Deck 34: Postpartum Complications

Question 1

____________________ is the most common postpartum infection.

Answer 1

Endometritis
Endometritis usually begins as a localized infection at the placental site;however,it can spread to involve the entire endometrium.Assessment for signs of endometritis may reveal a fever,elevated pulse,chills,anorexia,fatigue,pelvic pain,uterine tenderness,or foul-smelling profuse lochia.

Question 2

A woman who has recently given birth complains of pain and tenderness in her leg.On physical examination,the nurse notices warmth and redness over an enlarged,hardened area.The nurse should suspect ______ and should confirm the diagnosis by ________.

A)Disseminated intravascular coagulation (DIC);asking for laboratory tests
B)von Willebrand disease (vWD);noting whether bleeding times have been extended
C)Thrombophlebitis;using real-time and color Doppler ultrasound
D)Thrombocytopenic purpura;drawing blood for laboratory analysis

Answer 2

Thrombophlebitis;using real-time and color Doppler ultrasound

Question 3

Lacerations of the cervix,vagina,or perineum are also causes of PPH.Factors that influence the causes and incidence of obstetric lacerations of the lower genital tract include all except:

A)Operative or precipitate birth
B)Adherent retained placenta
C)Abnormal presentation of the fetus
D)Congenital abnormalities of the maternal soft parts

Answer 3

Adherent retained placenta

Question 4

Nurses need to know the basic definitions and incidence data about postpartum hemorrhage (PPH).For instance:

A)PPH is easy to recognize early;after all,the woman is bleeding
B)Traditionally,it takes more than 1000 ml of blood after vaginal birth and 2500 ml after cesarean birth to define the condition as PPH
C)If anything,nurses and doctors tend to overestimate the amount of blood loss
D)Traditionally,PPH has been classified as early or late with respect to birth

Question 5

A perinatal nurse is caring for a woman in the immediate postbirth period.Assessment reveals that the woman is experiencing profuse bleeding.The most likely etiology for the bleeding is:

A)Uterine atony
B)Uterine inversion
C)Vaginal hematoma
D)Vaginal laceration

Question 6

It is important for the perinatal nurse to be knowledgeable regarding conditions of abnormal adherence of the placenta.This occurs when the zygote implants in an area of defective endometrium and results in little to no zone separation between the placenta and decidua.Which classification of separation is not recognized as an abnormal adherence pattern?

A)Placenta accreta
B)Placenta increta
C)Placenta percreta
D)Placenta abruptio

Question 7

Which client is at greatest risk for early postpartum hemorrhage (PPH)?

A)A primiparous woman (G 2,P 1-0-0-1)being prepared for an emergency cesarean birth for fetal distress
B)A woman with severe preeclampsia on magnesium sulfate whose labor is being induced
C)A multiparous woman (G 3,P 2-0-0-2)with an 8-hour labor
D)A primigravida in spontaneous labor with preterm twins

Question 8

Medications used to manage postpartum hemorrhage (PPH)include (choose all that apply):

A)Oxytocin
B)Methergine
C)Terbutaline
D)Hemabate
E)Magnesium sulfate

Question 9

The perinatal nurse assisting with establishing lactation is aware that acute mastitis can be minimized by:

A)Washing the nipples and breasts with mild soap and water once a day
B)Using proper breastfeeding techniques
C)Wearing a nipple shield for the first few days of breastfeeding
D)Wearing a supportive bra 24 hours a day

Question 10

When caring for a postpartum woman experiencing hemorrhagic shock,the nurse recognizes that the most objective and least invasive assessment of adequate organ perfusion and oxygenation is:

A)Absence of cyanosis in the buccal mucosa
B)Cool,dry skin
C)Diminished restlessness
D)Urinary output of at least 30 ml/hr

Question 11

A perinatal nurse caring for a postpartum woman understands that late postpartum hemorrhage (PPH)is most likely caused by:

A)Subinvolution of the uterus
B)Defective vascularity of the decidua
C)Cervical lacerations
D)Coagulation disorders

Question 12

The most effective and least expensive treatment of puerperal infection is prevention.What is the most important strategy?

A)Large doses of vitamin C during pregnancy
B)Prophylactic antibiotics
C)Strict aseptic technique,including handwashing,by all health care personnel
D)Limited protein and fat intake

Question 13

A primary nursing responsibility when caring for a woman experiencing an obstetric hemorrhage associated with uterine atony is to:

A)Establish venous access
B)Perform fundal massage
C)Prepare the woman for surgical intervention
D)Catheterize the bladder

Question 14

One of the first symptoms of puerperal infection to assess for in the postpartum woman is:

A)Fatigue continuing for longer than 1 week
B)Pain with voiding
C)Profuse vaginal bleeding with ambulation
D)Temperature of 38° C (100.4° F)or higher on 2 successive days starting 24 hours after birth