Complication Postpartum

Complication Postpartum Related

Review Complication Postpartum related questions and content

The nurse and provider estimate the blood loss at delivery to be 400 mL in the measuring drape; now when doing the initial perineal care, the nurse finds a large amount of blood underneath the patient. What action reflects safe and accurate nursing care?

  • A. Estimate the amount of blood loss from the sheet and client clothing, and notify the physician.
  • B. Encourage the mother to report any additional bleeding or clots.
  • C. Draw the ordered hematocrit and notify the provider if the result is less than 28.
  • D. Weigh the blood-soaked linens and notify the provider of the additional blood loss.
Correct Answer: D

Rationale: The correct answer is D. Weighing the blood-soaked linens provides an accurate measurement of the additional blood loss, which is crucial for assessing the patient's condition accurately. Here's the rationale step-by-step:

1. Weighing the blood-soaked linens is an objective and precise method to quantify the additional blood loss.
2. This measurement helps to determine the total blood loss accurately, which is essential for assessing postpartum hemorrhage.
3. Providing this quantitative data to the provider enables them to make informed decisions about further interventions.
4. Estimating blood loss visually is subjective and can be inaccurate, leading to potential underestimation or overestimation.
5. Drawing hematocrit levels (choice C) may provide valuable information but does not directly address the immediate need to quantify the additional blood loss.
6. Encouraging the mother to report bleeding (choice B) is important for ongoing assessment but does not provide an objective measurement of the blood loss.

In summary

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The nurse is aware of concern about the increasing numbers of severe maternal morbidity (SMM). It is believed to be related to changes in the overall health of the population of women giving birth. Which reasons does the nurse identify as causes of SMM? Select all that apply.

  • A. Increases in maternal age
  • B. Prepregnancy obesity
  • C. Cesarean deliveries
  • D. Inability to pay for health care
Correct Answer: B

Rationale: Documented increases in maternal age is a likely cause for SMM; older women have increased risk. Obesity is a general health risk in the United States; prepregnancy obesity causes increased incidences of SMM. Cesarean deliveries are increasing, and surgical procedures always carry a risk for complications. Preexisting chronic medical conditions are a contributor to the increasing rates of SMM.

A post -cesarean section, breastfeeding client, whose subjective pain level is 2/5, requests her as needed (prn) narcotic analgesics every 3 hours. She states, 'I have decided to make sure that I feel as little pain from this experience as possible. ' Which of the following should the nurse conclude in relation to this woman 's behavior?

  • A. The woman needs a stronger narcotic order.
  • B. The woman is high risk for severe constipation.
  • C. The woman 's breast milk volume may drop while taking the medicine.
  • D. The woman 's newborn may become addicted to the medication.
Correct Answer: C

Rationale: Frequent use of narcotic analgesics can affect breast milk production, potentially causing a decrease in supply.

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 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.

The nurse notices the uterus is boggy and the bladder is full. What intervention should the nurse perform next?

  • A. Call for help.
  • B. Start IV bolus.
  • C. Get the person out of bed to walk to restroom.
  • D. Massage the fundus and assess the lochia.
Correct Answer: D

Rationale: A boggy uterus and full bladder may indicate uterine atonyand fundal massage is the first intervention to promote uterine contraction.

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