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Which statement indicates to the nurse that the patient understands the signs of late postpartum hemorrhage?
- A. My discharge would change to red after it has been pink or white.'
- B. If I have a postpartum hemorrhage, I will have severe abdominal pain.'
- C. I should be alert for an increase in bright red blood.'
- D. I would pass a large clot that was retained from the placenta.'
Correct Answer: A
Rationale: A return to red bleeding after lochia has changed to pink or white may indicate a late postpartum hemorrhage.
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What action should the nurse implement?
- A. Notify the charge nurse of a possible infection.
- B. Prepare to put the patient in isolation.
- C. Have the infant removed from the room and returned to the nursery.
- D. Assess the patient further.
Correct Answer: D
Rationale: A white blood cell count of 20,000 to 30,000 cells/dL is normal in the early postpartum period, so the patient should be assessed further for other signs of infection.
When weaning a newborn from breastfeeding, what should the mother do?
- A. Eliminate one feeding at a time.
- B. Eliminate the favorite feeding last.
- C. Expect the need for comfort feeding.
- D. Substitute formula for younger infants.
- E. Pump breasts in place of eliminated feeding.
Correct Answer: B,C,D
Rationale: When weaning a newborn from breastfeeding, the mother should eliminate the favorite feeding last, one feeding at a time, and expect the need for comfort feeding. In younger infants, formula will need to be substituted. Pumping in place of eliminated feeding would continue milk production.
What does the nurse recognize these signs indicate?
- A. Uterine atony
- B. Uterine dystocia
- C. Uterine hypoplasia
- D. Uterine dysfunction
Correct Answer: A
Rationale: Atony describes a lack of normal muscle tone. If the uterus is atonic, then muscle fibers are flaccid and will not compress bleeding vessels.
What action should the nurse implement based on these symptoms?
- A. Notify the charge nurse of a possible upper respiratory infection.
- B. Notify the physician of a possible pulmonary embolism.
- C. Document expected postpartum mucous membrane congestion.
- D. Medicate with antipyretic remedy for elevated temperature.
Correct Answer: B
Rationale: Symptoms of early pulmonary embolism may include cough, shortness of breath, and temperature elevation, requiring immediate notification of the physician.
What complication should the nurse be alert for in the immediate postpartum period?
- A. Cervical laceration
- B. Hematoma
- C. Endometritis
- D. Retained placental fragments
Correct Answer: B
Rationale: Delivering a large infant and a prolonged labor are risk factors for hematoma formation.