A nurse is preparing to discharge a client who had a postpartum hemorrhage due to uterine atony.
Which of the following instructions should the nurse include in the teaching? (Select all that apply)
Report any foul-smelling lochia or fever
Increase iron intake and take iron supplements as prescribed
Avoid sexual intercourse until the lochia has stopped
Limit fluid intake to prevent fluid overload
Perform pelvic floor exercises daily to strengthen the muscles
Correct Answer : A,B,C,E
These are the instructions that the nurse should include in the teaching for a client who had a postpartum hemorrhage due to uterine atony.
• Choice A is correct because foul-smelling lochia or fever can indicate an infection of the uterus or other reproductive organs, which can worsen bleeding and cause complications.
• Choice B is correct because iron intake and supplements can help replenish the blood loss and prevent anemia.
• Choice C is correct because sexual intercourse can cause trauma to the healing tissues and increase the risk of infection and bleeding. The lochia usually stops within four to six weeks after delivery.
• Choice D is wrong because limiting fluid intake can cause dehydration and impair blood circulation and clotting. The client should drink plenty of fluids to stay hydrated and promote healing.
• Choice E is correct because pelvic floor exercises can help strengthen the muscles that support the uterus and bladder, and prevent prolapse and urinary incontinence.
Uterine atony is a condition where the uterus does not contract enough after delivery, which can lead to excessive bleeding or postpartum hemorrhage. It is the most common cause of postpartum hemorrhage, accounting for up to 80% of cases. It can be caused by several factors, such as multiple pregnancy, large baby, prolonged or rapid labor, obesity, uterine fibroids, or medications that affect uterine contractions. It requires immediate medical treatment to stop the bleeding and prevent shock and organ failure.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Perineal hematoma.A perineal hematoma is a collection of blood in the soft tissues of the perineum that can result from trauma during delivery, such as vacuum-assisted birth.The client may present with a large, tense, bluish bulge on the perineum and severe pain in the area.
Choice B. Vulvar varicosity is wrong because it is a condition where the veins in the vulva become enlarged and swollen due to increased blood flow and pressure during pregnancy.It usually appears as bluish or purple veins on the vulva and may cause discomfort, itching, or heaviness in the area.
It is not related to vacuum-assisted birth or prolonged labor.
Choice C. Rectocele is wrong because it is a condition where the rectum bulges into the vagina due to weakening of the pelvic floor muscles and connective tissue.
It may cause symptoms such as difficulty with bowel movements, a feeling of pressure or fullness in the vagina, or sexual dysfunction.
It is not related to vacuum-assisted birth or prolonged labor.
Choice D. Episiotomy is wrong because it is a surgical incision made in the perineum to enlarge the vaginal opening during delivery.
It may be done to facilitate delivery, prevent severe tearing, or protect the baby’s head from trauma.
It is not a diagnosis but a procedure that may be performed during vacuum-assisted birth or normal vaginal delivery.
Correct Answer is A
Explanation
This is when the uterus does not contract enough to stop the bleeding from the placental site after delivery.It is the most common cause of postpartum hemorrhage.A boggy, deviated and above the umbilicus fundus indicates uterine atony.
Choice B. Retained placenta is wrong because it occurs when some or all of the placenta remains in the uterus after delivery.It can also cause postpartum hemorrhage, but it usually presents with a firm fundus and a continuous trickle of blood.
Choice C. Uterine inversion is wrong because it is a rare condition where the uterus turns inside out after delivery.It can also cause postpartum hemorrhage, but it usually presents with severe pain, shock and a palpable mass at the introitus.
Choice D. Cervical laceration is wrong because it is a tear in the cervix that can occur during delivery.It can also cause postpartum hemorrhage, but it usually presents with a firm fundus and bright red bleeding that does not respond to uterine massage.
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