Complication Postpartum

Complication Postpartum Related

Review Complication Postpartum related questions and content

The nurse is performing an assessment of the uterus 30 minutes after a normal delivery and finds the fundus to be soft and boggy. IV Pitocin is infusing at 150 mL/hr. What is the priority nursing intervention?

  • A. Increase the Pitocin, assess the fundus in 15 minutes, and update the licensed provider.
  • B. Perform external massage of the uterus until it is firm, assess for additional bleeding on the pad, and update the licensed provider.
  • C. Notify the provider of the increase in blood loss.
  • D. Assist the patient to the bathroom and reassess the fundus after the patient voids.
Correct Answer: B

Rationale: The correct answer is B because a soft and boggy fundus after delivery indicates uterine atony, which can lead to postpartum hemorrhage. Performing external massage of the uterus will help stimulate contractions and firm up the fundus. Assessing for additional bleeding is crucial to monitor for hemorrhage. Updating the licensed provider is important for further management.

Choice A is incorrect because simply increasing Pitocin without addressing the uterine atony may not resolve the issue. Choice C is incorrect as notifying the provider of increased blood loss is not the immediate priority; addressing the uterine atony is. Choice D is incorrect as assisting the patient to the bathroom does not address the soft and boggy fundus issue.

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The nurse is developing a plan of care for the postpartum client during the 'taking in ' phase. Which of the following should the nurse include in the plan?

  • A. Teach baby-care skills like diapering.
  • B. Discuss the labor and birth with the mother.
  • C. Discuss contraceptive choices with the mother.
  • D. Teach breastfeeding skills like pumping.
Correct Answer: B

Rationale: During the 'taking in' phase, the mother is focused on her own recovery and reliving the birth experience. Discussing the labor and birth is appropriate at this time.

The nurse works in a labor and delivery facility with new protocols for estimating postpartum blood loss. Which method for estimating blood loss is implemented in the delivery room?

  • A. Ask the patient how many peripads she considered to be “soaked.”
  • B. Collect blood in calibrated, under-buttocks drapes for vaginal birth.
  • C. Place a basin at the foot of the delivery table to catch any blood.
  • D. Rely on the primary health care provider’s estimate of blood loss.
Correct Answer: B

Rationale: Collecting blood in calibrated, under-buttocks drapes for vaginal birth and then weighing the drapes is the easiest way to estimate blood loss in the delivery room.

What symptom differentiates baby blues from PPD?

  • A. Baby blues last longer than 14 days.
  • B. Baby blues cause hallucinations.
  • C. Baby blues occur in the first few days of the postpartum period.
  • D. Baby blues are treated with inpatient therapy.
Correct Answer: A

Rationale: Baby blues typically last for a few days, while PPD lasts longer and includes more severe symptoms.

A G2 P2002, who is postpartum 6 hours from a spontaneous vaginal delivery, is assessed. The nurse notes that the fundus is firm at the umbilicus, there is heavy lochia rubra, and perineal sutures are intact. Which of the following actions should the nurse take at this time?

  • A. Do nothing. This is a normal finding.
  • B. Massage the woman 's fundus.
  • C. Take the woman to the bathroom to void.
  • D. Notify the woman 's primary health care provider.
Correct Answer: A

Rationale: A firm fundus at the umbilicus and heavy lochia rubra is normal during the first few hours after delivery.

The nurse screens for risk factors such as an infant in the neonatal intensive care unit (NICU), difficulty in role transition, birth complications, unmet social and physical needs, and lack of partner support for what complication?

  • A. maladaptive parenting
  • B. psychosis
  • C. postpartum depression
  • D. bipolar disorder
Correct Answer: C

Rationale: Risk factors such as those listed increase the likelihood of postpartum depression which affects a person's emotional and mental well-being.

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