postdelivery, calls the nurse in the obstetrician 's office and states, 'I am very embarrassed but I need help. Last night I had an orgasm when my husband and I were making love. You should have seen the milk. We were both soaking wet. What is wrong with me? ' The nurse should base the response to the client on which of the following?
- A. The woman is exhibiting signs of pathological galactorrhea.
- B. The same hormone stimulates orgasms and the milk ejection reflex.
- C. The woman should have a serum galactosemia assessment done.
- D. The baby is stimulating the woman to produce too much milk.
Correct Answer: B
Rationale: The hormone oxytocin is responsible for both milk ejection during breastfeeding and uterine contractions during orgasm, which explains the milk release.
The nurse on a postpartum unit observes a patient who delivered 2 days ago. The nurse notices extreme agitation and depressed mood. The patient states, “I think that my baby is deformed inside and we have to fix him.” Which risk factor is most strongly related to possible postpartum psychosis (PPP)?
- A. Separation from the baby’s father
- B. Personal history of bipolar disorder
- C. Prolonged labor resulting in cesarean
- D. Loss of first child from a heart defect
Correct Answer: B
Rationale: A patient history of either bipolar disorder or affective disorder can result in postpartum psychosis (PPP).
The nurse on a postpartum unit observes a patient who delivered 2 days ago. The nurse notices extreme agitation and depressed mood. The patient states, “I think that my baby is deformed inside and we have to fix him.” Which risk factor is most strongly related to possible postpartum psychosis (PPP)?
- A. Separation from the baby’s father
- B. Personal history of bipolar disorder
- C. Prolonged labor resulting in cesarean
- D. Loss of first child from a heart defect
Correct Answer: B
Rationale: The correct answer is B, personal history of bipolar disorder. Postpartum psychosis is a severe mental health condition that can occur in women with a history of bipolar disorder. Bipolar disorder is a major risk factor for developing postpartum psychosis due to the hormonal changes and stress of childbirth. The extreme agitation, depressed mood, and delusional thoughts exhibited by the patient in the scenario are indicative of postpartum psychosis.
Choice A, separation from the baby’s father, is not a strong risk factor for postpartum psychosis. Choice C, prolonged labor resulting in cesarean, is associated with physical complications but not necessarily with postpartum psychosis. Choice D, loss of the first child from a heart defect, is a traumatic event but is not directly linked to the development of postpartum psychosis.
Which condition is considered a medical emergency that requires immediate treatment?
- A. Inversion of the uterus
- B. Hypotonic uterus
- C. ITP
- D. Uterine atony
Correct Answer: A
Rationale: The correct answer is A: Inversion of the uterus. This condition is a medical emergency as it involves the uterus turning inside out, which can lead to severe hemorrhage and shock. Immediate treatment is crucial to prevent further complications.
B: Hypotonic uterus, while concerning, does not pose an immediate life-threatening risk compared to uterine inversion.
C: ITP (Immune Thrombocytopenic Purpura) is a disorder affecting platelet levels, but it is not a medical emergency that requires immediate treatment like uterine inversion.
D: Uterine atony is a common postpartum complication, but it does not pose the same urgent threat as uterine inversion.