Complication Postpartum

Complication Postpartum Related

Review Complication Postpartum related questions and content

The nurse is assisting the primary care provider with the third stage of a vaginal delivery. The patient is multiparous, experienced a precipitous birth, and has a history of hypertension. Which medical prescription does the nurse anticipate for this patient?

  • A. Methylergonovine
  • B. Fresh frozen plasma
  • C. Carboprost-tromethamine
  • D. Magnesium sulfate
Correct Answer: C

Rationale: The correct answer is C: Carboprost-tromethamine. In the given scenario, the patient is multiparous, had a precipitous birth, and has a history of hypertension. Carboprost-tromethamine is typically administered in the third stage of labor to manage postpartum hemorrhage, which is a potential complication in this case due to the patient's history of hypertension. Methylergonovine (choice A) is contraindicated in patients with hypertension due to its vasoconstrictive effects. Fresh frozen plasma (choice B) is not typically indicated for postpartum hemorrhage. Magnesium sulfate (choice D) is commonly used for pre-eclampsia/eclampsia but not specifically for postpartum hemorrhage in this scenario.

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The nurse is caring for a woman who is 6 hours postpartum after a vaginal delivery. She has a history of labial varicose veins and is reporting perineal pain of 8 on a 10-point scale. What interventions should the nurse include in the plan of care?

  • A. Provide the patient with an inflatable donut ring to sit on and administer her oral pain medication.
  • B. Explain that this is normal after a vaginal delivery and assist her to a side-lying position.
  • C. Assess the perineum for a hematoma or inflamed varicosities, and administer oral pain medication.
  • D. Administer oral stool softeners and encourage fluids.
Correct Answer: C

Rationale: The correct answer is C because it addresses the patient's specific issue of perineal pain related to her history of labial varicose veins. By assessing the perineum for a hematoma or inflamed varicosities, the nurse can identify the cause of the pain and provide appropriate treatment. Administering oral pain medication targets the source of discomfort.

Choice A is incorrect because providing an inflatable donut ring may offer temporary relief but does not address the underlying cause of the pain. Administering oral pain medication alone may not be sufficient without assessing the perineum.

Choice B is incorrect because dismissing the patient's pain as normal without further assessment can lead to overlooking potential complications. Assisting the patient to a side-lying position does not address the pain.

Choice D is incorrect because administering stool softeners and encouraging fluids may be beneficial for postpartum care but does not directly address the patient's perineal pain related to varicose veins.

The nurse educates the person recovering from a cesarean birth on how to care for the incision. What education is discussed?

  • A. Scrub the incision well twice daily.
  • B. Remove the dressing the day after birth.
  • C. Staples will be removed the day after birth.
  • D. Vertical incisions heal faster with less pain.
Correct Answer: B

Rationale: The dressing should be removed after the first 24 hours and incision care should focus on preventing infection and ensuring proper healing.

What nursing diagnosis would be appropriate for the person with a coagulation disorder?

  • A. risk for bleeding
  • B. risk for fluid overload
  • C. risk for breast-feeding failure
  • D. risk for hypertension
Correct Answer: B

Rationale: Risk for bleeding is the main diagnosis in patients with coagulation disorders.

What assessment finding suggests a possible infection?

  • A. painful fundal massage
  • B. breast-feeding every 2–3 hours
  • C. pulse 72
  • D. WBCs 10,000
Correct Answer: D

Rationale: The correct answer is D: WBCs 10,000. An elevated white blood cell count (WBC) is a common sign of infection as the body produces more WBCs to fight off pathogens. This increase in WBC count is known as leukocytosis and is a key indicator of an ongoing infection. In contrast, choices A, B, and C are not direct indicators of infection. A painful fundal massage may suggest uterine atony, breast-feeding every 2-3 hours is a normal part of postpartum care, and a pulse rate of 72 is within the normal range. Therefore, the most reliable assessment finding suggesting a possible infection is an elevated WBC count.

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.

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