ATI RN
Complications of Postpartum Questions
Question 1 of 5
A postpartum patient calls the clinic 4 days after the birth of her newborn because she is extremely tired and her vaginal bleeding is heavier. Which does the nurse anticipate when advising her to come in to the office right now?
Correct Answer: A
Rationale: The correct answer is A) A hematocrit will be drawn, and the licensed provider will check for retained placental fragments. This is the appropriate action because the patient's symptoms of extreme tiredness and heavier vaginal bleeding could indicate postpartum hemorrhage, which is a serious complication requiring immediate medical attention. Checking the hematocrit levels can help assess for anemia due to blood loss, while evaluating for retained placental fragments is crucial as they can lead to ongoing bleeding and infection if left untreated. Option B is incorrect as prescribing sleeping medication does not address the underlying cause of the symptoms, which could be a medical emergency. Option C is incorrect as lacerations would not typically cause extreme tiredness and heavy bleeding. Option D is also incorrect as reassuring the client without proper evaluation could delay necessary treatment for a potentially life-threatening condition. In an educational context, it's essential for healthcare providers to recognize and respond promptly to postpartum complications to ensure the well-being of both the mother and newborn. Understanding the signs and symptoms of postpartum hemorrhage and other complications is crucial for providing safe and effective care to postpartum patients. Prompt assessment and intervention can prevent serious consequences and optimize outcomes for the patient.
Question 2 of 5
A postpartum cesarean patient comes into the rural health clinic at 1 week postdelivery for an incision check by the nurse. The vital signs reveal a temperature of 100.5°F, and the patient reports moderate foul-smelling lochia. The nurse determines that the skin incision is healing normally, but when palpating the uterus, she discovers the patient to have uterine and pelvic tenderness. What are the most appropriate nursing actions?
Correct Answer: D
Rationale: The correct answer is D. In this scenario, the nurse should explain to the patient that the incision is healing well and provide appropriate measures to manage the elevated temperature and pain. It is essential to address the patient's current symptoms and provide symptomatic relief while ensuring proper healing of the incision. Continuing with the ordered pain medication and advising the patient to take Tylenol for the elevated temperature are appropriate actions to manage the immediate concerns. Option A is incorrect because jumping to conclusions about a uterine infection without further assessment or diagnostic tests can lead to unnecessary anxiety for the patient. Option B is incorrect as it dismisses the concerning symptoms of fever and foul-smelling lochia, which could indicate an infection or other complication. Option C is incorrect because the patient's symptoms of uterine tenderness and elevated temperature require immediate attention and should not be dismissed as normal postoperative pain. In an educational context, it is crucial for nurses to recognize and respond to postpartum complications promptly. Understanding the signs and symptoms of postpartum infections, such as fever and foul-smelling discharge, is essential for providing appropriate care and preventing potential complications. Nurses play a key role in early identification and intervention in postpartum complications to ensure optimal patient outcomes.
Question 3 of 5
A patient who has been on prolonged bedrest for bleeding associated with placenta previa was taken to the operating room for an emergency cesarean delivery. Sixteen hours postoperatively, the patient complains that her left leg is hurting. The nurse finds that the entire left leg is swollen and has pitting edema, while the right leg appears to be normal. Which order does the nurse anticipate when paging the health care provider to the room?
Correct Answer: B
Rationale: In this scenario, the correct answer is B) Ultrasound of the leg. The patient's presentation of unilateral leg swelling and pitting edema raises suspicion for deep vein thrombosis (DVT), a common complication postpartum, especially in women who have been on prolonged bedrest. An ultrasound of the leg is the most appropriate diagnostic test to confirm the presence of DVT. Option A) White blood cell count (WBC) is unlikely to be the priority in this case as the patient's symptoms are more suggestive of a vascular issue rather than an infectious process. Option C) X-ray of the leg is not the preferred initial imaging modality for evaluating DVT. Ultrasound is more sensitive and specific for detecting DVT. Option D) Serum creatinine is not relevant to the patient's presentation of unilateral leg swelling and pitting edema. It is more indicative of renal function and not the primary concern in this context. From an educational perspective, it is crucial for healthcare providers to recognize the signs and symptoms of DVT in postpartum patients, as prompt diagnosis and treatment are essential to prevent serious complications such as pulmonary embolism. Understanding the appropriate diagnostic approach in such cases is vital for providing safe and effective care to this patient population.
Question 4 of 5
One hour after a woman gives birth vaginally, the nurse notes that her fundus is firm, 2 fingerbreadths above the umbilicus, and deviated to the right. Lochia rubra is moderate. Her perineum is slightly edematous, with no bruising; an ice pack is in place. The priority nursing action is to:
Correct Answer: B
Rationale: The priority nursing action in this scenario is to have the woman empty her bladder (Option B). This is essential because a full bladder can displace the uterus, leading to potential complications such as uterine atony or hemorrhage. By ensuring the bladder is empty, the nurse helps the uterus contract effectively, reducing the risk of postpartum hemorrhage. Option A is incorrect because while it is important to document normal assessments, addressing the full bladder takes precedence due to its potential impact on uterine contraction. Option C is incorrect as removing the ice pack could lead to increased swelling and discomfort in the perineal area, which is not a priority at this time. Option D is incorrect because increasing the rate of oxytocin infusion without addressing the full bladder first may not effectively manage the situation. In an educational context, it is crucial for nurses to prioritize interventions based on their potential impact on patient outcomes. Understanding the physiological processes postpartum and how different factors can influence them is key to providing safe and effective care to women during the postpartum period. This case highlights the importance of basic nursing assessments and interventions in preventing complications following childbirth.
Question 5 of 5
The nurse's initial response if a pulmonary embolism is suspected should be to:
Correct Answer: B
Rationale: In the scenario of suspected pulmonary embolism in a postpartum patient, the nurse's initial response should be to raise the head of the bed and administer oxygen (Option B). This action is crucial as it helps to improve oxygenation and perfusion to vital organs, which is essential in managing a potential pulmonary embolism. Raising the head of the bed promotes optimal lung expansion and ventilation, while administering oxygen supports adequate oxygenation. These interventions are fundamental in stabilizing the patient's condition and preventing further complications related to hypoxia or respiratory distress. The other options are incorrect for several reasons: A) Starting a second IV line and preparing for transfusion is not the priority in a suspected pulmonary embolism. Immediate respiratory support takes precedence over initiating additional IV access. C) Inserting a catheter to monitor urine output is not the most urgent action in this critical situation. Monitoring urine output is important for assessing renal function but is not the primary intervention needed for a suspected pulmonary embolism. D) Lowering the head of the bed and elevating the legs is contraindicated in a suspected pulmonary embolism as it can further compromise oxygenation by impeding venous return to the heart, potentially exacerbating the embolism and leading to hemodynamic instability. In an educational context, understanding the prioritization of interventions in emergencies like pulmonary embolism is essential for nurses to provide safe and effective care. Critical thinking skills and quick decision-making are crucial in such situations to ensure the best outcomes for patients.