Postpartum Hemorrhage > Maternal & Newborn
Exam Review
Nursing Assessment
Total Questions : 6
Showing 6 questions, Sign in for moreA nurse is assessing a newborn’s color and oxygenation.
What is the term for the bluish discoloration of the hands and feet that is normal in newborns?
Explanation
Acrocyanosis is the term for the bluish discoloration of the hands and feet that is normal in newborns.It is caused by poor peripheral circulation and ineffective temperature regulation.It usually disappears within 24 to 48 hours after birth.
Choice B is wrong because cyanosis is the bluish discoloration of the skin and mucous membranes that indicates inadequate oxygenation.
It is not normal in newborns and requires immediate intervention.
Choice C is wrong because pallor is the paleness of the skin that indicates poor perfusion or anemia.
It is not normal in newborns and requires further evaluation.
Choice D is wrong because jaundice is the yellowish discoloration of the skin and sclera that indicates elevated bilirubin levels.
It is not normal in newborns within the first 24 hours of life and may indicate hemolytic disease or liver dysfunction.
A nurse is caring for a client who has postpartum hemorrhage due to uterine atony.
Which of the following actions should the nurse take first?
Explanation
Massaging the fundus stimulates uterine contractions and helps to stop the bleeding.
This is the first action the nurse should take to manage uterine atony.
Choice B is wrong because administering oxytocin is a pharmacological intervention that can be used after massaging the fundus if bleeding persists.
Oxytocin is a hormone that also stimulates uterine contractions and reduces blood loss.
Choice C is wrong because inserting an indwelling urinary catheter is not a priority action for postpartum hemorrhage.
A full bladder can interfere with uterine contractions and cause displacement of the uterus, but it is not the main cause of uterine atony.
Choice D is wrong because starting an IV infusion of lactated Ringer’s solution is a supportive measure that can be used to replace fluid loss and maintain blood pressure in postpartum hemorrhage.
However, it does not address the underlying cause of bleeding and should not be done before massaging the fundus.
A nurse is assessing a client who has postpartum hemorrhage.
Which of the following findings is an early sign of hypovolemic shock?
Explanation
Tachycardia is an early sign of hypovolemic shock, which is a life-threatening condition caused by excessive blood loss.Tachycardia is the body’s attempt to compensate for the reduced blood volume and maintain adequate blood pressure and perfusion to vital organs.
Choice B.Hypotension is wrong because it is a late sign of hypovolemic shock, indicating severe blood loss and decompensation.
Hypotension can lead to organ failure and death if not corrected promptly.
Choice C.Oliguria is wrong because it is not a specific sign of hypovolemic shock, but rather a consequence of reduced renal perfusion due to low blood pressure and volume.
Oliguria can also be caused by other factors such as dehydration, urinary tract obstruction, or renal disease.
Choice D.Pallor is wrong because it is not a reliable sign of hypovolemic shock, as it can be influenced by skin color, temperature, and lighting conditions.
Pallor can also occur in other conditions such as anemia, hypoxia, or vasovagal syncope.
Normal ranges for vital signs in postpartum women are:
• Heart rate: 60-100 beats per minute
• Blood pressure
A nurse is teaching a client who has postpartum hemorrhage about the risk factors for this condition.
Which of the following statements by the client indicates a need for further teaching?
Explanation
Having a history of fibroids can increase the risk of bleeding, but not postpartum hemorrhage.Fibroids are benign tumors that grow in the uterus and can cause heavy menstrual bleeding, but they do not affect the placenta or the uterus after delivery.
Choice A is wrong because having a large baby can increase the risk of postpartum hemorrhage.
A large baby can overstretch the uterine muscle and cause atony, which is the failure of the uterus to contract properly after delivery.Atony is the most common cause of postpartum hemorrhage.
Choice B is wrong because having a prolonged labor can increase the risk of postpartum hemorrhage.
A prolonged labor can exhaust the uterine muscle and impair its ability to contract after delivery.This can also lead to atony and excessive bleeding.
Choice D is wrong because having a low-lying placenta can increase the risk of postpartum hemorrhage.
A low-lying placenta, also called placenta previa, is when the placenta covers part of the cervix. This condition can increase the risk of postpartum hemorrhage, which is excessive bleeding after childbirth.
A nurse is preparing to administer methylergonovine to a client who has postpartum hemorrhage.
Which of the following assessments should the nurse perform before giving the medication?
Explanation
The nurse should perform a blood pressure assessment before giving methylergonovine to a client who has postpartum hemorrhage because methylergonovine can cause hypertension and cerebrovascular accidents.The nurse should administer methylergonovine over more than one minute and monitor blood pressure.
Choice B. Temperature is wrong because temperature is not affected by methylergonovine and is not a priority assessment for postpartum hemorrhage.
Choice C. Respiratory rate is wrong because respiratory rate is not affected by methylergonovine and is not a priority assessment for postpartum hemorrhage.
Choice D. Blood glucose is wrong because blood glucose is not affected by methylergonovine and is not a priority assessment for postpartum hemorrhage.
Postpartum hemorrhage is severe vaginal bleeding after childbirth that can lead to shock and death.
The major causes of postpartum hemorrhage are uterine atony, lacerations, retained placenta or clots, and clotting factor deficiency.
A nurse is reviewing the laboratory results of a client who has postpartum hemorrhage.
Which of the following findings should the nurse report to the provider?
Explanation
This is because a low platelet count (<150,000/mm3) indicates thrombocytopenia, which can increase the risk of bleeding and hemorrhage.
The nurse should report this finding to the provider as it may require treatment or transfusion.
Choice A is wrong because hemoglobin 10 g/dL is within the normal range for postpartum women (10-14 g/dL) and does not indicate hemorrhage.
Choice B is wrong because hematocrit 30% is also within the normal range for postpartum women (30-39%) and does not indicate hemorrhage.
Choice D is wrong because white blood cells 12,000/mm3 is slightly elevated but not abnormal for postpartum women, who may have a physiological leukocytosis due to stress, inflammation, or infection.
This finding does not indicate hemorrhage.
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