Postpartum Complications

24. A nurse is performing a postpartum assessment on a client on postpartum day one. The nurse notes the following four signs/symptoms. The nurse should report which of the signs/symptoms to the client's healthcare practitioner? 1. Foul-smelling lochia. 2. Engorged breasts. 3. Cracked nipples. 4. Cluster of hemorrhoids.

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47. The nurse administers RhoGAM to a postpartum client. Which of the following is the goal of the medication? 1. Inhibit the mother's active immune response. 2. Aggressively destroy the Rh antibodies produced by the mother. 3. Prevent fetal cells from migrating throughout the mother's circulation. 4. Change the maternal blood type to Rh-positive.

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51. A client, who had no prenatal care, delivers a 10-lb 10-oz baby boy whose serum glucose result 1 hour after delivery was 20 mg/dL. Based on these data, which of the following tests should the mother have at her 6-week postpartum checkup? 1. Glucose tolerance test. 2. Indirect Coombs test. 3. Blood urea nitrogen (BUN). 4. Complete blood count (CBC).

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77. A woman has just had a macrosomic baby after a 12-hour labor. For which of the following complications should the woman be carefully monitored? 1. Uterine atony. 2. Hypoprolactinemia. 3. Infection. 4. Mastitis.

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19. The nurse is discharging fi ve Rh-negative clients from the maternity unit. The nurse knows that the teaching was successful when the clients who had which of the following deliveries state that they understand why they must receive a RhoGAM injection? Select all that apply. 1. Abortion at 10 weeks' gestation. 2. Amniocentesis at 16 weeks' gestation. 3. Fetal demise at 24 weeks' gestation. 4. Birth of Rh-negative twins at 35 weeks' gestation. 5. Delivery of a 40-week-gestation, Rh-positive baby.

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34. A nurse is caring for a client, PP2, who is preparing to go home with her infant. The nurse notes that the client's blood type is O- (negative), the baby's type is A+ (positive), and the direct Coombs test is negative. Which of the following actions by the nurse is appropriate? 1. Advise the client to keep her physician appointment at the end of the week to receive her RhoGAM injection. 2. Make sure that the client receives a RhoGAM injection before she is discharged from the hospital. 3. Notify the client that because her baby's Coombs test was negative she will not receive an injection of RhoGAM. 4. Inform the client's physician that because the woman is being discharged on the second day, the RhoGAM could not be given.

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40. A postpartum client has been diagnosed with deep vein thrombosis. For which of the following additional complications is this client at high risk? 1. Hemorrhage. 2. Stroke. 3. Endometritis. 4. Hematoma.

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5. The nurse is performing a postpartum assessment on a client who delivered 4 hours ago. The nurse notes a fi rm uterus at the umbilicus with heavy lochial fl ow. Which of the following nursing actions is appropriate? 1. Massage the uterus. 2. Notify the obstetrician. 3. Administer an oxytocic as ordered. 4. Assist the client to the bathroom.

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50. A client is receiving IV heparin for deep vein thrombosis. Which of the following medications should the nurse obtain from the pharmacy to have on hand in case of heparin overdose? 1. Vitamin K. 2. Protamine. 3. Vitamin E. 4. Mannitol.

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76. Which of the following is a priority nursing diagnosis for a woman, G10 P6226, who is PP1 from a spontaneous vaginal delivery with a signifi cant postpartum hemorrhage? 1. Alteration in comfort related to afterbirth pains. 2. Risk for altered parenting related to grand multiparity. 3. Fluid volume defi cit related to blood loss. 4. Risk for sleep deprivation related to mothering role.

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18. The nurse notes the following vital signs of a postoperative cesarean client during the immediate postpartum period: 100.0ÅãF, P 68, R 12, BP 130/80. Which of the following is a correct interpretation of the fi ndings? 1. Temperature is elevated, a sign of infection. 2. Pulse is too low, a sign of vagal pathology. 3. Respirations are too low, a sign of medication toxicity. 4. Blood pressure is elevated, a sign of pre-eclampsia.

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7. A client received general anesthesia during her cesarean section 4 hours ago. Which of the following postpartum nursing interventions is important for the nurse to make? 1. Place the client fl at in bed. 2. Assess for dependent edema. 3. Auscultate lung fi elds. 4. Check patellar refl exes.

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71. The blood glucose of a client with type 1 diabetes 12 hours after delivery is 96 mg/ dL. The client has received no insulin since delivery. The drop in serum levels of which of the following hormones of pregnancy is responsible for the glucose level? 1. Estrogen. 2. Progesterone. 3. Human placental lactogen (hPL). 4. Human chorionic gonadotropin (hCG).

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22. A client, G1 P0000, is PP1 from a normal spontaneous delivery of a baby boy, Apgar 5/6. Because the client exhibited addictive behaviors, a toxicology assessment was performed; the results were positive for alcohol and cocaine. Which of the following interventions is appropriate for the nurse to perform for this postpartum client? 1. Strongly advise the client to breastfeed her baby. 2. Reprimand the mother for causing her baby to become addicted. 3. Suggest that the nursery nurse feed the baby in the nursery. 4. Provide the client with supervised instruction on baby-care skills.

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4. A client who is 2 weeks postpartum calls her obstetrician's nurse and states that she has had a whitish discharge for 1 week but that today she is "bleeding and saturating a pad about every . hour." Which of the following is an appropriate response by the nurse? 1. "That is normal. You are starting to menstruate again." 2. "You should stay on complete bedrest until the bleeding subsides." 3. "Pushing during a bowel movement may have loosened your stitches." 4. "The physician should see you. Please go to the emergency department."

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59. A nurse massages the uterus of a postpartum woman after diagnosing the woman at risk for injury related to uterine atony. Which of the following outcomes would indicate that the client's condition had improved? 1. Heavy lochia fl ow. 2. Decreased pain level. 3. Stable blood pressure. 4. Fundus fi rm at the umbilicus.

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