Complications of Postpartum

Complications of Postpartum Related

Review Complications of Postpartum related questions and content

Nurses need to understand the basic definitions and incidence data regarding PPH. Which statement regarding this condition is most accurate?

  • A. PPH is easy to recognize early; after all, the woman is bleeding.
  • B. Traditionally, it takes more than 1000 ml of blood after vaginal birth and 2500 ml after cesarean birth to define the condition as PPH.
  • C. If anything, nurses and physicians tend to overestimate the amount of blood loss.
  • D. Traditionally, PPH has been classified as early PPH or late PPH with respect to birth.
Correct Answer: B

Rationale: The correct answer is B because it accurately defines the criteria for postpartum hemorrhage (PPH). PPH is traditionally defined as losing more than 1000 ml of blood after vaginal birth and 2500 ml after cesarean birth. This definition helps healthcare providers recognize and manage PPH effectively.

Now, let's analyze why the other choices are incorrect:
A: This statement is incorrect because PPH may not always be easy to recognize early based solely on visible bleeding. Other signs and symptoms, such as tachycardia and hypotension, also play a crucial role in identifying PPH.
C: This statement is incorrect because underestimating, rather than overestimating, the amount of blood loss in PPH can lead to delayed intervention and potentially worsen the patient's condition.
D: This statement is incorrect because PPH is not classified based on timing (early or late PPH), but rather on the amount of blood loss as defined in choice B.

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The nurse is taking the postpartum patient’s vital signs. The newborn is across the room in the bassinet, and the postpartum person refuses to hold the newborn. What should the nurse do?

  • A. Call CPS for risk of child abuse
  • B. Ask the person if they are feeling depressed, hopeless, afraid, or overwhelmed.
  • C. Ask the health-care provider to order an antidepressant.
  • D. Discuss how good parents hold and talk to their newborns.
Correct Answer: B

Rationale: Assessing for signs of depression or anxiety is important if a postpartum person is disengaged from their newborn.

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: The correct answer is C: Development of abnormal vital signs. Stage 3 hemorrhage protocol is initiated when vital signs such as tachycardia, hypotension, and tachypnea are present, indicating severe blood loss. Increased patient restlessness (choice A) and manifestations of severe pain (choice B) are important but do not specifically indicate Stage 3 hemorrhage. Patient requesting water for extreme thirst (choice D) is not a typical sign of hemorrhage. Abnormal vital signs are the key indicator for initiating Stage 3 hemorrhage protocol as they reflect the body's compensatory mechanisms in response to significant blood loss.

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 correct answer is D. A peripad weighing 100 g within 15 minutes indicates excessive postpartum bleeding, requiring immediate intervention to prevent hypovolemic shock. A displaced uterus (choice A) and small clots with massage (choice C) are expected findings after delivery and can be managed with appropriate interventions. A boggy uterine fundus (choice B) may indicate uterine atony but does not necessarily require immediate notification unless accompanied by excessive bleeding.

What is one difference between recovery from a cesarean birth versus a vaginal birth?

  • A. Breast-feeding is discouraged after cesarean birth due to pain medications taken.
  • B. Lochia will be heavier after a cesarean birth.
  • C. Pain with movement is more intense after a cesarean birth.
  • D. Gas pain is more intense after a vaginal birth.
Correct Answer: C

Rationale: Recovery from a cesarean birth typically involves more intense pain due to abdominal incisions and a longer recovery period.

What is the most common reason for cracked, sore nipples?

  • A. hungry infant
  • B. pumping
  • C. ineffective latch
  • D. lack of supportive bra
Correct Answer: C

Rationale: The correct answer is C: ineffective latch. An ineffective latch during breastfeeding can lead to cracked, sore nipples due to improper positioning and poor attachment of the baby to the breast. This can cause friction and irritation on the nipples, leading to pain and discomfort. It is crucial for the baby to have a deep latch to ensure proper milk transfer and to prevent nipple damage.

Summary:
A: A hungry infant may lead to more frequent feedings but not necessarily cause cracked, sore nipples.
B: Pumping alone does not directly cause cracked, sore nipples; it is more related to how the baby latches during breastfeeding.
D: While a lack of supportive bra may contribute to discomfort, it is not the primary reason for cracked, sore nipples.

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