pu 23
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?
inspecting the placenta after delivery for intactness
The client, who has just been walking around her room, sits down and reports leg tightness and achiness. After resting, she states she is feeling much better. The nurse recognizes that this discomfort could be due to which cause?
thromboembolic disorder of the lower extremities
Which measurement best describes delayed postpartum hemorrhage?
blood loss in excess of 500 ml, occurring at least 24 hours and up to 12 weeks after birth
An expectant mother is on heparin for previous blood clots and voicing concerns about how her medications will affect her baby. The nurse would inform the mother that:
heparin does not cross the placenta and is safe for her to take.
The nurse is concerned that a postpartum client with a cervical laceration is developing hypovolemic shock. What did the nurse assess in this client?
weak and rapid pulse
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'm feeling so guilty and worthless lately."
The nurse determines that a woman is experiencing postpartum hemorrhage after a vaginal birth when the blood loss is greater than which amount?
500 ml
A postpartum woman is developing a thrombophlebitis in her right leg. Which assessments would the nurse make to detect this?
Assess for pedal edema.
A nurse is caring for a postpartum client diagnosed with von Willebrand disease. What should be the nurse's priority for this client?
Check the lochia.
The nurse is interacting with a young mother and her 2-week-old infant. Which behavior by the mother should the nurse prioritize and report to the RN or health care provider?
Not responding to the infant crying
A nurse is assessing a client who gave birth vaginally about 4 hours ago. The client tells the nurse that she changed her perineal pad about an hour ago. On inspection, the nurse notes that the pad is now saturated. The uterus is firm and approximately at the level of the umbilicus. Further inspection of the perineum reveals an area, bluish in color and bulging just under the skin surface. Which action would the nurse do next?
Notify the health care provider.
A new mother is holding her infant after a feeding. Which behavior by the mother would be concerning to the nurse related to malattachment?
She refers to the infant as "it" instead of saying the infant's name.
Which situation should concern the nurse treating a postpartum client within a few days of birth?
The client feels empty since she gave birth to the neonate.
The postpartum nurse is assessing clients, and all have given birth within the past 24 hours. Which client assessment leads the nurse to suspect the woman is experiencing postpartum blues?
a 30-year-old woman who is teary-eyed when asked how she and the baby are doing with breastfeeding
What postpartum client should the nurse monitor most closely for signs of a postpartum infection?
a client who had a nonelective cesarean birth
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?
delirium
Assessment of a postpartum client reveals a firm uterus with bright-red bleeding and a localized bluish bulging area just under the skin at the perineum. The woman also reports significant pelvic pain and is experiencing problems with voiding. The nurse suspects which condition?
hematoma
A postpartum client who had a cesarean birth reports right calf pain to the nurse. The nurse observes that the client has nonpitting edema from her right knee to her foot. The nurse knows to prepare the client for which test first?
venous duplex ultrasound of the right leg
A client in her sixth week postpartum reports general weakness. The client has stopped taking iron supplements that were prescribed to her during pregnancy. The nurse would assess the client for which condition?
hypovolemia
The nurse is administering methylergonovine 0.2 mg to a postpartum client with uterine subinvolution. Which assessment will the nurse need to make prior to administering the medication?
if blood pressure is lower than 140/90 mm Hg
A client presents to her postpartum appointment with vague reports. The nurse suspects postpartum depression based on which assessment finding?
lack of pleasure
Manual manipulation is used to reposition the uterus of a client experiencing uterine inversion. After the repositioning, which type of medication would the nurse administer as prescribed to the client?
oxytocin agent
A woman who gave birth to a healthy baby 5 days ago is experiencing fatigue and weepiness, lasting for short periods each day. Which condition does the nurse believe is causing this experience?
postpartum baby blues
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?
postpartum hemorrhage
Which assessment finding would be suggestive of adequate tissue perfusion in a client who has experienced a postpartum hemorrhage?
urinary output of 60 cc's over the last hour
A nurse is assigned to care for a client with a uterine prolapse. Which of the following would be most important for the nurse to assess when determining the severity of the prolapse?
uterine protrusion into the vagina
A nurse teaches a postpartum woman about her risk for thromboembolism. The nurse determines that additional teaching is required when the woman identifies which as a factor that increases her risk?
increase in red blood cell production
A nurse has just received a client from the surgical suite following a cesarean birth. The report given states a history of magnesium sulfate in the preoperative period. The nurse should assess the client for adverse effects from the magnesium sulfate by which initial nursing action?
Assessment of the fundus
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?
infection
The nurse is teaching a prenatal class about preparing for their expanding families. What is helpful advice from the nurse?
"The hormones of pregnancy may cause anxiety or depression postpartum."
A client has had a cesarean birth. Which amount of blood loss would the nurse document as a postpartum hemorrhage in this client?
1000 ml
The nurse is teaching a postpartum woman and her spouse about postpartum blues. The nurse would instruct the couple to seek further care if the client's symptoms persist beyond which time frame?
2 weeks
The nurse is giving an educational presentation to the local Le Leche league chapter. One woman asks about risk factors for mastitis. Which condition would the nurse most likely include in the response?
Pierced nipple
A postpartum woman is prescribed oxytocin to stimulate the uterus to contract. Which action would be most important for the nurse to do?
Piggyback the IV infusion into a primary line.
The father of a 2-week-old infant presents to the clinic with his disheveled wife for a postpartum visit. He reports his wife is acting differently, is extremely talkative and energetic, sleeping only 1 or 2 hours at a time (if at all), not eating, and appears to be totally neglecting the infant. The nurse should suspect the client is exhibiting signs and symptoms of which disorder?
Postpartum psychosis
The nurse is teaching a client about mastitis. Which statement should the nurse include in her teaching?
Symptoms include fever, chills, malaise, and localized breast tenderness.
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?
inability to concentrate loss of confidence decreased interest in life
The nurse is caring for a woman who delivered via a cesarean birth approximately 16 hours earlier. Which assessment finding should the nurse prioritize?
steadily decreasing volume of urine
A fundal massage is sometimes performed on a postpartum woman. The nurse would perform this procedure to address which condition?
uterine atony
