Question 1

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

Accepted Answer

Placenta abruptio is not recognized as an abnormal adherence pattern. Placenta accreta, placenta increta, and placenta percreta are all abnormal adherence patterns where the placenta attaches too deeply into the uterine wall.

Question 2

A perinatal nurse is caring for a woman in the immediate postbirth period.Assessment reveals that the client is experiencing profuse bleeding.What is the most likely cause for this bleeding?

Accepted Answer

Profuse bleeding post-birth is most likely due to uterine atony, which is the inability of the uterus to contract and stop bleeding, commonly caused by a retained placenta or overdistension of the uterus. Uterine inversion, vaginal hematoma, and vaginal laceration can also cause bleeding, but they are not as common as uterine atony in the immediate postbirth period.

Question 3

Which client is at greatest risk for early postpartum hemorrhage (PPH)?

Accepted Answer

The woman with severe preeclampsia is at highest risk for early PPH due to the potential for impaired uterine contractions and increased bleeding tendencies associated with the condition and medication management. The other clients listed have varying levels of risk but not as high as the client with severe preeclampsia.

Question 4

A woman who has recently given birth reports pain and tenderness in her leg.On physical examination,the nurse notices warmth and redness over an enlarged,hardened area.Which condition should the nurse suspect,and how will it be confirmed?

Accepted Answer

Thrombophlebitis would be the most likely condition in this scenario as it presents with pain, tenderness, warmth, and redness in the affected area. A hardened, enlarged area is also common with this condition. Real-time and color Doppler ultrasound is the preferred diagnostic tool to confirm the diagnosis. Option A is incorrect as DIC would present with bleeding and clotting in multiple areas, not just one leg. Option B is incorrect as von Willebrand disease is a bleeding disorder, not a clotting disorder. Option D is incorrect as ITP would not present with symptoms of pain, tenderness, warmth, and redness in the leg.

Question 5

The nurse suspects that her postpartum client is experiencing hemorrhagic shock.Which observation indicates or would confirm this diagnosis?

Accepted Answer

The answer of The nurse suspects that her postpartum client...

Question 6

What is one of the initial signs and symptoms of puerperal infection in the postpartum client?

Accepted Answer

A temperature of 38° C (100.4° F) or higher on 2 successive days is an initial sign and symptom of puerperal infection in the postpartum client.

Question 7

What is the primary nursing responsibility when caring for a client who is experiencing an obstetric hemorrhage associated with uterine atony?

Accepted Answer

Fundal massage is the primary nursing intervention for a client experiencing an obstetric hemorrhage associated with uterine atony. It helps to contract the uterus, which can stop the bleeding. Establishing venous access and catheterizing the bladder may be necessary, but they are not the primary interventions. Preparing for surgical intervention would only be necessary if all other interventions fail.

Question 8

Which is the initial treatment for the client diagnosed with von Willebrand disease (vWD)who experiences a postpartum hemorrhage (PPH)?

Accepted Answer

Desmopressin is often the initial treatment for patients with von Willebrand disease experiencing bleeding episodes, including postpartum hemorrhage, as it can increase the levels of von Willebrand factor and factor VIII in the blood.

Question 9

What is the most common reason for late postpartum hemorrhage (PPH)?

Accepted Answer

Subinvolution of the uterus, or failure of the uterus to return to its pre-pregnancy size, is the most common reason for late PPH, which occurs 24 hours to 6 weeks after delivery.

Question 10

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

Accepted Answer

Operative and precipitate births, abnormal presentation of the fetus, congenital abnormalities of the maternal soft tissue, and previous scarring from infection can all influence the causes and incidence of obstetric lacerations of the lower genital tract. Adherent retained placenta is not directly related to lacerations but rather to retained tissue causing PPH.

Question 11

Which condition is considered a medical emergency that requires immediate treatment?

Accepted Answer

Inversion of the uterus is a rare but life-threatening condition that requires immediate medical intervention to prevent severe hemorrhage and shock.

Question 12

What would a steady trickle of bright red blood from the vagina in the presence of a firm fundus suggest to the nurse?

Accepted Answer

Lacerations of the genital tract can cause a steady trickle of bright red blood even when the uterus (fundus) is firm, indicating that the bleeding is not due to uterine atony but rather to an injury to the genital tract.

Question 13

Nurses need to understand the basic definitions and incidence data regarding post-partum hemorrhage (PPH).Which statement regarding this condition is most accurate?

Accepted Answer

Traditionally, PPH has been classified as early PPH (within 24 hours of birth) or late PPH (between 24 hours and 12 weeks after birth). Option A is incorrect as early recognition requires careful assessment of blood loss and vital signs, as excessive bleeding may not always be obvious. Option B is incorrect as new definitions suggest that even smaller amounts of blood loss can still be significant. Option C is also incorrect as research shows that nurses and physicians tend to underestimate, rather than overestimate, the amount of blood loss.

Question 14

The most effective and least expensive treatment of puerperal infection is prevention.What is the most important strategy for the nurse to adopt?

Accepted Answer

The most important strategy for the nurse to adopt in prevention of puerperal infection is strict aseptic technique by all health care personnel. This includes hand washing, proper use of personal protective equipment, and proper disinfection of equipment and surfaces. Large doses of vitamin C during pregnancy and limited protein and fat intake may have some benefits, but they are not proven to prevent puerperal infection. Prophylactic antibiotics may be used in certain high-risk cases, but they should be used judiciously to prevent antibiotic resistance.

Question 15

If nonsurgical treatment for late postpartum hemorrhage (PPH)is ineffective,which surgical procedure would be appropriate to correct the cause of this condition?

Accepted Answer

Dilation and curettage (D&C) is a surgical procedure often used to diagnose or treat conditions like heavy bleeding or to clear the uterine lining after a miscarriage or abortion. In the context of late postpartum hemorrhage (PPH), if nonsurgical treatments fail, D&C can be used to remove any retained placental fragments or membranes that might be causing the bleeding.

Question 16

Which medications are used to manage postpartum hemorrhage (PPH)? (Select all that apply. )

Accepted Answer

Oxytocin, Methergine, and Hemabate are commonly used medications to manage postpartum hemorrhage. Terbutaline and magnesium sulfate are not typically used for this purpose.

Quiz 33: Postpartum Complications

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

A perinatal nurse is caring for a woman in the immediate postbirth period.Assessment reveals that the client is experiencing profuse bleeding.What is the most likely cause for this bleeding?

Which client is at greatest risk for early postpartum hemorrhage (PPH) ?

A woman who has recently given birth reports pain and tenderness in her leg.On physical examination,the nurse notices warmth and redness over an enlarged,hardened area.Which condition should the nurse suspect,and how will it be confirmed?

The nurse suspects that her postpartum client is experiencing hemorrhagic shock.Which observation indicates or would confirm this diagnosis?

What is one of the initial signs and symptoms of puerperal infection in the postpartum client?

What is the primary nursing responsibility when caring for a client who is experiencing an obstetric hemorrhage associated with uterine atony?

Which is the initial treatment for the client diagnosed with von Willebrand disease (vWD) who experiences a postpartum hemorrhage (PPH) ?

What is the most common reason for late postpartum hemorrhage (PPH) ?

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

Which condition is considered a medical emergency that requires immediate treatment?

What would a steady trickle of bright red blood from the vagina in the presence of a firm fundus suggest to the nurse?

Nurses need to understand the basic definitions and incidence data regarding post-partum hemorrhage (PPH) .Which statement regarding this condition is most accurate?

The most effective and least expensive treatment of puerperal infection is prevention.What is the most important strategy for the nurse to adopt?

If nonsurgical treatment for late postpartum hemorrhage (PPH) is ineffective,which surgical procedure would be appropriate to correct the cause of this condition?

Which medications are used to manage postpartum hemorrhage (PPH) ? (Select all that apply. )