The obstetric nurse is preparing the client for an emergency cesarean birth, with no time to administer spinal anesthesia; general anesthesia will be used.
What is the greatest risk of administering general anesthesia to the client during postpartum?

Choice A rationale

Elevating the mother's legs may help with venous return and circulation, but it does not directly address a soft and boggy uterus, which indicates uterine atony and a risk for hemorrhage. The immediate priority is to promote uterine contraction.

Choice B rationale

A soft and boggy uterus indicates uterine atony, a primary cause of postpartum hemorrhage. Massaging the fundus stimulates the uterine muscles to contract, which helps to compress the blood vessels at the placental site and reduce bleeding. This is the most appropriate initial intervention to address uterine atony.

Choice C rationale

Encouraging the mother to void is important in the postpartum period as a full bladder can displace the uterus and interfere with its ability to contract. However, in the presence of a soft and boggy uterus, the immediate priority is to directly stimulate uterine contraction through fundal massage before addressing bladder emptying.

Choice D rationale

Pushing on the uterus to express clots without first ensuring the uterus is firm is contraindicated. A soft, atonic uterus is more susceptible to inversion if pressure is applied. Fundal massage should be performed first to encourage uterine contraction and firmness before attempting to express any clots.

Choice A rationale

The risk for newborn infection is primarily associated with prolonged rupture of membranes or maternal infection during labor, not directly with the administration of general anesthesia during a cesarean birth.

Choice B rationale

While the postpartum period is a time of increased risk for DVT due to hormonal changes and decreased mobility, general anesthesia itself does not significantly increase this risk compared to regional anesthesia. Surgical procedures in general increase DVT risk.

Choice C rationale

General anesthesia can lead to uterine atony, a condition where the uterus fails to contract adequately after delivery. This lack of contraction can result in postpartum hemorrhage, making postpartum bleeding the greatest risk associated with general anesthesia in this scenario.

Choice D rationale

The risk for infection is primarily associated with the surgical incision and the postpartum period in general, not specifically with the type of anesthesia used during the cesarean birth.