A nurse is assessing a client who had a cesarean birth and is experiencing postpartum hemorrhage due to uterine dehiscence.

Which of the following manifestations should alert the nurse to this complication?

Abdominal pain and tenderness

Foul-smelling lochia and fever

Absent or decreased bowel sounds and distension

Heavy vaginal bleeding and clots

Answer and Explanation

The Correct Answer is D

Heavy vaginal bleeding and clots are symptoms of postpartum hemorrhage due to uterine dehiscence. Uterine dehiscence is the opening of the incision line after cesarean section and it is a rare complication. It can be caused by infection, hematoma, suture technique or trauma.

Choice A is wrong because abdominal pain and tenderness are more likely to be caused by other postpartum complications such as endometritis, wound infection, hematoma or uterine rupture.

Choice B is wrong because foul-smelling lochia and fever are signs of postpartum infection such as endometritis or wound abscess.

Choice C is wrong because absent or decreased bowel sounds and distension are not specific to postpartum hemorrhage. They can be caused by ileus, bowel obstruction, peritonitis or other abdominal disorders.

Normal ranges for blood loss after delivery are less than 500 mL for vaginal delivery and less than 1000 mL for cesarean delivery. Normal ranges for vital signs after delivery are pulse 50 to 90 beats/minute, blood pressure 85/60 to 140/90 mm Hg, respiratory rate 12 to 20 breaths/minute and temperature 36.2 to 37.6 °C.

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Correct Answer is ["A","B"]

Explanation

The correct answer is choice A and B.Administering oxytocin after delivery is an effective way to prevent and treat uterine atony, which is the most common cause of PPH.Encouraging frequent voiding can help reduce bladder distension, which can interfere with uterine contraction and increase bleeding.

Choice C is wrong because assessing vital signs every 4 hours is not frequent enough for a client who is at risk for PPH.Vital signs should be monitored every 15 minutes for the first hour, then every hour for the next 4 hours, and then every 4 hours thereafter.

Choice D is wrong because encouraging ambulation as soon as possible can increase the risk of bleeding and shock in a client who has retained placental fragments.Ambulation should be delayed until the fragments are removed and the bleeding is controlled.

A. "I will need to take iron supplements for at least 6 months." B. "I will avoid lifting anything heavier than my baby for 2 weeks." C. "I will resume sexual intercourse as soon as I feel ready." D. "I will seek counseling if I have feelings of grief or loss."

Correct Answer is D

Explanation

“I will seek counseling if I have feelings of grief or loss.” This statement indicates that the client understands the potential psychological impact of having a hysterectomy due to postpartum hemorrhage and placenta accreta, which is a condition where the placenta invades the uterine wall and causes severe bleeding.The client may experience emotional distress, such as sadness, anger, guilt, or anxiety, due to the loss of fertility and the traumatic event.

Seeking counseling can help the client cope with these feelings and adjust to the changes in her life.

Choice A is wrong because iron supplements are not necessary for at least 6 months after a hysterectomy.Iron supplements are usually prescribed for anemia caused by blood loss, but the duration of treatment depends on the severity of the anemia and the client’s response to therapy.

The client should have regular blood tests to monitor her hemoglobin and iron levels and follow the advice of her health care provider regarding iron supplementation.

Choice B is wrong because avoiding lifting anything heavier than the baby for 2 weeks is not enough to prevent complications after a hysterectomy.

A hyster ...

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A nurse is assessing a client who had a cesarean birth and is experiencing postpartum hemorrhage due to uterine dehiscence. Which of the following manifestations should alert the nurse to this complication?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has just delivered her baby and is at risk for PPH due to retained placental fragments. Which interventions should be included in this client’s plan of care? (Select all that apply.)

Correct Answer is ["A","B"]

Explanation

A nurse is providing discharge instructions to a client who had postpartum hemorrhage due to placenta accreta and underwent hysterectomy. Which of the following statements by the client indicates an understanding of the teaching?

Correct Answer is D

Explanation

A nurse is providing discharge instructions to a client who had postpartum hemorrhage and received blood transfusions during her hospital stay. Which of the following information should the nurse include in the teaching? (Select all that apply)

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A nurse is caring for a client who has postpartum hemorrhage and is receiving IV fluids and blood products. Which of the following interventions should the nurse include in the plan of care? (Select all that apply.)

A nurse is caring for a client who delivered vaginally 4 hours ago and has saturated two perineal pads in 15 minutes. The nurse identifies this as which of the following types of postpartum hemorrhage?

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A nurse is caring for a client who has just delivered a baby and is experiencing postpartum hemorrhage due to retained placental fragments. Which of the following interventions should the nurse anticipate? Select all that apply:

A nurse is evaluating the effectiveness of interventions for a client who has postpartum hemorrhage due to retained placental fragments. Which of the following outcomes indicates that the interventions are successful?

Which of the following is a nursing intervention for postpartum hemorrhage?

A nurse is assessing a client who had a cesarean birth and is experiencing postpartum hemorrhage due to uterine dehiscence.

Which of the following manifestations should alert the nurse to this complication?