Deck 33: Postpartum Complications

Question 1

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

A) Inversion of the uterus
B) Hypotonic uterus
C) ITP
D) Uterine atony

Answer 1

Inversion of the uterus

Question 2

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

A) Large doses of vitamin C during pregnancy
B) Prophylactic antibiotics
C) Strict aseptic technique, including hand washing, by all health care personnel
D) Limited protein and fat intake

Answer 2

Strict aseptic technique, including hand washing, by all health care personnel

Question 3

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?

A) Uterine atony
B) Uterine inversion
C) Vaginal hematoma
D) Vaginal laceration

Answer 3

Uterine atony

Question 4

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 induced
C) Multiparous woman (G 3, P 2-0-0-2) with an 8-hour labor
D) Primigravida in spontaneous labor with preterm twins

Question 5

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?

A) Operative and precipitate births
B) Adherent retained placenta
C) Abnormal presentation of the fetus
D) Congenital abnormalities of the maternal soft tissue
E) Previous scarring from infection

Question 6

Nurses need to understand the basic definitions and incidence data regarding PPH.Which statement regarding this condition is most accurate?

A) PPH is easy to recognize early; after all, the woman is bleeding.
B) Traditionally, it takes more than 1000 ml of blood after vaginal birth and 2500 ml after cesarean birth to define the condition as PPH.
C) If anything, nurses and physicians tend to overestimate the amount of blood loss.
D) Traditionally, PPH has been classified as early PPH or late PPH with respect to birth.

Question 7

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

Question 8

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

A) Subinvolution of the uterus
B) Defective vascularity of the decidua
C) Cervical lacerations
D) Coagulation disorders

Question 9

Which medications are used to manage PPH?

A) Oxytocin
B) Methergine
C) Terbutaline
D) Hemabate
E) Magnesium sulfate

Question 10

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

A) Hysterectomy
B) Laparoscopy
C) Laparotomy
D) Dilation and curettage (D&C)

Question 11

A woman who has recently given birth complains of 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?

A) Disseminated intravascular coagulation (DIC); asking for laboratory tests
B) von Willebrand disease (vWD); noting whether bleeding times have been extended
C) Thrombophlebitis; using real-time and color Doppler ultrasound
D) Idiopathic or immune thrombocytopenic purpura (ITP); drawing blood for laboratory analysis

Question 12

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

A) Fatigue continuing for longer than 1 week
B) Pain with voiding
C) Profuse vaginal lochia with ambulation
D) Temperature of 38° C (100.4° F) or higher on 2 successive days

Question 13

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

A) Uterine atony
B) Lacerations of the genital tract
C) Perineal hematoma
D) Infection of the uterus

Question 14

Which is the initial treatment for the client with vWD who experiences a PPH?

A) Cryoprecipitate
B) Factor VIII and von Willebrand factor (vWf)
C) Desmopressin
D) Hemabate

Question 15

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

A) Absence of cyanosis in the buccal mucosa
B) Cool, dry skin
C) Calm mental status
D) Urinary output of at least 30 ml/hr

Question 16

PPH may be sudden and result in rapid blood loss. The nurse must be alert to the symptoms of hemorrhage and hypovolemic shock and be prepared to act quickly to minimize blood loss. Astute assessment of the client's circulatory status can be performed with noninvasive monitoring. Match the type of noninvasive assessment that the nurse would perform with the appropriate clinical manifestation or body system.

Skin color,temperature,and turgor

A)Palpation
B)Auscultation
C)Inspection
D)Observation
E)Measurement

Question 17

PPH may be sudden and result in rapid blood loss. The nurse must be alert to the symptoms of hemorrhage and hypovolemic shock and be prepared to act quickly to minimize blood loss. Astute assessment of the client's circulatory status can be performed with noninvasive monitoring. Match the type of noninvasive assessment that the nurse would perform with the appropriate clinical manifestation or body system.

Pulse oximetry

A)Palpation
B)Auscultation
C)Inspection
D)Observation
E)Measurement

Question 18

PPH may be sudden and result in rapid blood loss. The nurse must be alert to the symptoms of hemorrhage and hypovolemic shock and be prepared to act quickly to minimize blood loss. Astute assessment of the client's circulatory status can be performed with noninvasive monitoring. Match the type of noninvasive assessment that the nurse would perform with the appropriate clinical manifestation or body system.

Arterial pulses

A)Palpation
B)Auscultation
C)Inspection
D)Observation
E)Measurement

Question 19

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

A) Establishing venous access
B) Performing fundal massage
C) Preparing the woman for surgical intervention
D) Catheterizing the bladder

Question 20

PPH may be sudden and result in rapid blood loss. The nurse must be alert to the symptoms of hemorrhage and hypovolemic shock and be prepared to act quickly to minimize blood loss. Astute assessment of the client's circulatory status can be performed with noninvasive monitoring. Match the type of noninvasive assessment that the nurse would perform with the appropriate clinical manifestation or body system.

Heart sounds

A)Palpation
B)Auscultation
C)Inspection
D)Observation
E)Measurement

Question 21

PPH may be sudden and result in rapid blood loss. The nurse must be alert to the symptoms of hemorrhage and hypovolemic shock and be prepared to act quickly to minimize blood loss. Astute assessment of the client's circulatory status can be performed with noninvasive monitoring. Match the type of noninvasive assessment that the nurse would perform with the appropriate clinical manifestation or body system.

Presence or absence of anxiety

A)Palpation
B)Auscultation
C)Inspection
D)Observation
E)Measurement