A new mother calls the nurse into the room to tell her she gets abdominal cramps every time the baby breastfeeds.
Which of the following is the correct explanation for this?

Breastfeeding causes the ovaries to release prolactin and that will cause you to have increased abdominal pain.

Milk production can be painful.

When you breastfeed, the brain releases oxytocin that triggers the milk ejection reflex and makes your uterus contract causing cramps.

That is probably because the baby is laying on your belly as you feed.

Answer and Explanation

The Correct Answer is C

Choice A rationale

This statement is factually incorrect. Prolactin is the hormone primarily responsible for milk production (lactogenesis), not abdominal pain or uterine cramping. While prolactin levels do rise in response to breastfeeding, its main role is to stimulate the mammary glands to produce milk. Oxytocin, not prolactin, is the hormone that causes uterine contractions. The abdominal cramps are a direct result of the uterus contracting, not the release of prolactin.

Choice B rationale

While some women may experience discomfort during breastfeeding, the sensation of abdominal cramping is not due to the process of milk production itself. The production of milk in the mammary glands is a hormonal process mediated by prolactin and does not cause uterine cramping. The cramps a new mother feels while breastfeeding are a separate physiological response, caused by a different hormone, and are a normal part of the postpartum recovery process.

Choice C rationale

The correct explanation is that when an infant suckles at the breast, it stimulates nerve endings in the nipple, which sends a signal to the mother's brain. The hypothalamus then signals the posterior pituitary gland to release the hormone oxytocin. Oxytocin causes the myoepithelial cells around the milk ducts to contract, leading to the milk ejection reflex. Concurrently, oxytocin also acts on the uterine muscles, causing them to contract. These uterine contractions are what a new mother feels as abdominal cramps, which help the uterus return to its pre-pregnancy size.

Choice D rationale

While the position of the baby can affect the mother's comfort, it is not the cause of the internal abdominal cramping. The cramps are an involuntary physiological response to the release of oxytocin, a hormone triggered by the baby's suckling. The baby's weight or position on the mother's abdomen does not directly cause the uterine muscle contractions responsible for the cramps. The cramping sensation is a result of the hormonal action within the body, not external pressure.

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Correct Answer is ["C","D","E"]

Explanation

Choice A rationale

Terbutaline (Brethine) is a beta-2 adrenergic receptor agonist used as a tocolytic to relax the uterine muscles and inhibit contractions, primarily to delay preterm labor. Its effect is opposite to what is needed in postpartum hemorrhage, where the goal is to stimulate uterine contractions to stop bleeding. Therefore, it is not used to manage PPH.

Choice B rationale

Magnesium sulfate is a central nervous system depressant and a smooth muscle relaxant. It is primarily used to prevent seizures in preeclampsia and to a lesser extent as a tocolytic. Its muscle-relaxing properties would be counterproductive in a PPH, as uterine contraction is needed to stop bleeding.

Choice C rationale

Carboprost Tromethamine (Hemabate) is a prostaglandin F2 alpha analogue that causes intense uterine contractions. It is effective in managing postpartum hemorrhage by helping the uterus to contract and compress the blood vessels at the placental site, thereby reducing blood loss.

Choice D rationale

Oxytocin (Pitocin) is a synthetic form of the hormone oxytocin. It is a first-line drug used to prevent and treat postpartum hemorrhage. It stimulates powerful and rhythmic contractions of the uterine muscle, which constricts the uterine blood vessels, thereby controlling bleeding.

Choice E rationale

Methylergonovine (Methergine) is an ergot alkaloid that acts on the smooth muscle of the uterus, increasing the tone, rate, and amplitude of contractions. It is highly effective in treating PPH, but it is contraindicated in women with hypertension due to its vasoconstrictive properties

A. 15 minutes. B. 5 minutes. C. 10 minutes. D. 30 minutes.

Correct Answer is B

Explanation

Choice A rationale

While vital signs every 15 minutes may be appropriate for a patient in the immediate postpartum period without complications, it is not frequent enough for a patient who is actively hemorrhaging. A patient who has lost more than 500 mL of blood is at high risk for decompensation, and less frequent monitoring could delay the recognition of critical changes in heart rate or blood pressure, compromising patient safety and outcomes.

Choice B rationale

A patient experiencing a postpartum hemorrhage with a blood loss exceeding 500 mL is at risk for hypovolemic shock. Frequent monitoring of maternal vital signs every 5 minutes allows for early detection of changes in hemodynamic status. Tachycardia and hypotension are key indicators of hypovolemia. This rapid assessment frequency is crucial for timely intervention, such as initiating fluid resuscitation, administering uterotonic medications, or escalating care, to prevent irreversible shock and ensure patient survival.

Choice C rationale

Monitoring vital signs every 10 minutes for a patient with an active postpartum hemorrhage is not sufficient to ensure patient safety. Significant changes in a patient's hemodynamic status, such as a sharp drop in blood pressure or a rapid increase in heart rate, can occur within a few minutes. A 10-minute interval could result in a delayed response to a deteriorating condition, increasing the risk of severe complications or even mortality related to the blood loss.

Choice D rationale

Assessing vital signs every 30 minutes is not appropriate for a patient who is actively bleeding and has lost more than 500 mL of blood. This interval is typically used for a stable postpartum patient with no complications, not one experiencing a medical emergency. The slow pace of assessment could lead to a catastrophic delay in identifying and responding to signs of shock, such as a drop in blood pressure and an increase in heart rate, jeopardizing the patient's life. .

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A new mother calls the nurse into the room to tell her she gets abdominal cramps every time the baby breastfeeds. Which of the following is the correct explanation for this?

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Naxlex Comprehensive Predictor Exams

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

Correct Answer is ["C","D","E"]

Explanation

The nurse is caring for a patient who is actively bleeding and who has already lost more than 500ml of blood following her spontaneous vaginal delivery. In caring for this patient, the nurse initiates maternal vital sign assessments at intervals of:

Correct Answer is B

Explanation

A woman gave birth to an infant boy 6 hours ago. Where would the nurse expect to locate this woman's fundus?

The nurse notices that her postpartum patient has soaked through a large pad in 30 minutes. The nurse assesses the client’s fundus and finds it firm, midline, and at the appropriate height. The nurse should next:

The nurse expects which of the following to be included in the active management of the third stage of labor? SELECT ALL THAT APPLY.

Which of the following could increase a woman's risk for postpartum hemorrhage?

A woman gave birth 48 hours ago to a healthy infant girl. She has decided to bottle-feed. During your assessment, you notice that both of her breasts are swollen, warm, and tender on palpation. The woman should be advised that this condition can best be treated by:

The nurse is teaching the postpartum mother who is ready for discharge.

A patient with a history of chronic hypertension begins to hemorrhage following a precipitous vaginal delivery. The nurse knows that all of the following medications can be administered to this patient, EXCEPT:

A new mother calls the nurse into the room to tell her she gets abdominal cramps every time the baby breastfeeds.
Which of the following is the correct explanation for this?