Hemabate has been ordered for a postpartum patient who has uncontrolled bleeding and uterine atony. Which is the appropriate nursing action?

Correct Answer: C

Rationale: The correct answer is C. The rationale is as follows: 1. Hemabate is a medication used to treat postpartum hemorrhage due to uterine atony. 2. Checking the patient's record for a history of asthma is crucial as Hemabate can exacerbate asthma symptoms. 3. Asking the provider for an antidiarrheal medication is appropriate to manage potential side effects of Hemabate. 4. Checking vital signs for hypotension (Choice A) is important but not the immediate nursing action. 5. Checking blood glucose and increasing IV fluids (Choice B) are not directly related to the administration of Hemabate. 6. Checking for a history of hypothyroid and asking for anti-nausea medication (Choice D) is irrelevant to Hemabate administration.

Correct Answer: C

Rationale: The correct answer is C: Remove the IV, restart it in a new location, and complete the antibiotic administration. This is the correct action because the patient's IV site is showing signs of infection (redness, inflammation, swelling, tenderness). By removing the IV, the nurse can prevent the spread of infection and restart the antibiotic infusion in a new, sterile site to ensure proper treatment. A: Flushing the IV with normal saline will not address the underlying issue of infection and may worsen the patient's condition. B: Putting the IV antibiotic on a pump for more accurate infusion does not address the fact that the current IV site is infected and needs to be removed. D: Allowing the IV to continue to drip slowly is not appropriate when the site is showing signs of infection.

Correct Answer: A

Rationale: Late postpartum hemorrhage (PPH), defined as occurring between 24 hours and up to 12 weeks after delivery, is most commonly due to subinvolution of the uterus. This occurs when the uterus fails to return to its normal pre-pregnancy size. Subinvolution can be caused by retained products of conception, uterine infection, uterine anomalies, or inadequate contraction of the uterine muscles. When the uterus does not contract effectively, it is unable to compress the blood vessels at the site of the placental attachment, leading to persistent bleeding. Subinvolution of the uterus is an important cause of late PPH and requires prompt intervention to prevent excessive blood loss and its associated complications.

Correct Answer: D

Rationale: Hemorrhagic shock is characterized by inadequate tissue perfusion due to severe blood loss, leading to decreased circulating volume. The body's compensatory mechanisms kick in to maintain blood pressure, causing the peripheral blood vessels to constrict. This constriction can lead to cool, clammy, and pale skin as the body shunts blood away from the skin's surface to the vital organs. The skin may also feel cool to the touch due to reduced perfusion. This observation is significant in indicating hemorrhagic shock because it signifies the body's response to the insufficient circulating volume and the need to prioritize perfusion to essential organs.

Correct Answer: D

Rationale: One of the initial signs and symptoms of puerperal infection in the postpartum client is an elevated temperature. A temperature of 38° C (100.4° F) or higher on 2 successive days is indicative of an infection. This can be a key indicator for healthcare providers to suspect puerperal infection, also known as postpartum infection or postpartum sepsis. It is important to monitor postpartum clients closely for any signs of infection, especially in the immediate postpartum period. Prompt recognition and management of puerperal infection is crucial to prevent serious complications for the mother.