Complications of Postpartum

Complications of Postpartum Related

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What is the primary nursing responsibility when caring for a client who is experiencing an obstetric hemorrhage associated with uterine atony?

  • A. Establishing venous access
  • B. Performing fundal massage
  • C. Preparing the woman for surgical intervention
  • D. Catheterizing the bladder
Correct Answer: B

Rationale: The correct answer is B: Performing fundal massage. Fundal massage helps to stimulate contractions of the uterus, which can help control bleeding in cases of uterine atony. This is a primary nursing responsibility to address the immediate cause of the hemorrhage. Establishing venous access (choice A) is important but not the primary responsibility in this situation. Preparing for surgical intervention (choice C) may be necessary if conservative measures fail, but it is not the initial step. Catheterizing the bladder (choice D) is not directly related to managing obstetric hemorrhage associated with uterine atony.

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The nurse notices the uterus is boggy and the bladder is full. What intervention should the nurse perform next?

  • A. Call for help.
  • B. Start IV bolus.
  • C. Get the person out of bed to walk to restroom.
  • D. Massage the fundus and assess the lochia.
Correct Answer: D

Rationale: Massaging the fundus and assessing the lochia is critical to manage uterine atony.

What nursing intervention does the nurse include in the plan of care for a person with postpartum endometritis?

  • A. Monitor for signs of sepsis.
  • B. Discourage breast-feeding.
  • C. Avoid fundal assessment.
  • D. Increase family visiting hours.
Correct Answer: A

Rationale: The correct answer is A: Monitor for signs of sepsis. Postpartum endometritis is a bacterial infection of the uterine lining that can lead to sepsis if not treated promptly. Monitoring for signs of sepsis is crucial for early detection and intervention to prevent serious complications. Option B is incorrect because breastfeeding is encouraged to promote bonding and provide nutrition. Option C is incorrect as fundal assessment is necessary to monitor uterine involution. Option D is incorrect as increasing family visiting hours is not directly related to managing postpartum endometritis.

The nurse is aware the greatest source of bleeding during childbirth occurs following detachment of the placenta. Which physiological change takes place immediately after the expulsion of the placenta to decrease the amount of blood loss?

  • A. Contractions of the uterine myometrium
  • B. Factor VIII complex increases during gestation
  • C. Platelet activity increases before labor and delivery
  • D. Fibrin formation increases before the birth occurs
Correct Answer: A

Rationale: After placenta detachment, contractions of the myometrium compress the blood vessels at the placental site, thus decreasing the amount of blood loss.

What assessment finding suggests a possible infection?

  • A. painful fundal massage
  • B. breast-feeding every 2 -3 hours
  • C. pulse 72
  • D. WBCs 10
Correct Answer: A

Rationale: Painful fundal massage can be a sign of uterine infection (endometritis) especially if accompanied by other symptoms like fever.

A 3-day-postpartum breastfeeding woman is being assessed. Her breasts are firm and warm to the touch. When asked when she last fed the baby her reply is, 'I fed the baby last evening. I let the nurses feed him in the nursery last night. I needed to rest. ' Which of the following actions should the nurse take at this time?

  • A. Encourage the woman exclusively to breastfeed her baby.
  • B. Have the woman massage her breasts hourly.
  • C. Obtain an order to culture her expressed breast milk.
  • D. Take the temperature and pulse rate of the woman.
Correct Answer: A

Rationale: Breastfeeding exclusively can help relieve engorgement, and frequent feedings prevent further complications.

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