Postpartum Hemorrhage > Maternal & Newborn
Exam Review
Surgical Management
Total Questions : 5
Showing 5 questions, Sign in for moreA nurse is caring for a client who is experiencing postpartum hemorrhage.
Which of the following surgical management should the nurse expect to be performed on the client?
Explanation
Uterine artery embolization to block blood flow to the uterus.This is a minimally invasive procedure that involves injecting small particles into the uterine arteries to occlude them and stop the bleeding.It is an effective and fertility-preserving option for postpartum hemorrhage that does not respond to medical management.
ChoiceA.
Manual removal of placenta or retained fragments under anesthesiais wrong because it is not a surgical management, but a manual one.It is usually done before resorting to surgery, and it may not be sufficient to control the bleeding if there is uterine atony or lacerations.
ChoiceB.
Repair of lacerations or hematomas under anesthesiais wrong because it is not a surgical management for postpartum hemorrhage, but a surgical repair of the injuries that may have caused the bleeding.
It may be necessary to perform this repair, but it does not address the underlying cause of hemorrhage, such as uterine atony or placental abnormalities
A nurse is caring for a client who is experiencing postpartum hemorrhage.
Which of the following surgical management should the nurse expect to be performed on the client as a last resort?
Explanation
Hysterectomy to remove the uterus.This is because hysterectomy is the last resort for surgical management of postpartum hemorrhage when all other methods have failed or are contraindicated.Hysterectomy is the definitive treatment for uncontrollable bleeding from the uterus.
Choice A. Manual removal of placenta or retained fragments under anesthesia is wrong because this is not a surgical procedure but a manual one.It is done to remove any retained products of conception that may cause bleeding or infection.
Choice B. Repair of lacerations or hematomas under anesthesia is wrong because this is not a surgical procedure but a repair one.It is done to stop bleeding from any tears or bruises in the genital tract that may occur during delivery.
Choice C. Uterine tamponade with balloon catheter or gauze packing to compress bleeding vessels is wrong because this is not a surgical procedure but a minimally invasive one.It is done to apply pressure inside the uterine cavity to stop bleeding from the placental site or uterine atony.
Choice D. B-Lynch suture to compress the uterus with stitches is wrong because this is not a last resort but a conservative surgical procedure.
A nurse is caring for a client who is experiencing postpartum hemorrhage.
Which of the following surgical management should the nurse expect to be performed on the client if she has uterine atony?
Explanation
Uterine tamponade with balloon catheter or gauze packing to compress bleeding vessels is a surgical management that can be used for postpartum hemorrhage due to uterine atony.
Uterine atony is the failure of the uterus to contract and retract after delivery, which can lead to excessive bleeding from the placental site.
Choice A is wrong because manual removal of placenta or retained fragments under anesthesia is not a surgical management for uterine atony, but for retained placenta, which is a different cause of postpartum hemorrhage.
Choice B is wrong because repair of lacerations or hematomas under anesthesia is not a surgical management for uterine atony, but for genital tract trauma, which is another cause of postpartum hemorrhage.
Choice D is wrong because uterine artery embolization to block blood flow to the uterus is not a surgical management for uterine atony, but for refractory cases of postpartum hemorrhage that do not respond to other interventions.It is also a minimally invasive procedure that does not require laparotomy.
Normal ranges for blood loss after vaginal delivery are less than 500 mL and after cesarean delivery are less than 1000 mL.Postpartum hemorrhage is defined as blood loss greater than these amounts within 24 hours of delivery.
A nurse is caring for a client who is experiencing postpartum hemorrhage due to bleeding vessels in her uterus that are not responding to other treatments.
Which of the following surgical management should the nurse expect to be performed on the client?
Explanation
Uterine artery embolization to block blood flow to the uterus.This is a surgical procedure that can be used to control postpartum hemorrhage when medical management and other conservative surgical techniques have failed.Uterine artery embolization involves injecting small particles into the uterine arteries to occlude the bleeding vessels and reduce blood loss.
Choice A is wrong because manual removal of placenta or retained fragments under anesthesia is not a surgical procedure, but a manual technique that can be used to treat postpartum hemorrhage caused by retained placental tissue.
Choice B is wrong because repair of lacerations or hematomas under anesthesia is a surgical procedure that can be used to treat postpartum hemorrhage caused by genital tract trauma, not by bleeding vessels in the uterus.
Choice C is wrong because uterine tamponade with balloon catheter or gauze packing to compress bleeding vessels is not a surgical procedure, but a minimally invasive technique that can be used to treat postpartum hemorrhage caused by uterine atony or placenta accreta.
A nurse is caring for a client who is experiencing postpartum hemorrhage due to bleeding vessels in her uterus that are not responding to other treatments and has already undergone uterine artery embolization but still has excessive bleeding.
Which of the following surgical management should the nurse expect to be performed on the client?
Explanation
B-Lynch suture to compress the uterus with stitches.This is a surgical technique that may be used to arrest postpartum hemorrhage resulting from uterine atony.
It involves placing sutures around the uterus in a compression pattern to reduce the blood flow and contract the uterus.
Choice A is wrong because manual removal of placenta or retained fragments under anesthesia is not a surgical management but a medical one.
It is used to remove any retained products of conception that may prevent the uterus from contracting and cause bleeding.
Choice B is wrong because repair of lacerations or hematomas under anesthesia is not a surgical management for bleeding vessels in the uterus, but for trauma to the genital tract or vulva.
Lacerations or hematomas may occur due to delivery or instrumentation and can cause significant blood loss.
Choice C is wrong because uterine tamponade with balloon catheter or gauze packing to compress bleeding vessels is not a surgical management but a minimally invasive one.
It is used to apply pressure inside the uterine cavity and stop the bleeding from the placental site or other sources.
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