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What is one of the initial signs and symptoms of puerperal infection in the postpartum client?
- A. Fatigue continuing for longer than 1 week
- B. Pain with voiding
- C. Profuse vaginal lochia with ambulation
- D. Temperature of 38° C (100.4° F) or higher on 2 successive days
Correct Answer: D
Rationale: One of the initial signs and symptoms of puerperal infection in the postpartum client is an elevated temperature. A temperature of 38° C (100.4° F) or higher on 2 successive days is indicative of an infection. This can be a key indicator for healthcare providers to suspect puerperal infection, also known as postpartum infection or postpartum sepsis. It is important to monitor postpartum clients closely for any signs of infection, especially in the immediate postpartum period. Prompt recognition and management of puerperal infection is crucial to prevent serious complications for the mother.
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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.
Which condition is considered a medical emergency that requires immediate treatment?
- A. Inversion of the uterus
- B. Hypotonic uterus
- C. ITP
- D. Uterine atony
Correct Answer: A
Rationale: The correct answer is A: Inversion of the uterus. This condition is a medical emergency as it involves the uterus turning inside out, which can lead to severe hemorrhage and shock. Immediate treatment is crucial to prevent further complications.
B: Hypotonic uterus, while concerning, does not pose an immediate life-threatening risk compared to uterine inversion.
C: ITP (Immune Thrombocytopenic Purpura) is a disorder affecting platelet levels, but it is not a medical emergency that requires immediate treatment like uterine inversion.
D: Uterine atony is a common postpartum complication, but it does not pose the same urgent threat as uterine inversion.
The nurse is providing care for a patient who is 8 hours postpartum after a vaginal delivery. The patient reports severe perineal pain unaffected by pain medication. The nurse notices a 4 cm area of discoloration on the labia that is tender to the touch. Which action does the nurse take?
- A. Continue to apply ice to the area for 24 hours.
- B. Monitor vital signs and report any abnormal readings.
- C. Contact the primary care provider for further evaluation.
- D. Relieve pressure by placing patient in a side-lying position.
Correct Answer: C
Rationale: The primary care provider needs to be contacted about the assessment findings; the hematoma may need to be evaluated further and/or evacuation of the hematoma performed.
Choose the signs and symptoms that suggest postpartum hemorrhage causing a hematoma.
- A. Rectal pain accompanied by a rising pulse
- B. Cramping accompanied by a steady trickle of blood
- C. Soft uterine fundus and falling blood pressure
- D. Heavy lochia accompanied by tachypnea and dyspnea
Correct Answer: A
Rationale: Hematomas may cause pain and lead to hemodynamic changes such as a rising pulse. Rectal pain is a common sign of a perineal hematoma.
What information about pain medication should postpartum discharge instructions include?
- A. Narcotic medications can cause constipation.
- B. Stop taking iron after birth.
- C. Do not take NSAIDs while breast-feeding.
- D. Acetaminophen should be avoided.
Correct Answer: A
Rationale: Narcotic pain medications can lead to constipation so it is essential to manage this issue with appropriate interventions.