Complications of Postpartum

Complications of Postpartum Related

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The most effective and least expensive treatment of puerperal infection is prevention. What is the most important strategy for the nurse to adopt?

  • A. Large doses of vitamin C during pregnancy
  • B. Prophylactic antibiotics
  • C. Strict aseptic technique, including hand washing, by all health care personnel
  • D. Limited protein and fat intake
Correct Answer: C

Rationale: The most important strategy for the nurse to adopt in preventing puerperal infection is option C, which is the strict aseptic technique, including hand washing, by all health care personnel. Puerperal infection, also known as postpartum infection, is a serious complication following childbirth that can lead to severe consequences if not prevented. Maintaining proper hygiene practices, such as hand washing and using aseptic techniques, is crucial in preventing the spread of pathogens that can cause infections. This simple yet effective measure can significantly reduce the risk of puerperal infections among postpartum women. Large doses of vitamin C during pregnancy (option A) may have benefits for overall health but are not specifically proven to prevent puerperal infections. Prophylactic antibiotics (option B) may be used in certain cases but are not the primary strategy for prevention in all cases. Limiting protein and fat intake (option D) is not a recommended approach

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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: The correct answer is B. The nurse should ask the postpartum person if they are feeling depressed, hopeless, afraid, or overwhelmed. This is important because it can help assess the person's mental and emotional state, which could be contributing to their refusal to hold the newborn. It also shows empathy and support for the person's feelings.

Choice A is incorrect because calling Child Protective Services (CPS) would be premature and could escalate the situation unnecessarily. Choice C is incorrect as starting an antidepressant should only be considered after a thorough evaluation by a healthcare provider. Choice D is incorrect because it does not address the underlying issue of the person's emotional state and may come off as judgmental.

Which is the initial treatment for the client with vWD who experiences a PPH?

  • A. Cryoprecipitate
  • B. Factor VIII and von Willebrand factor (vWf)
  • C. Desmopressin
  • D. Hemabate
Correct Answer: C

Rationale: Desmopressin (DDAVP) is the initial treatment for a client with von Willebrand disease (vWD) who experiences a postpartum hemorrhage (PPH). Desmopressin works by releasing von Willebrand factor (vWF) stored in the endothelial cells, increasing the levels of vWF and factor VIII. This can help improve clotting function in patients with vWD, thereby helping to stop the bleeding. It is a safe and effective treatment for many individuals with vWD and is often used as the first-line therapy in cases of bleeding episodes or surgeries. Cryoprecipitate may also be used in severe bleeding situations if desmopressin is ineffective. Hemabate is not indicated for the treatment of vWD and PPH.

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: The foul-smelling lochia, fever, and uterine tenderness point toward a uterine infection, requiring further investigation.

The nurse is providing care for a patient who is 1 day postpartum and exhibiting symptoms of postpartum psychosis. Which medical management does the nurse expect for this patient?

  • A. Prescriptions for antidepressant/antipsychotic drugs
  • B. Discharge to home with 24-hour observation in place
  • C. Immediate hospitalization in a psychiatric unit
  • D. Prescribed neonate visits during in-patient treatment
Correct Answer: C

Rationale: The nurse expects the health care provider to immediately hospitalize the patient in a psychiatric unit. Maintaining the patient in the postpartum unit delays necessary psychiatric treatment.

What is a risk factor for uterine atony?

  • A. small for gestational age
  • B. primipara
  • C. multiple gestation
  • D. intrauterine growth restriction
Correct Answer: C

Rationale: Risk factors for uterine atony include multiple gestation and large infants.

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