Chapter 28: Postpartum Maternal Complications

Chapter 28: Postpartum Maternal Complications

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. Which statement by a postpartum client indicates that further teaching is not needed regarding thrombus formation?

ANS:  D

Venous congestion begins as soon as the client stands up. The stockings should be applied before she rises from the bed in the morning. The client should avoid knee pillows because they increase pressure on the popliteal space. Sitting in a chair with legs in a dependent position causes pooling of blood in the lower extremities. As soon as possible, the client should ambulate frequently.

PTS:   1                    DIF:    Cognitive Level: Application           REF:   607

OBJ:   Nursing Process Step: Evaluation     MSC:  Client Needs: Health Promotion and Maintenance

2. The nurse knows that late postpartum hemorrhage can be prevented by:

ANS:  B

If a portion of the placenta is missing, the clinician can explore the uterus, locate the missing fragments, and remove the potential cause of late postpartum hemorrhage. Manual removal of the placenta increases the risk of postpartum hemorrhage. Broad-spectrum antibiotics will be given if postpartum infection is suspected. The placenta is usually delivered 5 to 30 minutes after birth of the baby without pulling on the cord. That can cause uterine inversion.

PTS:   1                    DIF:    Cognitive Level: Application           REF:   602

OBJ:   Nursing Process Step: Implementation

MSC:  Client Needs: Physiologic Integrity

3. A multiparous client 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 client void and massages her fundus, but the fundus remains difficult to find and the rubra lochia remains heavy. Which action should the nurse take next?

ANS:  C

Treatment of excessive bleeding requires the collaboration of the health care provider and the nurses. Do not leave the client alone. The nurse should call the clinician while a second nurse rechecks the vital signs. The client has voided successfully, so a Foley catheter is not needed at this time. The uterine muscle can be overstimulated by massage, leading to uterine atony and rebound hemorrhage.

PTS:   1                    DIF:    Cognitive Level: Application           REF:   604

OBJ:   Nursing Process Step: Implementation

MSC:  Client Needs: Physiologic Integrity

4. Early postpartum hemorrhage is defined as a blood loss greater than:

ANS:  B

The average amount of bleeding after a vaginal birth is 500 mL. Early postpartum hemorrhage occurs in the first 24 hours, not 48 hours. Blood loss after a cesarean averages 1000 mL. Late postpartum hemorrhage is 48 hours and later.

PTS:   1                    DIF:    Cognitive Level: Understanding       REF:   598

OBJ:   Nursing Process Step: Assessment   MSC:  Client Needs: Physiologic Integrity

5. A steady trickle of bright red blood from the vagina in the presence of a firm fundus suggests:

ANS:  D

Undetected lacerations will bleed slowly and continuously. Bleeding from lacerations is uncontrolled by uterine contraction. The fundus would not be firm with uterine atony. A hematoma would be internal. Swelling and discoloration would be noticed, but bright bleeding would not be. With an infection of the uterus, there would be an odor to the lochia and systemic symptoms such as fever and malaise.

PTS:   1                    DIF:    Cognitive Level: Understanding       REF:   601

OBJ:   Nursing Process Step: Assessment   MSC:  Client Needs: Physiologic Integrity