Deck 10: Nursing Care of Women with Complications After Birth

Question 1

What should the nurse's first action be when postpartum hemorrhage from uterine atony is suspected?

A) Teach the patient how to massage the abdomen and then get help.
B) Start IV fluids to prevent hypovolemia and then notify the registered nurse.
C) Begin massaging the fundus while another person notifies the physician.
D) Ask the patient to void and reassess fundal tone and location.

Answer 1

Begin massaging the fundus while another person notifies the physician.

Question 2

At her 6-week postpartum checkup,a woman mentions to the nurse that she cannot sleep and is not eating.She feels guilty because sometimes she believes her infant is dead.What does the nurse recognize as the cause of this woman's symptoms?

A) Bipolar disorder
B) Major depression
C) Postpartum blues
D) Postpartum depression

Answer 2

Major depression

Question 3

What statement by the patient leads the nurse to determine a woman with mastitis understands treatment instructions?

A) "I will apply cold compresses to the painful areas."
B) "I will take a warm shower before nursing the baby."
C) "I will nurse first on the affected side."
D) "I will empty the affected breast every 8 hours."

Answer 3

"I will take a warm shower before nursing the baby."

Question 4

What is the best response to a postpartum woman who tells the nurse she feels "tired and sick all of the time since I had the baby 3 months ago"?

A) "This is a normal response for the body after pregnancy. Try to get more rest."
B) "I'll bet you will snap out of this funk real soon."
C) "Why don't you arrange for a babysitter so you and your husband can have a night out?"
D) "Let's talk about this further. I am concerned about how you are feeling."

Question 5

Five days after a spontaneous vaginal delivery,a woman comes to the emergency room because she has a fever and persistent cramping.What does the nurse recognize as the possible cause of these signs and symptoms?

A) Dehydration
B) Hypovolemic shock
C) Endometritis
D) Cystitis

Question 6

After a prolonged labor,a woman vaginally delivered a 10 pound,3 ounce infant boy.What complication should the nurse be alert for in the immediate postpartum period?

A) Cervical laceration
B) Hematoma
C) Endometritis
D) Retained placental fragments

Question 7

What is the first sign of hypovolemic shock from postpartum hemorrhage?

A) Cold, clammy skin
B) Tachycardia
C) Hypotension
D) Decreased urinary output

Question 8

During a postpartum assessment,a woman reports her right calf is painful.The nurse observes edema and redness along the saphenous vein in the right lower leg.Based on this finding,what does the nurse explain the probable treatment will involve?

A) Anticoagulants for 6 weeks
B) Application of ice to the affected leg
C) Gentle massage of the affected leg
D) Passive leg exercises twice a day

Question 9

The nurse assesses a boggy uterus with the fundus above the umbilicus and deviated to the side.What should the nurse's next assessment be?

A) Fullness of the bladder
B) Amount of lochia
C) Blood pressure
D) Level of pain

Question 10

A 4-week postpartum patient with mastitis asks the nurse if she can continue to breastfeed.What is the nurse's most helpful response?

A) "Stop breastfeeding until the infection clears."
B) "Pump the breasts to continue milk production, but do not give breast milk to the infant."
C) "Begin all feedings with the affected breast until the mastitis is resolved."
D) "Breastfeeding can continue unless there is abscess formation."

Question 11

While caring for a postpartum patient who had a vaginal delivery yesterday,the nurse assesses a firm uterine fundus and a trickle of bright blood.How does the nurse most likely feel and react to this finding?

A) Concerned and reports a probable cervical laceration
B) Attentive and massages the uterus to expel retained clots
C) Distressed and reports a possible clotting disorder
D) Satisfied with the normal early postpartum finding

Question 12

A woman had a vaginal delivery two days ago and is preparing for discharge.What will the nurse plan to teach the woman to report to help prevent postpartum complications?

A) Fever
B) Change in lochia from red to white
C) Contractions
D) Fatigue and irritability

Question 13

Which statement indicates to the nurse on a postpartum home visit 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."

Question 14

A woman has had persistent lochia rubra for 2 weeks after her delivery and is experiencing pelvic discomfort.What does the nurse explain is the usual treatment for subinvolution?

A) Uterine massage
B) Oxytocin infusion
C) Dilation and curettage
D) Hysterectomy

Question 15

One day after discharge,the postpartum patient calls the clinic complaining of a reddened area on her lower leg,temperature elevation of 37° C (99.8° F),rust-colored lochia,and sore breasts.What does the nurse suspect from these symptoms?

A) Phlebitis
B) Puerperal infection
C) Late postpartum hemorrhage
D) Mastitis

Question 16

Three weeks after delivering her first child,a woman tells the nurse,"I waited so long for this baby and now that she is here,I can't believe how different my life is from what I expected." What is the best nursing response to the woman's statement?

A) "How is your partner adjusting to the change?"
B) "I hear this from a lot of first-time mothers."
C) "Have you told anyone else about your feelings?"
D) "Tell me how things are different."

Question 17

The 1-day postpartum patient shows a temperature elevation,cough,and slight shortness of breath on exertion.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.

Question 18

Although the nurse has massaged the uterus every 15 minutes,it remains flaccid,and the patient continues to pass large clots.What does the nurse recognize these signs indicate?

A) Uterine atony
B) Uterine dystocia
C) Uterine hypoplasia
D) Uterine dysfunction

Question 19

The nurse is caring for a woman who had a cesarean birth yesterday.Varicose veins are visible on both legs.What nursing action is the most appropriate to prevent thrombus formation?

A) Have the woman sit in a chair for meals.
B) Monitor vital signs every 4 hours and report any changes.
C) Tell the woman to remain in bed with her legs elevated.
D) Assist the woman with ambulation for short periods of time.

Question 20

Massage and putting the infant to the breast of a postpartum patient have been ineffective in controlling a boggy uterus.What will the nurse anticipate might be ordered by the physician?

A) Ritodrine
B) Magnesium sulfate
C) Oxytocin
D) Bromocriptine

Question 21

The nurse weighs a saturated perineal pad and finds it to weigh 15 grams.The nurse is aware that this indicates a blood loss of _____ mL.

Question 22

A postpartum patient is experiencing hypovolemic shock.What interventions can the nurse anticipate?

A) Provision of IV fluids
B) Placement of an indwelling Foley catheter
C) Assessment of oxygen saturation
D) Administration of anticoagulants
E) Blood transfusion

Question 23

The nurse instructs the postpartum patient that her nutritional intake should include which food(s)particularly supportive to healing?

A) Legumes
B) Potatoes and pasta
C) Citrus fruits
D) Rice
E) Cantaloupe

Question 24

The nurse explains that a slower than expected return of the uterus to the nonpregnant state is called _______________.

Question 25

A postpartum patient experiences anaphylactic shock.What is the most likely cause?

A) Pulmonary embolism
B) Hypertension
C) Allergy
D) Blood clotting disorder

Question 26

A(n) is a collection of blood within the tissues.

Question 27

A nurse is discussing risk factors for postpartum shock with a childbirth preparation class.What will the nurse include in this education session?

A) Hypertension
B) Blood clotting disorders
C) Anemia
D) Infection
E) Postpartum hemorrhage

Question 28

A woman is prescribed Coumadin (warfarin)to treat deep vein thrombosis.What will the nurse instruct this woman is the antidote for warfarin overdose?

A) Vitamin A
B) Vitamin B
C) Vitamin E
D) Vitamin K

Question 29

The nurse assesses a positive Homans sign when the patient's leg is flexed and foot sharply dorsiflexed.Where does the patient report that the pain is felt?

A) Groin
B) Achilles tendon
C) Top of the foot
D) Calf of the leg

Question 30

A woman is diagnosed with a urinary tract infection in the postpartum period.What foods can the nurse encourage to increase the acidity of urine?

A) Apricots
B) Cranberry juice
C) Plums
D) Prunes
E) Apples

Question 31

The nurse assesses the perineal pad placed on a 3-hour postdelivery patient and finds that there is no lochia on it.What would the nurse expect to find on further assessment?

A) A firm fundus the size of a grapefruit
B) A full bladder
C) Retained placental fragments
D) Vital signs indicative of shock
E) A soft, boggy fundus

Question 32

The new mother who had a vaginal delivery yesterday has a white blood cell count of 30,000 cells/dL.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.

Question 33

What will the nurse teach a nursing mother to do to reduce the risk of mastitis?

A) Limit fluid intake to 1 liter per day.
B) Empty both breasts with each feeding.
C) Take warm showers.
D) Wear a supportive bra.
E) Pump breasts to ensure emptying.