Complications of Postpartum

Complications of Postpartum Related

Review Complications of Postpartum related questions and content

The nurse is aware the greatest source of bleeding during childbirth occurs following detachment of the placenta. Which physiological change takes place immediately after the expulsion of the placenta to decrease the amount of blood loss?

  • A. Contractions of the uterine myometrium
  • B. Factor VIII complex increases during gestation
  • C. Platelet activity increases before labor and delivery
  • D. Fibrin formation increases before the birth occurs
Correct Answer: A

Rationale: The correct answer is A: Contractions of the uterine myometrium. After the placenta is expelled, the uterine myometrium contracts, causing compression of blood vessels at the site of placental detachment, which helps to decrease blood loss. This contraction also helps to close off blood vessels and reduce the risk of postpartum hemorrhage.

Summary of other choices:
B: Factor VIII complex increases during gestation - Factor VIII is involved in blood clotting, but its increase during gestation is not directly related to decreasing blood loss after placental expulsion.
C: Platelet activity increases before labor and delivery - While platelet activity is important for blood clotting, the increase before labor and delivery does not specifically address the immediate decrease in blood loss after placental expulsion.
D: Fibrin formation increases before the birth occurs - Fibrin formation is part of the clotting process, but its increase before birth does not directly address the immediate decrease in blood loss post

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The third stage of labor has just ended for a client who has decided to bottle feed her baby. Which of the following maternal hormones will increase sharply at this time?

  • A. Estrogen.
  • B. Prolactin.
  • C. Human placental lactogen.
  • D. Human chorionic gonadotropin.
Correct Answer: B

Rationale: After delivery, prolactin levels rise to stimulate milk production, even if the mother has decided to bottle feed. Estrogen and other hormones also fluctuate, but prolactin will be the most significant in this case.

A patient, G2 P1102, who delivered her baby 8 hours ago, now has a temperature of 100.2°F. Which of the following is the appropriate nursing intervention at this time?

  • A. Notify the doctor to get an order for acetaminophen.
  • B. Request an infectious disease consult from the doctor.
  • C. Provide the woman with cool compresses.
  • D. Encourage intake of water and other fluids.
Correct Answer: D

Rationale: A slight increase in temperature is common in the first 24 hours after delivery due to hormonal changes and dehydration. Encouraging fluid intake is an appropriate intervention.

Postpartum teaching related to urinary health should emphasize:

  • A. Drinking any type of fluid whenever thirsty.
  • B. Allowing the bladder to fill to promote emptying.
  • C. Cleansing the perineum in a front-to-back direction.
  • D. Eating two servings of acidic fruits or vegetables each day.
Correct Answer: C

Rationale: Proper perineal care such as wiping front to back is essential to prevent urinary tract infections after birth.

The nurse is admitting a 38-year-old patient to triage in early labor with ruptured membranes. Her history includes a previous vaginal delivery 4 years ago and the presence of a uterine fibroid. What interventions are appropriate based on the hemorrhage risk for this patient?

  • A. The patient is a moderate hemorrhage risk, so a type and screen should be ordered.
  • B. The patient is a high hemorrhage risk, so 4 units of packed red blood cells should be ordered.
  • C. The patient is a low hemorrhage risk, so a hold tube should be drawn.
  • D. The patient is a moderate hemorrhage risk, but blood is not drawn at this time.
Correct Answer: A

Rationale: Since the patient has a previous history of delivery and uterine fibroids, she is considered at moderate hemorrhage risk and a type and screen should be ordered.

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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