Chapter 22

Which factor puts a multiparous client on her first postpartum day at risk for developing hemorrhage? uterine atony moderate amount of lochia rubra thrombophlebitis hemoglobin level of 12 g/dl (120 g/L)

uterine atony

A client who gave birth several hours ago is experiencing postpartum hemorrhage. She had a cesarean birth and received deep, general anesthesia. She has a history of postpartum hemorrhage with her previous births. The blood is a dark red. Which cause of the hemorrhage is most likely in this client? retained placental fragment uterine atony cervical laceration disseminated intravascular coagulation

uterine atony

A nurse is reviewing a journal article on the causes of postpartum hemorrhage. Which condition would the nurse most likely find as the most common cause? uterine atony labor augmentation uterine inversion cervical or vaginal lacerations

uterine atony

A nurse is assessing a postpartum client who is at home. Which statement by the client would lead the nurse to suspect that the client may be developing postpartum depression? "I just feel so overwhelmed and tired." "It's strange, one minute I'm happy, the next I'm sad." "I keep hearing voices telling me to take my baby to the river." "I'm feeling so guilty and worthless lately."

"I'm feeling so guilty and worthless lately."

A nurse is assessing the perineum of a postpartum woman using the REEDA scale. The woman is one day postpartum. The nurse notes that the woman has serous discharge. Which score would the nurse assign this finding? 1 0 3 2

1

A client has had a cesarean birth. Which amount of blood loss would the nurse document as a postpartum hemorrhage in this client? 250 mL 1000 mL 500 mL 750 mL

1000 ml

The nurse is caring for a client who has given birth to twins. During which time period would the nurse instruct on the possibility of a late postpartum hemorrhage? 24 hours to 12 weeks after birth 24 to 48 hours after birth 6 weeks to 6 months after birth 6 weeks to 3 months after birth

24 hours to 12 weeks after birth

The nurse is assisting with a birth, and the client has just delivered the placenta. Suddenly, bright red blood gushes from the vagina. The nurse recognizes that which occurrence is the most likely cause of this postpartum hemorrhage? A cervical laceration Retained placental fragments Disseminated intravascular coagulation Uterine atony

A cervical laceration

The nurse is caring for four postpartum client, monitoring them for postpartum infection. Which client is the priority due to current vital signs suggesting a postpartum infection? Client 20 hours postpartum with a temperature of 102.4°F (39.1°C) Client 30 hours postpartum with a temperature of 100.4°F (38°C) Client 25 hours postpartum with a temperature of 99.2°F (37.3°C) Client 35 hours postpartum with a temperature of 99.6°F (37.5°C) SUBMIT ANSWER

Client 30 hours postpartum with a temperature of 100.4°F (38°C)

A group of nurses are reviewing information about mastitis and its causes in an effort to develop a teaching program on prevention for postpartum women. The nurses demonstrate understanding of the information when they focus the teaching on ways to minimize risk of exposure to which organism? Proteus S. aureus E. coli Klebsiella

S. aureus

Which intervention(s) will the nurse recommend for a breastfeeding mother diagnosed with mastitis? Select all that apply. Take antibiotics as prescribed Encourage client to breastfeed the infant every 3 to 4 hours Apply warm compresses to the affected breast PRN Rub expressed breast milk on the nipples after each feeding session Do not breastfeed from the affected breast Take acetaminophen as needed for pain

Take antibiotics as prescribed Apply warm compresses to the affected breast PRN Rub expressed breast milk on the nipples after each feeding session Take acetaminophen as needed for pain

Disseminated intravascular coagulation is a life-threatening condition that the nurse recognizes can occur as a complication secondary to which primary conditions? Select all that apply. abruptio placenta severe preeclampsia ectopic pregnancy septicemia isoimmunization

abruptio placenta severe preeclampsia septicemia

The nurse is conducting a class for postpartum women about mood disorders. The nurse describes a transient, self-limiting mood disorder that affects mothers after birth. The nurse determines that the women understood the description when they identify the condition as postpartum: depression. psychosis. blues. bipolar disorder.

blues.

A nurse is assigned to care for a client experiencing early postpartum hemorrhage. The nurse is required to administer the prescribed methylergonovine maleate intramuscularly to the client. Which condition would the nurse identify as necessitating the cautious administration of this drug? mild fever low blood pressure respiratory problems cardiovascular disease

cardiovascular disease

A nurse is making a home visit to a postpartum client. Which finding would lead the nurse to suspect that a woman is experiencing postpartum psychosis? feelings of guilt delirium sadness insomnia

delirium

A multipara client develops thrombophlebitis after birth. Which assessment findings would lead the nurse to intervene immediately? weakness, anorexia, change in level of consciousness, and coma pallor, tachycardia, seizures, and jaundice dyspnea, diaphoresis, hypotension, and chest pain dyspnea, bradycardia, hypertension, and confusion

dyspnea, diaphoresis, hypotension, and chest pain

A postpartum woman has a history of von Willebrand disease (vWD). The client is being prepared for discharge, and a referral for health care follow up is made to assess for potential postpartum hemorrhage. The nurse understands that this client is at greatest risk for hemorrhage during which time during the postpartum period? first 6 weeks first 3 days first month first week

first week

A client experienced prolonged labor with prolonged premature rupture of membranes. The nurse would be alert for which condition in the mother and the newborn? hypovolemia hemorrhage trauma infection

infection

A nurse is developing a program to help reduce the risk of late postpartum hemorrhage in clients in the labor and birth unit. Which measure would the nurse emphasize as part of this program? manually removing the placenta at birth inspecting the placenta after delivery for intactness applying pressure to the umbilical cord to remove the placenta administering broad-spectrum antibiotics

inspecting the placenta after delivery for intactness

A client in her seventh week of the postpartum period is experiencing bouts of sadness and insomnia. The nurse suspects that the client may have developed postpartum depression. What signs or symptoms are indicative of postpartum depression? Select all that apply. loss of confidence inability to concentrate manifestations of mania bizarre behavior decreased interest in life

loss of confidence inability to concentrate decreased interest in life

A postpartum client is prescribed medication therapy as part of the treatment plan for postpartum hemorrhage. Which medication would the nurse expect to administer in this situation?

methylergonovine

A nurse is caring for a client who gave birth vaginally 2 hours ago. What postpartum complication can the nurse assess within the first few hours following birth? postpartal blues postpartal hemorrhage postpartum depression postpartal infection

postpartal hemorrhage

A nurse is assessing a postpartum client. Which finding would the cause the nurse the greatest concern? perineal pain with swelling along the episiotomy calf pain with dorsiflexion of the foot leg pain on ambulation with mild ankle edema sharp, stabbing chest pain with shortness of breath

sharp, stabbing chest pain with shortness of breath

When assessing the postpartum woman, the nurse uses indicators other than pulse rate and blood pressure for postpartum hemorrhage because: they relate more to change in condition than to the amount of blood lost. maternal anxiety adversely affects these vital signs. the body's compensatory mechanisms activate and prevent any changes. these measurements may not change until after the blood loss is large.

these measurements may not change until after the blood loss is large.

Which postpartum clients would require the nurse to intervene? Select all that apply. First day postpartum client with blood pressure 84/48, pulse 128, respiratory rate 16. Postpartum client requesting newborn stay in nursery so that she can nap. Primipara with vital signs including temperature 100.2°F (37.9°C), blood pressure 140/86, pulse 124, respiratory rate 12. Postpartum client with urine output of 30 ml/hour for 2 hours. Primipara with vital signs including temperature 100.2°F (37.9°C), respiratory rate 28, oxygen saturation 94%. Multipara with vital signs including temperature 99°F (37.2°C), blood pressure 136/84, pulse 96, respiratory rate 32.

Primipara with vital signs including temperature 100.2°F (37.9°C), blood pressure 140/86, pulse 124, respiratory rate 12. Multipara with vital signs including temperature 99°F (37.2°C), blood pressure 136/84, pulse 96, respiratory rate 32. Postpartum client with urine output of 30 ml/hour for 2 hours. First day postpartum client with blood pressure 84/48, pulse 128, respiratory rate 16. Primipara with vital signs including temperature 100.2°F (37.9°C), respiratory rate 28, oxygen saturation 94%.

Which complication is most likely responsible for a late postpartum hemorrhage? perineal laceration clotting deficiency uterine subinvolution cervical laceration

uterine subinvolution

As part of an in-service program to a group of home health care nurses who care for postpartum women, a nurse is describing postpartum depression. The nurse determines that the teaching was successful when the group identifies that this condition becomes evident at which time after birth of the newborn? within the first 2 weeks in the first week within the first 6 weeks in approximately 1 month

within the first 6 weeks

A nurse finds that a client is bleeding excessively after a vaginal birth. Which assessment finding would indicate retained placental fragments as a cause of bleeding? Large uterus with painless dark red blood mixed with clots firm uterus with trickle of bright red blood in perineum firm uterus with a steady stream of bright red blood soft and boggy uterus that deviates from the midline

Large uterus with painless dark red blood mixed with clots