A nurse is caring for a patient who just stabilized after she had a postpartum hemorrhage with a QBL of 1300 ml. Which of the following are priorities for her care?

Choice A rationale

Difficulty breathing can indicate an anaphylactic reaction, a rare but serious side effect of Hemabate. It involves bronchoconstriction triggered by prostaglandin administration, usually necessitating emergency interventions.

Choice B rationale

Diarrhea is common due to prostaglandin's stimulation of smooth muscle in the gastrointestinal tract, leading to increased motility. This adverse effect often accompanies other systemic effects like cramping.

Choice C rationale

Hypotension, while possible, is less frequent and usually transient. It may result from the vasodilatory properties of prostaglandins but is not a primary side effect.

Choice D rationale

Palpitations occur less commonly and may arise if Hemabate induces systemic changes affecting heart rate, including reflex tachycardia secondary to other hemodynamic shifts.

Choice A rationale

Bottle feeding does not impact recovery from postpartum hemorrhage. Breastfeeding promotes oxytocin release, aiding uterine contractions to minimize bleeding risk, unlike bottle feeding, which has no therapeutic impact.

Choice B rationale

Aspirin is contraindicated postpartum as it increases bleeding risk due to its antiplatelet effects. Analgesic alternatives like acetaminophen are preferred for pain relief in hemorrhage recovery settings.

Choice C rationale

Frequent fundal assessments monitor for uterine atony, a leading hemorrhage cause. Ensuring the uterus remains firm and contracted is critical in preventing recurrent excessive blood loss postpartum.

Choice D rationale

A CBC after six hours checks hemoglobin, hematocrit, and platelet levels, identifying ongoing bleeding or anemia. Timely lab evaluation ensures appropriate interventions like transfusions or iron supplementation.