Nokea
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: The correct answer is C because early (primary) postpartum hemorrhage (PPH) often occurs due to uterine atony, which is the inability of the uterus to contract effectively after childbirth. This leads to excessive bleeding within 24 hours of delivery. Choice A is incorrect because early PPH occurs within 24 hours postpartum, not after 12 weeks. Choice B is incorrect because early PPH is indeed an emergency due to the risk of rapid blood loss. Choice D is incorrect as early PPH is typically diagnosed before or shortly after discharge, not after.
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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.
The nurse is preparing to place a peripad on the perineum of a client who delivered her baby 10 minutes earlier. The client states 'I don 't use those. I always use tampons. ' Which of the following actions by the nurse is appropriate at this time?
- A. Remove the peripad and insert a tampon into the woman 's vagina.
- B. Advise the client that for the first two days she will be bleeding too heavily for a tampon.
- C. State that it is unsafe to place anything into the vagina until involution is complete.
- D. Remind the client that a tampon would hurt until the soreness from the delivery resolves.
Correct Answer: B
Rationale: The nurse should explain that for the first two days after delivery, the bleeding is too heavy to use tampons, and this could increase the risk of infection.
Immediately after delivery, a woman is shaking uncontrollably. Which of the following nursing actions is most appropriate?
- A. Provide the woman with warm blankets.
- B. Put the woman in the Trendelenburg position.
- C. Notify the primary health care provider.
- D. Increase the intravenous infusion.
Correct Answer: A
Rationale: Shaking or chills immediately after delivery is common due to the drop in body temperature. Providing warm blankets helps alleviate this discomfort.
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 person with a cesarean birth has additional nursing concerns beyond those of a person with a vaginal birth. What concern should the nurse anticipate for the cesarean birth?
- A. increased risk for DVT
- B. faster recovery
- C. less use of pain medication
- D. less risk for infection
Correct Answer: A
Rationale: Cesarean births involve surgical incisions which increase the risk of deep vein thrombosis (DVT) due to reduced mobility and other factors.