A nurse is evaluating a client who had a postpartum hemorrhage and received fluid resuscitation and blood transfusion therapy.

Which of the following findings indicates an improvement in the client’s condition?

Urine output of 40 mL/hr

Pulse rate of 110 beats/min

Hematocrit level of 32%

Blood pressure of 90/60 mm Hg

Answer and Explanation

The Correct Answer is A

Urine output of 40 mL/hr indicates an improvement in the client’s condition. According to the MSF Medical Guidelines, the objective of resuscitation in postpartum hemorrhage is to maintain a urine output of at least 30 mL/hour.

A urine output of 40 mL/hr suggests that the client has adequate fluid replacement and blood transfusion therapy.

Choice B is wrong because a pulse rate of 110 beats/min is still high and indicates tachycardia.

Tachycardia is a sign of hypovolemia and shock due to blood loss. The normal pulse rate for an adult is 60 to 100 beats/min.

Choice C is wrong because a hematocrit level of 32% is low and indicates anemia.

Anemia is a complication of postpartum hemorrhage due to reduced red blood cell count. The normal hematocrit level for women is 36% to 48%.

Choice D is wrong because a blood pressure of 90/60 mm Hg is low and indicates hypotension.

Hypotension is a sign of hypovolemia and shock due to blood loss. The normal blood pressure for an adult is 120/80 mm Hg.

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Correct Answer is B

Explanation

This is because a boggy uterus that is displaced to the right of midline indicates that the bladder is full and pushing the uterus out of place.A full bladder can prevent the uterus from contracting effectively after delivery, leading to excessive bleeding and postpartum hemorrhage (PPH).

Emptying the bladder can help the uterus return to its normal position and tone.

Choice A is wrong because applying ice packs to the perineum may help reduce swelling and pain, but it will not address the underlying cause of the boggy uterus.

Choice C is wrong because increasing the rate of IV fluids may worsen the bleeding by diluting the blood and reducing its clotting ability.

Choice D is wrong because administering carboprost, a medication that stimulates uterine contractions, may be indicated if other measures fail to restore uterine tone, but it is not the first action to take.Carboprost also has side effects such as fever, nausea, vomiting, and diarrhea.

Normal ranges for uterine size and position after delivery are:

• Immediately after delivery: at or slightly below the level of the umbilicus (navel)

• 6 hours after delivery: 1 fingerbreadth above the umbilicus

• 12 hours

A. The client reports minimal cramping and discomfort B. The client has a firm and midline uterus at the umbilicus C. The client passes small clots with moderate lochia rubra D. The client has a pulse rate of 100 beats/min and a blood pressure of 110/70 mm Hg

Correct Answer is B

Explanation

The client has a firm and midline uterus at the umbilicus.This indicates that the interventions for postpartum hemorrhage due to retained placental fragments are successful because the uterus has contracted and expelled the fragments, and there is no excessive bleeding.

Choice A is wrong because minimal cramping and discomfort are not specific signs of successful interventions for postpartum hemorrhage.

They may also occur in normal postpartum recovery.

Choice C is wrong because passing small clots with moderate lochia rubra may indicate that there are still some retained placental fragments or that the uterus is not contracting adequately.

Choice D is wrong because a pulse rate of 100 beats/min and a blood pressure of 110/70 mm Hg are not normal ranges for an adult.A pulse rate of 60 to 100 beats/min and a blood pressure of less than 120/80 mm Hg are considered normal.A high pulse rate and a low blood pressure may indicate hypovolemia or shock due to blood loss.

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A nurse is evaluating a client who had a postpartum hemorrhage and received fluid resuscitation and blood transfusion therapy. Which of the following findings indicates an improvement in the client’s condition?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who delivered vaginally 4 hours ago and has a boggy uterus that is displaced to the right of midline. Which of the following actions should the nurse take first?

Correct Answer is B

Explanation

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?

Correct Answer is B

Explanation

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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.)

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A nurse is evaluating a client who had a postpartum hemorrhage and received fluid resuscitation and blood transfusion therapy.

Which of the following findings indicates an improvement in the client’s condition?