Complication Postpartum

Complication Postpartum Related

Review Complication Postpartum related questions and content

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.

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A woman who is 3 hours postpartum has had difficulty in urinating. She finally urinates 100 mL. The initial nursing action is to:

  • A. Insert an indwelling catheter.
  • B. Have her drink additional fluids.
  • C. Assess the height of her fundus.
  • D. Chart the urination amount.
Correct Answer: C

Rationale: Before taking further action, the nurse should assess the height of the fundus to determine if a full bladder may be contributing to urinary retention.

What is characteristic of an early (primary) PPH?

  • A. occurs after 12 weeks postpartum
  • B. is not an emergency
  • C. often occurs due to uterine atony
  • D. is diagnosed after the person is discharged
Correct Answer: C

Rationale: Early PPH is typically caused by uterine atony.

What important assessment should the nurse perform on all postpartum persons?

  • A. Screen for PPD with the EPDS.
  • B. Screen for drug use with a urine drug screen.
  • C. Screen for breast-feeding failure.
  • D. Screen for contraception contraindications.
Correct Answer: A

Rationale: Using the Edinburgh Postnatal Depression Scale (EPDS) helps identify postpartum depression and provides early intervention.

The nurse notices the person with a PPH looks pale and their capillary refill is >3 seconds. What intervention can the nurse initiate?

  • A. Wrap the person in a warm blanket.
  • B. Put a pulse oximeter on the patient’s finger.
  • C. Sit the person up at 90 degrees.
  • D. Start an IV bolus.
Correct Answer: D

Rationale: A pale appearance with delayed capillary refill is indicative of shock and may require rapid intervention.

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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