The nurse is educating her G5P5 postpartum patient at discharge after experiencing a postpartum hemorrhage post-delivery. Which education topics are appropriate for this patient?
Postpartum hemorrhage can occur late, even 2–4 weeks after delivery.
Do not breastfeed for at least 24 hours.
We may send you home on Oxytocin.
Report to the midwife or physician if you saturate your peri-pad in 1 hour or less.
Postpartum hemorrhage only occurs 24–48 hours after birth.
Correct Answer : A,C,D
Choice A rationale
Postpartum hemorrhage may occur weeks after delivery due to subinvolution of the uterus or retained placental fragments. Educating about late risks ensures patients monitor symptoms and seek timely care.
Choice B rationale
Breastfeeding is encouraged even after postpartum hemorrhage as it helps stimulate uterine contractions, reducing bleeding risk. Recommending avoidance could delay recovery and is scientifically unsupported unless contraindicated.
Choice C rationale
Oxytocin may be prescribed for ongoing uterine atony or to prevent late postpartum hemorrhage. It is essential to educate patients about its purpose and correct administration for safety and effectiveness.
Choice D rationale
Saturating a peri-pad within 1 hour may indicate active bleeding. Reporting this promptly ensures swift intervention to prevent further complications, aligning with standard postpartum care protocols.
Choice E rationale
Postpartum hemorrhage is not limited to 24–48 hours after birth; late-onset hemorrhage, occurring up to weeks later, is a known complication. Misleading patients with this incorrect timeframe can delay critical interventions.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
A soft fundus indicates uterine atony, an abnormal finding requiring immediate intervention. This teaching would lead to improper patient monitoring of complications such as hemorrhage.
Choice B rationale
Clots as large as a golf ball are not considered normal and may signal uterine atony or retained placental fragments, which necessitate medical intervention for hemorrhage risk.
Choice C rationale
Decreased brownish-red lochia may reflect normal postpartum changes as it progresses to serosa and alba but is not typically an indicator of complications.
Choice D rationale
Increased lochia or a return to bright red bleeding signals potential complications like subinvolution or late postpartum hemorrhage, which demand prompt medical attention.
Correct Answer is D
Explanation
Choice A rationale
Preterm neonates lack developed mechanisms to shiver for thermogenesis, relying instead on non-shivering thermogenesis primarily through brown fat metabolism, which is underdeveloped in preterm infants.
Choice B rationale
The fetal position does not significantly affect heat retention in preterm neonates, as their thermoregulatory mechanisms depend on adequate fat stores and skin coverage.
Choice C rationale
Blood vessels in preterm neonates are closer to the skin's surface, increasing heat loss due to greater exposure and lack of insulating subcutaneous fat.
Choice D rationale
Preterm neonates have minimal body fat, impeding insulation and heat retention, leading to rapid heat loss, necessitating external warming measures like incubators or radiant warmers.
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