Nokea
If nonsurgical treatment for late PPH is ineffective, which surgical procedure would be appropriate to correct the cause of this condition?
- A. Hysterectomy
- B. Laparoscopy
- C. Laparotomy
- D. Dilation and curettage (D&
Correct Answer: A
Rationale: The correct answer is A: Hysterectomy. Hysterectomy is the appropriate surgical procedure for late postpartum hemorrhage (PPH) when nonsurgical treatments fail. It involves the removal of the uterus, which can effectively stop the bleeding. Other choices like Laparoscopy (B) and Laparotomy (C) are surgical techniques used to access the abdomen but do not address the underlying cause of PPH. Dilation and curettage (D&C) (D) is a procedure to remove tissue from the uterus and would not be effective in treating late PPH.
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The nurse is caring for a breastfeeding mother who asks advice on foods that will provide both vitamin A and iron. Which of the following should the nurse recommend?
- A. 1/2 cup raw celery dipped in 1 ounce cream cheese.
- B. 8 ounce yogurt mixed with 1 medium banana.
- C. 12 ounce strawberry milk shake.
- D. 1 1/2 cup raw broccoli.
Correct Answer: D
Rationale: Raw broccoli is a good source of vitamin A and iron, making it an ideal choice for the patient.
Lacerations of the cervix, vagina, or perineum are also causes of PPH. Which factors influence the causes and incidence of obstetric lacerations of the lower genital tract? (Select all that apply.)
- A. Operative and precipitate births
- B. Adherent retained placenta
- C. Abnormal presentation of the fetus
- D. Congenital abnormalities of the maternal soft tissue
Correct Answer: A
Rationale: The correct answer is A because operative and precipitate births increase the risk of obstetric lacerations due to the rapid delivery or use of instruments. Operative births involve interventions like forceps or vacuum extraction, which can cause trauma. Precipitate births, characterized by rapid labor and delivery, may lead to tearing of the lower genital tract. Choices B, C, and D are incorrect as they do not directly influence the causes and incidence of obstetric lacerations. Adherent retained placenta, abnormal fetal presentation, and congenital abnormalities of maternal soft tissue are not primary factors contributing to lacerations during childbirth.
What nursing diagnosis would be appropriate for the person with a coagulation disorder?
- A. risk for hypertension
- B. risk for bleeding
- C. risk for fluid overload
- D. risk for breast-feeding failure
Correct Answer: B
Rationale: Coagulation disorders like von Willebrand increase the risk for bleeding and hemorrhage.
What assessment data increases the risk of postpartum infection?
- A. precipitous labor
- B. urinary retention
- C. breast-feeding
- D. intact perineum
Correct Answer: A
Rationale: Precipitous labor increases the risk of postpartum infection.
The nurse is caring for a client who had a cesarean section under spinal anesthesia less than 2 hours ago. Which of the following nursing actions is appropriate at this time?
- A. Elevate the head of the bed 60 degrees.
- B. Report absence of bowel sounds to the physician.
- C. Have her turn and deep breathe every 2 hours.
- D. Assess for patellar hyperreflexia bilaterally.
Correct Answer: C
Rationale: Post-spinal anesthesia, it is important to encourage the patient to change positions to prevent complications such as atelectasis and improve circulation.