Complications of Postpartum

Complications of Postpartum Related

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

  • A. Reassure the postpartum person that infection will resolve without antibiotics.
  • B. Assess for REEDA.
  • C. Call health-care provider when temperature is 99.0° F.
  • D. Scrub the incision vigorously with soap and water.
Correct Answer: B

Rationale: The correct answer is B: Assess for REEDA. REEDA stands for Redness, Edema, Ecchymosis, Drainage, and Approximation, which are key indicators of wound infection. By assessing for REEDA, the nurse can monitor and evaluate the progress of the infection. This intervention allows for early detection and prompt treatment of wound infections.

Choice A is incorrect because reassuring the postpartum person without antibiotics may lead to worsening infection. Choice C is incorrect as a temperature of 99.0° F is not necessarily indicative of a wound infection. Choice D is incorrect as scrubbing the incision vigorously with soap and water can introduce more bacteria and worsen the infection.

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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: Von Willebrand disorder is a bleeding disorder that increases the risk of postpartum hemorrhage due to impaired clotting.

What assessment finding would indicate a fluid volume deficit?

  • A. skin tenting with testing of skin turgor
  • B. hypertension
  • C. bradycardia
  • D. bounding pulse
Correct Answer: A

Rationale: The correct answer is A because skin tenting with testing of skin turgor is a classic sign of fluid volume deficit. When there is a lack of fluid in the body, the skin loses its elasticity, causing it to tent or stay elevated when pinched. This indicates dehydration.

Choice B, hypertension, is incorrect because fluid volume deficit typically leads to hypotension, not hypertension. Choice C, bradycardia, is also incorrect as fluid volume deficit usually causes tachycardia to compensate for decreased blood volume. Choice D, bounding pulse, is incorrect as it is associated with fluid overload, not deficit.

A 1-day postpartum woman states, 'I think I have a urinary tract infection. I have to go to the bathroom all the time. ' Which of the following actions should the nurse take?

  • A. Assure the woman that frequent urination is normal after delivery.
  • B. Obtain an order for a urine culture.
  • C. Assess the urine for cloudiness.
  • D. Ask the woman if she is prone to urinary tract infections.
Correct Answer: C

Rationale: Frequent urination is common postpartum, but assessing the urine for cloudiness is important in determining whether a urinary tract infection is present.

The nurse continues to monitor a patient after a vaginal delivery with an estimated blood loss of 1,000 mL. Which assessment finding does the nurse recognize as requiring Stage 3 hemorrhage protocol?

  • A. Increased patient restlessness.
  • B. Manifestations of severe pain.
  • C. Development of abnormal vital signs.
  • D. Patient requests water for extreme thirst.
Correct Answer: C

Rationale: Vital signs will remain normal during Stages 1 and 2. The evidence of abnormal vital signs is one indicator of Stage 3 hemorrhage.

Which is the initial treatment for the client with vWD who experiences a PPH?

  • A. Cryoprecipitate
  • B. Factor VIII and von Willebrand factor (vWf)
  • C. Desmopressin
  • D. Hemabate
Correct Answer: C

Rationale: Desmopressin (DDAVP) is the initial treatment for a client with von Willebrand disease (vWD) who experiences a postpartum hemorrhage (PPH). Desmopressin works by releasing von Willebrand factor (vWF) stored in the endothelial cells, increasing the levels of vWF and factor VIII. This can help improve clotting function in patients with vWD, thereby helping to stop the bleeding. It is a safe and effective treatment for many individuals with vWD and is often used as the first-line therapy in cases of bleeding episodes or surgeries. Cryoprecipitate may also be used in severe bleeding situations if desmopressin is ineffective. Hemabate is not indicated for the treatment of vWD and PPH.

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