Complications of Postpartum

Complications of Postpartum Related

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Which classification of placental separation is not recognized as an abnormal adherence pattern?

  • A. Placenta accreta
  • B. Placenta increta
  • C. Placenta percreta
  • D. Placenta abruptio
Correct Answer: D

Rationale: Placenta abruptio, also known as abruptio placentae, is the premature separation of the placenta from the uterine wall before delivery. It is not classified as an abnormal adherence pattern like placenta accreta, increta, and percreta. Placenta accreta occurs when the placenta attaches too deeply into the uterine wall. Placenta increta is when the placenta invades the myometrium, and placenta percreta is when it penetrates through the myometrium and reaches the serosa. These abnormal adherence patterns are associated with risks and complications during pregnancy and delivery, while placenta abruptio is a separate condition related to premature placental separation.

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The nurse monitors his or her postpartum clients carefully because which of the following physiological changes occurs during the early postpartum period?

  • A. Decreased urinary output.
  • B. Increased blood pressure.
  • C. Decreased blood volume.
  • D. Increased estrogen level.
Correct Answer: C

Rationale: During the early postpartum period, the body loses blood volume, and the circulatory system adjusts to the new state, which can result in changes in vital signs.

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: Ambulation helps prevent DVT and promotes circulation post-cesarean.

The nurse in the obstetric clinic received a telephone call from a bottle-feeding mother of a 3-day-old. The client states that her breasts are firm, red, and warm to the touch. Which of the following is the best action for the nurse to advise the client to perform?

  • A. Intermittently apply ice packs to her axillae and breasts.
  • B. Apply lanolin to her breasts and nipples every 3 hours.
  • C. Express milk from the breasts every 3 hours.
  • D. Ask the primary health care provider to order a milk suppressant.
Correct Answer: A

Rationale: Ice packs can help reduce inflammation and pain associated with engorgement in women who choose to bottle-feed.

The nurse is examining a 2-day-postpartum client whose fundus is 2 cm below the umbilicus and whose bright red lochia saturates about 4 inches of a pad in 1 hour. What should the nurse document in the nursing record?

  • A. Abnormal involution, lochia rubra heavy.
  • B. Abnormal involution, lochia serosa scant.
  • C. Normal involution, lochia rubra moderate.
  • D. Normal involution, lochia serosa heavy.
Correct Answer: C

Rationale: Lochia rubra is expected for the first few days postpartum, and the amount described here is moderate, which is normal.

What is characteristic of a late (secondary) PPH?

  • A. occurs within the first 24 hours
  • B. is caused by subinvolution of the uterus
  • C. does not occur after cesarean births
  • D. cannot be treated with Methergine
Correct Answer: B

Rationale: The correct answer is B because late (secondary) postpartum hemorrhage (PPH) is typically caused by subinvolution of the uterus, leading to persistent bleeding after the first 24 hours postpartum. This is due to inadequate contraction of the uterus to stop bleeding from the placental site.

Choice A is incorrect because a late PPH occurs after the first 24 hours, not within it. Choice C is incorrect because late PPH can occur after cesarean births as well. Choice D is incorrect because Methergine is commonly used to treat late PPH by promoting uterine contractions and controlling bleeding.

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