High risk postpartum

2 (It is important for the nurse to notify the OB the client is bleeding more than she should after the delivery. The uterus is contracted and firm, and not displaced. )

The nurse is performing a postpartum assessment on a client who delivered 4 hrs ago. The nurse notes a firm uterus at the umbilicus with heavy lochial flow. Which of the following nursing actions is appropriate? 1. massage the uterus 2. notify the OB 3. administer the oxytocic as ordered 4. assist the client to the Bathroom

1,2 (Hembate can cause N/V/D and hyperthermia. Hembate is an oxytocic agent that acts on the myometrial tissue of the uterus. During postpartum it acts directly at the site of placental separation to stop uncontrolled bleeding. It is i type of prostaglandin)

A client has just received Hembate (carboprost) because of uterine atony not controlled by IV oxytocin. For which of the following side effects of the medication will then nurse monitor this patient? Select all 1. hyperthermia 2. diarrhea 3. hypotension 4. palpitations 5. anasarca

1 (sudden lower back pain is a sign of transfusion reaction. If the client is receiving the wrong type of blood or is allergic to the blood she will develop flank or kidney pain. Stop the infusion immed and report to HCP and blood bank)

A client is receiving a blood transfusion after the delivery of placenta accreta and hysterectomy. which of the following complaints by the client would warrant immed DC the infusion? 1. my lower back hurts all of a sudden 2. my hands feel so cold 3. I feel like my heart is beating fast 4. I feel like I need to have a BM

4

A client who is 2 weeks postpartum calls her OB 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 1/2 hr. Which of the following is an appropriate response by the nurse? 1. that is normal you are starting to mestruate again 2. you should stay on complete bedrest until the bleeding subsides 3. pushing during a bowel movement may have loosened your stiches 4. The HCP should see you. Please go to the ER

3 (1&2 are if they have Diabetes Type 2. 4, babies rarely develop diabetes before age 2. Women who develop gestational diabetes are at high risk for developing type 2 diabetes. They should be encouraged to eat healthy and to exercise to prevent the onset or delay the onset)

A gestational diabetic client who delivered yesterday is currently on the postpartum unit. Which of the following statements is appropriate for the nurse to make at this time? 1. monitor your blood glucose 5 times a day until your 6 week checkup 2. I will teach you how to inject insulin before you are discharged 3. Daily exercise will help to prevent you from becoming diabetic in the future 4. Your baby should be assessed every 6 months for signs of juvenile diabetes