Complication Postpartum

Complication Postpartum Related

Review Complication Postpartum related questions and content

The nurse on a postpartum unit observes a patient who delivered 2 days ago. The nurse notices extreme agitation and depressed mood. The patient states, “I think that my baby is deformed inside and we have to fix him.” Which risk factor is most strongly related to possible postpartum psychosis (PPP)?

  • A. Separation from the baby’s father
  • B. Personal history of bipolar disorder
  • C. Prolonged labor resulting in cesarean
  • D. Loss of first child from a heart defect
Correct Answer: B

Rationale: The correct answer is B, personal history of bipolar disorder. Postpartum psychosis is a severe mental health condition that can occur in women with a history of bipolar disorder. Bipolar disorder is a major risk factor for developing postpartum psychosis due to the hormonal changes and stress of childbirth. The extreme agitation, depressed mood, and delusional thoughts exhibited by the patient in the scenario are indicative of postpartum psychosis.

Choice A, separation from the baby’s father, is not a strong risk factor for postpartum psychosis. Choice C, prolonged labor resulting in cesarean, is associated with physical complications but not necessarily with postpartum psychosis. Choice D, loss of the first child from a heart defect, is a traumatic event but is not directly linked to the development of postpartum psychosis.

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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 is the most common reason for late postpartum hemorrhage (PPH)?

  • A. Subinvolution of the uterus
  • B. Defective vascularity of the decidua
  • C. Cervical lacerations
  • D. Coagulation disorders
Correct Answer: A

Rationale: The correct answer is A: Subinvolution of the uterus. This is the most common cause of late postpartum hemorrhage (PPH) due to incomplete contraction and retraction of the uterus leading to persistent bleeding. Subinvolution can result from retained placental fragments, uterine infections, or inadequate involution. Choice B, defective vascularity of the decidua, is less common and not typically associated with late PPH. Cervical lacerations (Choice C) usually cause immediate bleeding after delivery, not late PPH. Coagulation disorders (Choice D) can cause both early and late PPH but are less common than subinvolution.

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.

To prevent infection, the nurse teaches the postpartum client to perform which of the following tasks?

  • A. Apply antibiotic ointment to the perineum daily.
  • B. Change the peripad at each voiding.
  • C. Void at least every two hours.
  • D. Spray the perineum with povidone-iodine after toileting.
Correct Answer: B

Rationale: Changing peripads frequently helps prevent the growth of bacteria and reduces the risk of infection.

When referring to the 4 T’s of PPH, what does tissue refer to?

  • A. Placental tissue or membranes are retained.
  • B. Tissue of the perineum is torn.
  • C. Tissue of the uterus is torn.
  • D. Tissue is not perfused.
Correct Answer: A

Rationale: The correct answer is A because in the context of Postpartum Hemorrhage (PPH), the 4 T’s stand for Tone, Trauma, Tissue, and Thrombin. Tissue refers to placental tissue or membranes being retained, leading to excessive bleeding. This can be a common cause of PPH.

Option B is incorrect because it refers to perineal tears, which are related to trauma and not specifically related to tissue retention causing PPH. Option C is incorrect as it refers to uterine tissue tears, which is more related to trauma rather than retained tissue. Option D is incorrect because it refers to tissue not being perfused, which is not directly related to the concept of tissue retention causing PPH.

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