What would a steady trickle of bright red blood from the vagina in the presence of a firm fundus suggest to the nurse?
- A. Uterine atony
- B. Lacerations of the genital tract
- C. Perineal hematoma
- D. Infection of the uterus
Correct Answer: A
Rationale: The steady trickle of bright red blood from the vagina in the presence of a firm fundus suggests uterine atony. Uterine atony is a condition where the uterus fails to contract effectively after childbirth, resulting in postpartum hemorrhage. The firm fundus indicates that the uterus is not properly contracting to control bleeding, leading to the continuous flow of blood from the vagina. Prompt intervention is crucial to manage uterine atony and prevent further complications such as excessive blood loss.
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What is a risk factor for PPD?
- A. vaginal birth
- B. family support
- C. traumatic birth
- D. breast-feeding
Correct Answer: C
Rationale: The correct answer is C: traumatic birth. Traumatic birth can lead to postpartum depression (PPD) due to the physical and emotional stress experienced during labor and delivery. This can trigger feelings of anxiety, helplessness, and trauma that contribute to the development of PPD. Vaginal birth (choice A) and breast-feeding (choice D) are not inherently risk factors for PPD. Family support (choice B) is typically considered a protective factor against PPD, providing emotional and practical assistance for new mothers.
The nurse on a postpartum unit observes a patient who delivered 2 days ago. The nurse notices extreme agitation and depressed mood. The patient states, “I think that my baby is deformed inside and we have to fix him.” Which risk factor is most strongly related to possible postpartum psychosis (PPP)?
- A. Separation from the baby’s father
- B. Personal history of bipolar disorder
- C. Prolonged labor resulting in cesarean
- D. Loss of first child from a heart defect
Correct Answer: B
Rationale: The correct answer is B, personal history of bipolar disorder. Postpartum psychosis is a severe mental health condition that can occur in women with a history of bipolar disorder. Bipolar disorder is a major risk factor for developing postpartum psychosis due to the hormonal changes and stress of childbirth. The extreme agitation, depressed mood, and delusional thoughts exhibited by the patient in the scenario are indicative of postpartum psychosis.
Choice A, separation from the baby’s father, is not a strong risk factor for postpartum psychosis. Choice C, prolonged labor resulting in cesarean, is associated with physical complications but not necessarily with postpartum psychosis. Choice D, loss of the first child from a heart defect, is a traumatic event but is not directly linked to the development of postpartum psychosis.
The nurse on a postpartum unit observes a patient who delivered 2 days ago. The nurse notices extreme agitation and depressed mood. The patient states, “I think that my baby is deformed inside and we have to fix him.” Which risk factor is most strongly related to possible postpartum psychosis (PPP)?
- A. Separation from the baby’s father
- B. Personal history of bipolar disorder
- C. Prolonged labor resulting in cesarean
- D. Loss of first child from a heart defect
Correct Answer: B
Rationale: A patient history of either bipolar disorder or affective disorder can result in postpartum psychosis (PPP).
The nurse educates the non -breast-feeding person on breast discomfort caused by engorgement. What instructions would they give?
- A. Massage breasts to release milk.
- B. Apply cold packs and cabbage leaves.
- C. Stand in the warm shower to stimulate letdown.
- D. Do not wear a bra.
Correct Answer: B
Rationale: Cold packs and cabbage leaves help reduce swelling and discomfort caused by engorgement in non-breastfeeding individuals.
A woman who has recently given birth complains of pain and tenderness in her leg. On physical examination, the nurse notices warmth and redness over an enlarged, hardened area. Which condition should the nurse suspect, and how will it be confirmed?
- A. Disseminated intravascular coagulation (DIC); asking for laboratory tests
- B. von Willebrand disease (vWD); noting whether bleeding times have been extended
- C. Thrombophlebitis; using real-time and color Doppler ultrasound
- D. Idiopathic or immune thrombocytopenic purpura (ITP); drawing blood for laboratory analysis
Correct Answer: C
Rationale: Pain and tenderness in the extremities, which show warmth, redness, and hardness, is likely thrombophlebitis. A Doppler ultrasound examination is a common noninvasive way to confirm the diagnosis. A diagnosis of DIC is made according to clinical findings and laboratory markers. With DIC, a physical examination will reveal symptoms that may include unusual bleeding, petechiae around a blood pressure cuff on the woman’s arm, and/or excessive bleeding from the site of a slight trauma such as a venipuncture site. Symptoms of vWD, a type of hemophilia, include recurrent bleeding episodes, prolonged bleeding time, and factor VIII deficiency. A risk for PPH exists with vWD but does not exhibit a warm or reddened area in an extremity. ITP is an autoimmune disorder in which the life span of antiplatelet antibodies is decreased. Increased bleeding time is a diagnostic finding, and the risk of postpartum uterine bleeding is increase