A 25-year-old client experienced a severe postpartum hemorrhage following the vaginal birth of twins and is now transferred to the postpartum unit.

What complication should the nurse prioritize during the client’s assessment?

Hard, painful uterine afterpains.

Disseminated intravascular coagulation.

Postpartum psychosis.

Placenta accreta.

Answer and Explanation

The Correct Answer is B

Choice A rationale

While hard, painful uterine afterpains can be uncomfortable for the patient, they are a normal part of the postpartum period and are not typically a priority complication following a severe postpartum hemorrhage16.

Choice B rationale

Disseminated intravascular coagulation (DIC) is a serious condition that can occur as a complication of severe postpartum hemorrhage. It involves an overactive clotting process leading to the formation of small blood clots that can block blood vessels and cause significant organ damage16.

Choice C rationale

Postpartum psychosis is a serious mental health disorder that can occur after childbirth. However, it is not directly related to postpartum hemorrhage and would not typically be the priority complication in this scenario16.

Choice D rationale

Placenta accreta is a condition where the placenta grows too deeply into the uterine wall. While it can cause severe bleeding after delivery, it would not typically be a priority complication to assess for following a severe postpartum hemorrhage16.

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Correct Answer is B

Explanation

Choice A rationale

Administering oxygen via facemask is a common intervention for variable decelerations, but it is not the first action that should be taken.

Choice B rationale

Changing the client’s position is the recommended first action for variable decelerations. Repositioning the mother, such as moving her to a lateral or knee-chest position, can relieve potential cord compression and improve fetal oxygenation.

Choice C rationale

Turning off the oxytocin infusion is another intervention for variable decelerations, but it is not the first action that should be taken.

Choice D rationale

Assessing cervical dilation is not the first action that should be taken in response to variable decelerations.

A. When the placental site has healed. B. When ovulation resumes. C. Six to eight weeks after birth. D. Four weeks after birth.

Correct Answer is C

Explanation

Choice A rationale

While the healing of the placental site is a part of the postpartum recovery process, it does not directly correlate with the return of menstruation.

Choice B rationale

Ovulation does need to resume for menstruation to return, but the timing of ovulation resuming postpartum can vary greatly among individuals and does not provide a specific timeframe.

Choice C rationale

For a postpartum client who is formula-feeding her new baby, menstruation typically resumes six to eight weeks after birth.

Choice D rationale

While it is possible for menstruation to resume four weeks after birth, this is less common. The typical timeframe for the return of menstruation for a postpartum client who is formula- feeding is six to eight weeks.

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A 25-year-old client experienced a severe postpartum hemorrhage following the vaginal birth of twins and is now transferred to the postpartum unit.What complication should the nurse prioritize during the client’s assessment?

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A 25-year-old client experienced a severe postpartum hemorrhage following the vaginal birth of twins and is now transferred to the postpartum unit.

What complication should the nurse prioritize during the client’s assessment?