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?
Encourage bottle feeding.
Give aspirin for pain.
Perform frequent fundal assessments.
Check a CBC in 6 hours.
Correct Answer : C,D
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.
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Correct Answer is B
Explanation
Choice A rationale
Surgical intervention is a secondary measure for obstetric hemorrhage and is considered only after initial non-invasive interventions fail to control bleeding, such as fundal massage and uterotonic medications.
Choice B rationale
Fundal massage is the first-line intervention for uterine atony as it stimulates uterine contractions, reducing blood loss by compressing blood vessels at the placental site and promoting hemostasis.
Choice C rationale
Establishing venous access is essential for fluid resuscitation and medication administration but is not the immediate priority compared to fundal massage for controlling active bleeding.
Choice D rationale
Catheterizing the bladder may help assess urinary output and prevent bladder distension, which can impede uterine contraction, but it is not the initial intervention for hemorrhage.
Correct Answer is B
Explanation
Choice A rationale
Maternal mortality in the United States is among the highest in industrialized nations, with rates significantly exceeding those of comparable countries due to systemic healthcare disparities and limited access to care.
Choice B rationale
The United States has a maternal mortality rate of approximately 18.6 deaths per 100,000 live births, which is higher than other industrialized nations, where rates are often below 10 deaths per 100,000 live births.
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