Maternal and Infant Chapter 25

Which assessment finding would lead the nurse to suspect a postpartal complication?

20 to 24 sanitary pads saturated/24 hours

Endometritis is a preventable postpartal complication that may lead to a more serious illness. What are the important components of the nurse's assessment to determine the early signs of endometritis?

Assess lochia for color, odor, and amount. Assess uterus for tenderness, size, and consistency. Assess vital signs to support evaluation of other data.

Which of the following instructions would be most appropriate to teach a woman to prevent thrombophlebitis?

Drinking adequate amounts of fluid; ambulating soon after birth as able; doing leg lifts while resting in bed

Identify the cardinal signs of postpartalinduced hypertension.

Elevated blood pressure, edema, proteinuria

Which measure would be most appropriate when caring for the client who has experienced a fourth-degree perineal laceration?

Encourage fluid intake and foods high in fiber

Infection of the lining of the uterus.

Endometritis

Which of the following is viewed as a risk factor for a woman developing a postpartal infection?

Excessive blood loss

True or False. Most postpartal infections are caused by staphyloccocal organisms.

False

Infection of the breast.

Mastitis

Which medication would the nurse expect to administer as ordered for a client who is experiencing postpartum hemorrhage from uterine atony?

Methergine

A collection of blood in the subcutaneous layer of the perineum

Perineal hematomas

Infection of the peritoneal cavity.

Peritonitis

Overwhelming sadness extending beyond the immediate postpartum period.

Postpartal depression

What are the common causes of disseminated intravascular coagulation during the postpartal period?

Premature separation of the placenta, missed early abortion, and fetal death in utero.

Mrs. Jones is experiencing signs of shock about 3 hours after delivery. Which of the following would the nurse expect to find when assessing Mrs. Jones?

Rapid respirations

Which of the following assessment findings would lead a nurse to suspect that a woman has developed postpartum depression?

Reports of feelings of loss; history of previous depression; lack of support persons

Explain why it is important to inspect the placenta after an uncomplicated delivery?

Retained placental fragments keep the uterus from contracting fully, leading to possible hemorrhage. Inspection of the placenta is key to ensure that the entire placenta has been expelled. Retained fragments are common with succenturiate placenta and placenta accreta, which can be noted on inspection.

Inflammation of the lining of a blood vessel with the formation of blood clots.

Thrombophlebitis

True of False. An elevated level of human chorionic gonadotropin (hCG) is present if the postpartal woman has retained placental fragments after the birth of the placenta.

True

True or False. The majority of the complications occurring during the puerperium are preventable.

True

True or False. Women who experience blood loss greater than 500 cc in 24 hours are traditionally considered to be hemorrhaging and may require blood replacement.

True

Result of edema of the bladder from pressures during childbirth.

Urinary retention

What is the rationale that supports teaching women to wipe the perineal area from front to back when cleansing or removing feces?

When wiping from back to front, organisms may be brought forward from the rectum to the vagina or perineal site of injury.

Define disseminated intravascular coagulation (DIC).

deficiency in clotting ability caused by vascular injury.

an infection of the endometrium, the lining of the uterus

endometritis

When assessing lochia to detect a cervical tear that occurred during the birthing process, the nurse would note that blood from a cervical tear is _____ than normal lochia.

lighter

infection of the breast

mastitis

The nurse would weigh ____ _____ to get an accurate account of measuring blood loss from lochia.

perineal pads

infection of the peritoneal cavity

peritonitis

overall feeling of sadness in a woman accompanied by extreme fatigue, an inability to stop crying, increased anxiety about her own or her infant's health, insecurity (unwilling to be left alone or unable to make decisions), psychosomatic symptoms, and either depressive or manic mood fluctuations during the first year following birth

postpartal depression

psychiatric illness occurring during the postpartum period

postpartal psychosis

inflammation of the lining of a blood vessel with the formation of blood clots

thrombophlebitis

The four reasons that are most often found to be the precipitating causes of postpartal hemorrhage include

uterine atony, lacerations, retained placental fragments, uterine inversion, or disseminated intravascular coagulation

_____ _____ refers to a prolapse of the fundus through the cervix so that the uterus turns inside out.

uterine inversion

a rate phenomenon in which the uterus turns inside out

uterine inversion