Postpartum Hemorrhage (Sherpath Sunday Wk 5)

After a vaginal delivery, an estimated blood loss greater than _________mL would indicate a diagnosis of a postpartum hemorrhage.

500mL

The nurse understands that which conditions are risks for a uterine inversion? (Select all that apply.) Precipitous delivery Short umbilical cord Polyhydramnios Fundal implantation of the placenta Prolonged labor

Short umbilical cord Fundal implantation of the placenta Prolonged labor

On assessment, the postpartum nurse notes a firm fundus, bright red blood oozing from the vagina, and a saturated perineal pad. What diagnosis would the nurse expect based on these assessment findings? Vaginal hematoma Placenta accreta Vaginal laceration Uterine inversion

Vaginal laceration

The nurse understands that an early postpartum hemorrhage is defined as an estimated blood loss greater than _____mL in the first 24 hours after a vaginal delivery.

500mL

The nurse recognizes that a steady trickle of bright red blood from the vagina in the presence of a firm fundus may indicate which condition? Uterine atony Retained placenta Infection of the uterus A laceration within the genital tract

A laceration within the genital tract

A nurse is monitoring a new mother in the postpartum period for signs of hemorrhage. Which sign, if noted in the mother, indicates excessive blood loss? An increase in the pulse from 88 to 110 beats/min A blood pressure change from 130/88 to 124/80 mm Hg An increase in the respiratory rate from 18 to 20 breaths/min A change in the O2 saturation from 99% to 96%

An increase in the pulse from 88 to 110 beats/min

A woman delivered a 9-lb, 10-oz baby 1 hour ago. When the nurse arrives to perform the 15-minute assessment, the patient says that she "feels all wet underneath." The nurse discovers that both perineal pads are completely saturated and that the patient is lying in a 6-inch-diameter puddle of blood. After calling for help, which action would the nurse take next? Assess the fundus for firmness. Estimate the blood loss by weighing the perineal pads. Check the perineum for lacerations. Manually remove any contents in the uterus.

Assess the fundus for firmness.

Methylergonovine is prescribed for a woman to treat postpartum hemorrhage (PPH). Before administration of this medication, which nursing assessment is the priority? Deep tendon reflexes Uterine tone Amount of lochia Blood pressure

Blood pressure

In the fourth stage of labor, the nurse recognizes that a full bladder increases the risk for which postpartum complication? Retained placenta Boggy uterus Infection Shock

Boggy uterus

Which risk factor places a woman at risk for subinvolution of the uterus? Chorioamnionitis Forceful traction of the umbilical cord Vacuum extraction Precipitous delivery

Chorioamnionitis

A nurse is caring for the following labor patients. Which patients would the nurse be prepared to monitor closely for signs of postpartum hemorrhage (PPH)? (Select all that apply.) G1 P0000, delivered a 29-week fetal demise vaginally after 8 hours in labor G2 P1001, delivered a 4200-g neonate vaginally after 4 hours of labor G2 P0010, delivered a 3750-g neonate by cesarean section for breech presentation G4 P3003, delivered a 3500-g neonate by cesarean section with a placenta accreta G3 P0200, delivered a 3900-g neonate vaginally after 36 hours in labor

G2 P1001, delivered a 4200-g neonate vaginally after 4 hours of labor G4 P3003, delivered a 3500-g neonate by cesarean section with a placenta accreta G3 P0200, delivered a 3900-g neonate vaginally after 36 hours in labor

When caring for a patient with a postpartum hemorrhage, which interventions would the nurse initiate to improve the patient's status? (Select all that apply.) Insertion of an indwelling catheter Fundal massage Pad count Administration of tocolytic drugs Intravenous (IV) fluid replacement

Insertion of an indwelling catheter Fundal massage Intravenous (IV) fluid replacement

The nurse understands that which action after the birth of the newborn can prevent a postpartum hemorrhage? Administration of broad-spectrum antibiotics Inspection of the placenta Manual removal of the placenta after birth Pulling on the umbilical cord to hasten delivery of the placenta

Inspection of the placenta

A multiparous woman is admitted to the postpartum unit after a rapid labor and birth of a 4000-g infant. Her fundus is boggy, lochia is heavy, and vital signs are unchanged. The nurse has the woman void and massages her fundus, but the patient's fundus remains difficult to find and the lochia remains bright red and heavy. Which action would the nurse take next? Vigorously massage the fundus Notify the health care provider Recheck the vital signs Insert an indwelling catheter

Notify the health care provider

A multiparous woman is admitted to the postpartum unit after a rapid labor and birth of a 4000-g infant. Her fundus is boggy, lochia is heavy, and vital signs are unchanged. The nurse has the woman void and massages her fundus, but the fundus remains difficult to find, and the rubra lochia remains heavy. Which action would the nurse take next? Continue to vigorously massage the fundus. Notify the health care provider. Recheck vital signs. Insert a Foley catheter.

Notify the health care provider.

Which conditions are risk factors for uterine atony? (Select all that apply.) Primiparous birth Polyhydramnios Precipitous birth Fetal macrosomia Chorioamnionitis

Polyhydramnios Fetal macrosomia Chorioamnionitis

A woman, 1 day postpartum, is being carefully monitored after a significant postpartum hemorrhage (PPH). Which finding would the nurse report to the health care provider? Urine output of 160 mL for the past 8 hours Weight loss of 2 lb since delivery Pulse rate of 68 beats/min Fundus firm at the umbilicus

Urine output of 160 mL for the past 8 hours

Which type of hematoma is most common in vaginal births and is visible from the outside? Vaginal Vulvar Cervical Retroperitoneal

Vulvar