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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: Retained placental tissue or membranes can cause postpartum hemorrhage (PPH) by preventing the uterus from contracting properly.
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A woman who is 18 hours postpartum says she is having 'hot flashes ' and 'sweats all the time. ' The appropriate nursing response is to:
- A. Report her signs and symptoms of hypovolemic shock.
- B. Tell her that her body is getting rid of unneeded fluid.
- C. Notify her nurse-midwife that she may have an infection.
- D. Limit her intake of caffeine-containing fluids.
Correct Answer: B
Rationale: Hot flashes and sweating are common during the postpartum period as the body gets rid of excess fluids. It is not an indicator of hypovolemic shock or infection.
The nurse is assessing a patient who is 12 hours postpartum. The uterus is firm to palpation, at midline, and is 1 cm below the umbilicus with continuous heavy vaginal bleeding. What is the nurse’s first action?
- A. Massage the uterus and resume the IV Pitocin drip.
- B. Change the peri-pad and reassess the bleeding.
- C. Call the provider to check for a cervical laceration.
- D. Administer the ordered iron supplement and ibuprofen.
Correct Answer: A
Rationale: The nurse must address the uterine tone and bleeding immediately by massaging the uterus and resuming Pitocin to prevent hemorrhage.
Why does the nurse encourage ambulation in a patient who has experienced a cesarean birth?
- A. Ambulation helps to prevent DVT.
- B. Ambulation causes the person to lose weight in the hospital.
- C. Ambulation helps with breast-feeding.
- D. Ambulation decreases peristalsis.
Correct Answer: B
Rationale: The correct answer is B because ambulation after a cesarean birth helps the patient to lose weight. Walking promotes circulation, aids in healing, and can prevent complications such as blood clots and pneumonia. It also helps to restore strength and energy levels. Choices A, C, and D are incorrect because ambulation primarily benefits the patient's overall well-being and recovery, rather than directly preventing DVT, aiding breastfeeding, or decreasing peristalsis.
The nurse is preparing discharge teaching for a postpartum patient who exhibits signs and symptoms of an episiotomy infection and is on oral antibiotic therapy. Which discharge teaching will the nurse provide regarding pain management?
- A. Application of hot packs to the perineal area
- B. Information applicable to medication therapy
- C. Instructions to improve circulation by ambulating
- D. Medicating for pain above level 4 on a 0 to 10 scale
Correct Answer: B
Rationale: The nurse will need to provide applicable discharge teaching for both antibiotic and analgesic therapy. Antibiotics need to be taken as ordered and until they are gone.
The nurse develops a plan to increase a patient 's milk supply. What is an intervention they can implement?
- A. Pump between nursing sessions.
- B. Nurse every 6 hours.
- C. Keep newborn in bassinet between sessions.
- D. Offer a pacifier when newborn cries.
Correct Answer: A
Rationale: Pumping between breastfeeding sessions can help stimulate milk production by increasing demand.