The nurse is assigned to care for the postpartum client during her shift.
The nurse knows one of the most common risk factors for early (PPH) postpartum hemorrhage is uterine atony. When providing care, the nurse would plan to:.
Have the client void frequently.
Massage the uterus.
Have the client in a side-lying position for comfort.
Keep the patient on strict bed rest for 24 hours to avoid stress on the uterus.
The Correct Answer is B
Massaging the uterus helps it contract and prevent excessive bleeding after delivery. Uterine atony is a condition where the uterus does not contract enough to clamp the blood vessels that supply the placenta, leading to postpartum hemorrhage. Uterine massage is one of the interventions to treat uterine atony and restore uterine tone.
Choice A is wrong because having the client void frequently does not directly affect the uterine contraction. However, a full bladder can interfere with uterine contraction and cause displacement of the uterus, so it is important to monitor the bladder status and empty it as needed.
Choice C is wrong because having the client in a side-lying position for comfort does not help with uterine contraction. However, this position may be beneficial for other reasons, such as reducing edema and pain in the perineal area.
Choice D is wrong because keeping the patient on strict bed rest for 24 hours to avoid stress on the uterus does not help with uterine contraction. In fact, early ambulation after delivery can help prevent thromboembolic complications and promote recovery.
Normal ranges for postpartum blood loss are less than 500 mL for vaginal delivery and less than 1000 mL for cesarean delivery. Postpartum hemorrhage is defined as blood loss greater than or equal to 1000 mL or blood loss accompanied by signs or symptoms of hypovolemia within 24 hours after birth.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
The correct answer is choice A. A patient who weighed less than 5 lb (2,268 gm) at birth is at risk for having an infant with intrauterine growth retardation (IUGR).This is because low birth weight is a possible indicator of genetic factors or placental insufficiency that can affect fetal growth.
Choice B is wrong because an ectopic pregnancy one year ago does not increase the risk of IUGR.An ectopic pregnancy is when the fertilized egg implants outside the uterus, usually in the fallopian tube.It does not affect the placental function or fetal development in a subsequent pregnancy.
Choice C is wrong because a mitral valve prolapse does not increase the risk of IUGR.
A mitral valve prolapse is when the valve between the left atrium and left ventricle of the heart does not close properly.It usually does not cause any symptoms or complications during pregnancy, unless it is associated with severe regurgitation or arrhythmias.
Choice D is wrong because the father’s age of 42 years old does not increase the risk of IUGR.The father’s age may affect the risk of chromosomal abnormalities or congenital anomalies in the fetus, but not the fetal growth.
Some of the other risk factors for IUGR include maternal smoking, alcohol, or drug use, medical conditions like anemia or lupus, infections such as rubella or syphilis, carrying twins or multiples, high blood pressure, gestational diabetes, and placenta problems.
Correct Answer is A
Explanation
The correct answer is choice A: “The discharge that you are describing is normal at this time.” This is because the client is experiencing lochia serosa, which is a brownish discharge that occurs from about day 4 to day 10 postpartum.
Lochia serosa is composed of old blood, serum, leukocytes, and tissue debris.
It indicates that the placental site is healing and the uterus is involuting.
Choice B is wrong because fever is a sign of infection, not normal lochia.
Choice C is wrong because ovulation usually does not resume until 6 weeks postpartum for nonbreastfeeding women and later for breastfeeding women.
Choice D is wrong because iron supplements do not affect lochia color or amount.
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