A woman who has recently given birth complains of pain and tenderness in her leg. On physical examination, the nurse notices warmth and redness over an enlarged, hardened area. Which condition should the nurse suspect, and how will it be confirmed?

Correct Answer: C

Rationale: The correct answer is C: Thrombophlebitis; using real-time and color Doppler ultrasound. Thrombophlebitis is the inflammation of a vein with the formation of a blood clot. In this scenario, the woman's symptoms of pain, tenderness, warmth, redness, and an enlarged, hardened area in her leg are indicative of thrombophlebitis. Using real-time and color Doppler ultrasound will confirm the diagnosis by visualizing the blood clot in the affected vein. This diagnostic method is effective in detecting thrombosis and determining the extent of the clot, guiding appropriate treatment. Incorrect choices: A: Disseminated intravascular coagulation (DIC) is a systemic process causing widespread clotting in small blood vessels, leading to bleeding. Asking for laboratory tests wouldn't be the appropriate way to confirm thrombophlebitis. B: von Willebrand disease (vWD) is a genetic bleeding disorder, and checking

Correct Answer: A

Rationale: The correct answer is A: Uterine atony. A steady trickle of bright red blood with a firm fundus suggests uterine atony, which is the inability of the uterus to contract effectively after childbirth. This can lead to postpartum hemorrhage. Other choices are incorrect as they do not align with the clinical presentation. B: Lacerations of the genital tract would present with more active bleeding and not a steady trickle. C: Perineal hematoma involves bleeding in the perineal area, not from the vagina. D: Infection of the uterus would typically present with other symptoms like fever and foul-smelling discharge.

Correct Answer: A

Rationale: The correct answer is A: Oxytocin. Oxytocin is the first-line medication for managing postpartum hemorrhage (PPH) as it helps in the contraction of the uterus to control bleeding. Methergine (B) is used for uterine atony but is not the first-line choice. Terbutaline (C) is a tocolytic agent and not indicated for PPH. Hemabate (D) is used as a second-line medication for PPH after oxytocin.

Correct Answer: B

Rationale: The correct answer is B because collecting blood in calibrated, under-buttocks drapes for vaginal birth allows for a more accurate estimation of postpartum blood loss. This method provides a quantitative measurement, unlike the subjective method in option A. Option C does not provide a direct measurement of blood loss and may not be accurate. Option D relies on the health care provider's estimate, which may not always be precise or consistent. By using calibrated drapes, the nurse can easily measure and monitor blood loss, ensuring better patient care and outcomes.

Correct Answer: C

Rationale: The correct answer is C because changes in blood pressure may not be an immediate sign of hemorrhage. Hemorrhage can occur rapidly and cause a drop in blood pressure, but it may not be the first sign observed. Vital signs such as blood pressure can fluctuate for various reasons, making it challenging to solely rely on them to identify hemorrhage risk. Elevated blood pressure from prenatal conditions (A) and increased respirations due to labor activity (B) are more likely to be expected and can be explained by those specific factors. Heart rate increasing with the intensity of labor (D) is a common physiological response and may not necessarily indicate hemorrhage.