Complications of Postpartum

Complications of Postpartum Related

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Which client is at greatest risk for early PPH?

  • A. Primiparous woman (G 2, P 1-0-0-1) being prepared for an emergency cesarean birth for fetal distress
  • B. Woman with severe preeclampsia on magnesium sulfate whose labor is being
  • C. Multiparous woman (G 3, P 2-0-0-2) with an 8-hour labor
  • D. Primigravida in spontaneous labor with preterm twins
Correct Answer: B

Rationale: The correct answer is B because a woman with severe preeclampsia on magnesium sulfate is at the greatest risk for early postpartum hemorrhage (PPH) due to the increased risk of placental abruption, coagulopathy, and uterine atony associated with preeclampsia and magnesium sulfate use. Preeclampsia can lead to poor placental perfusion, increasing the risk of hemorrhage during and after delivery. Magnesium sulfate can also affect blood clotting mechanisms, further increasing the risk of excessive bleeding. The other choices are less likely to be at greatest risk for early PPH. Choice A involves a primiparous woman with cesarean delivery, which may have controlled bleeding. Choice C is a multiparous woman with a relatively short labor duration, which is not a significant risk factor for early PPH. Choice D is a primigravida with preterm twins, which does not inherently increase the risk of early PPH

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What nursing diagnosis would be appropriate for the person with a coagulation disorder?

  • A. risk for hypertension
  • B. risk for bleeding
  • C. risk for fluid overload
  • D. risk for breast-feeding failure
Correct Answer: B

Rationale: Coagulation disorders like von Willebrand increase the risk for bleeding and hemorrhage.

What is one difference between recovery from a cesarean birth versus a vaginal birth?

  • A. Breast-feeding is discouraged after cesarean birth due to pain medications taken.
  • B. Lochia will be heavier after a cesarean birth.
  • C. Pain with movement is more intense after a cesarean birth.
  • D. Gas pain is more intense after a vaginal birth.
Correct Answer: C

Rationale: Recovery from a cesarean birth typically involves more intense pain due to abdominal incisions and a longer recovery period.

A primipara, 2 hours postpartum, requests that the nurse diaper her baby after a feeding because 'I am so tired right now. I just want to have something to eat and take a nap. ' Based on this information, the nurse concludes that the woman is exhibiting signs of which of the following?

  • A. Social deprivation.
  • B. Child neglect.
  • C. Normal postpartum behavior.
  • D. Postpartum depression.
Correct Answer: C

Rationale: Requesting rest after feeding is typical postpartum behavior and does not indicate neglect or depression.

Lacerations of the cervix, vagina, or perineum are also causes of PPH. Which factors influence the causes and incidence of obstetric lacerations of the lower genital tract? (Select all that apply.)

  • A. Operative and precipitate births
  • B. Adherent retained placenta
  • C. Abnormal presentation of the fetus
  • D. Congenital abnormalities of the maternal soft tissue
Correct Answer: A

Rationale: The correct answer is A because operative and precipitate births increase the risk of obstetric lacerations due to the rapid delivery or use of instruments. Operative births involve interventions like forceps or vacuum extraction, which can cause trauma. Precipitate births, characterized by rapid labor and delivery, may lead to tearing of the lower genital tract. Choices B, C, and D are incorrect as they do not directly influence the causes and incidence of obstetric lacerations. Adherent retained placenta, abnormal fetal presentation, and congenital abnormalities of maternal soft tissue are not primary factors contributing to lacerations during childbirth.

What is a risk factor for uterine atony?

  • A. small for gestational age
  • B. primipara
  • C. multiple gestation
  • D. intrauterine growth restriction
Correct Answer: C

Rationale: Risk factors for uterine atony include multiple gestation and large infants.

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