Complication Postpartum

Complication Postpartum Related

Review Complication Postpartum related questions and content

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.

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Hemabate has been ordered for a postpartum patient who has uncontrolled bleeding and uterine atony. Which is the appropriate nursing action?

  • A. Check the patient’s vital signs first for hypotension, and lower the head of the bed.
  • B. Check the patient’s blood glucose and increase the IV fluid rate.
  • C. Check the patient’s record for a history of asthma, and ask the licensed provider for an order of an antidiarrheal medication.
  • D. Check the patient’s record for a history of hypothyroid, and ask the licensed provider to order something for nausea.
Correct Answer: C

Rationale: The correct answer is C. The rationale is as follows:
1. Hemabate is a medication used to treat postpartum hemorrhage due to uterine atony.
2. Checking the patient's record for a history of asthma is crucial as Hemabate can exacerbate asthma symptoms.
3. Asking the provider for an antidiarrheal medication is appropriate to manage potential side effects of Hemabate.
4. Checking vital signs for hypotension (Choice A) is important but not the immediate nursing action.
5. Checking blood glucose and increasing IV fluids (Choice B) are not directly related to the administration of Hemabate.
6. Checking for a history of hypothyroid and asking for anti-nausea medication (Choice D) is irrelevant to Hemabate administration.

The lactation nurse takes a phone call from a mother who is breastfeeding her 2-month-old infant. The mother reports an area of redness and warmth on the breast and a painful burning sensation when breastfeeding. Which statement by the nurse is correct if mastitis is suspected?

  • A. If your nipples are cracked, you will need to stop breastfeeding.
  • B. Pump your milk and throw it away until the infection is gone.
  • C. The baby gave you an infection and needs to be on antibiotics.
  • D. Continuing to breastfeed will help clear up the condition.
Correct Answer: D

Rationale: Mastitis is generally self-limiting, and continued breastfeeding can help clear up the infection and condition. If antibiotic therapy is indicated, the infection generally resolves within 24 to 48 hours of antibiotic therapy.

The postpartum nurse notices that the last dose of IV Cefazolin is not running well. The patient’s IV site appears red, inflamed, and swollen. The patient states that the IV is tender and sore. What are the nurse’s next actions?

  • A. Flush the IV with normal saline to improve the flow rate.
  • B. Put the IV antibiotic on a pump for more accurate infusion of the correct dose.
  • C. Remove the IV, restart it in a new location, and complete the antibiotic administration.
  • D. Allow the IV to continue to drip slowly since it is her last dose.
Correct Answer: C

Rationale: The IV site indicates phlebitis, and the appropriate action is to remove and restart the IV to avoid further complications.

What is characteristic of a late (secondary) PPH?

  • A. occurs within the first 24 hours
  • B. is caused by subinvolution of the uterus
  • C. does not occur after cesarean births
  • D. cannot be treated with Methergine
Correct Answer: B

Rationale: Late (secondary) postpartum hemorrhage is typically caused by subinvolution of the uterus and may occur after the first 24 hours.

The nurse assesses for signs of depression or postpartum blues. How can the nurse explain the difference?

  • A. PPD is less severe and resolves in a few weeks.
  • B. Postpartum blues can last up to a year.
  • C. PPD is a normal expectation of postpartum.
  • D. Postpartum blues symptoms include irritability and sadness.
Correct Answer: D

Rationale: Postpartum blues are more temporary and less severe whereas postpartum depression (PPD) involves more severe symptoms and requires treatment.

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