Nokea
What is a risk factor for PPD?
- A. vaginal birth
- B. family support
- C. traumatic birth
- D. breast-feeding
Correct Answer: C
Rationale: A traumatic birth experience including complications or high-stress events increases the risk of postpartum depression (PPD).
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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.
A woman who has recently given birth complains of pain and tenderness in her leg. On physical examination, the nurse notices warmth and redness over an enlarged, hardened area. Which condition should the nurse suspect, and how will it be confirmed?
- A. Disseminated intravascular coagulation (DIC); asking for laboratory tests
- B. von Willebrand disease (vWD); noting whether bleeding times have been extended
- C. Thrombophlebitis; using real-time and color Doppler ultrasound
- D. Idiopathic or immune thrombocytopenic purpura (ITP); drawing blood for laboratory analysis
Correct Answer: C
Rationale: Pain and tenderness in the extremities, which show warmth, redness, and hardness, is likely thrombophlebitis. A Doppler ultrasound examination is a common noninvasive way to confirm the diagnosis. A diagnosis of DIC is made according to clinical findings and laboratory markers. With DIC, a physical examination will reveal symptoms that may include unusual bleeding, petechiae around a blood pressure cuff on the woman’s arm, and/or excessive bleeding from the site of a slight trauma such as a venipuncture site. Symptoms of vWD, a type of hemophilia, include recurrent bleeding episodes, prolonged bleeding time, and factor VIII deficiency. A risk for PPH exists with vWD but does not exhibit a warm or reddened area in an extremity. ITP is an autoimmune disorder in which the life span of antiplatelet antibodies is decreased. Increased bleeding time is a diagnostic finding, and the risk of postpartum uterine bleeding is increase
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.
What is a risk factor for PPH found in the prenatal record?
- A. primipara
- B. rubella nonimmune
- C. von Willebrand disorder
- D. history of appendectomy
Correct Answer: C
Rationale: The correct answer is C: von Willebrand disorder. This is a risk factor for postpartum hemorrhage (PPH) as it can lead to abnormal bleeding during and after childbirth. von Willebrand disorder is a hereditary bleeding disorder that affects the blood's ability to clot properly. This can increase the likelihood of excessive bleeding during delivery, putting the mother at risk for PPH.
Choice A: primipara is incorrect, as being a first-time mother (primipara) is not a direct risk factor for PPH.
Choice B: rubella nonimmune is incorrect, as rubella immunity status is not directly related to the risk of PPH.
Choice D: history of appendectomy is incorrect, as a previous appendectomy is not a known risk factor for PPH.
In summary, the presence of von Willebrand disorder in the prenatal record is a significant risk factor for PPH due to its impact on blood clotting ability during childbirth.
A postoperative cesarean section woman is to receive morphine 4 mg q 3 -4 h subcutaneously for pain. The morphine is available on the unit in premeasured syringes 10 mg/1 mL. Each time the nurse administers the medication, how many milliliters (mL) of morphine will be wasted? Calculate to the nearest tenth.
- A. 0.4 mL
- B. 0.6 mL
- C. 0.8 mL
- D. 1.0 mL
Correct Answer: B
Rationale: The nurse needs to administer 4 mg, and the syringe has 10 mg per 1 mL. Therefore, 4 mg will require 0.4 mL, and 0.6 mL will be wasted.