ATI RN
Complications of Postpartum Questions
Question 1 of 5
Lacerations of the cervix, vagina, or perineum are also causes of PPH. Which factors influence the causes and incidence of obstetric lacerations of the lower genital tract? (Select all that apply.)
Correct Answer: A
Rationale: The correct answer is A because operative and precipitate births increase the risk of obstetric lacerations due to the rapid delivery or use of instruments. Operative births involve interventions like forceps or vacuum extraction, which can cause trauma. Precipitate births, characterized by rapid labor and delivery, may lead to tearing of the lower genital tract. Choices B, C, and D are incorrect as they do not directly influence the causes and incidence of obstetric lacerations. Adherent retained placenta, abnormal fetal presentation, and congenital abnormalities of maternal soft tissue are not primary factors contributing to lacerations during childbirth.
Question 2 of 5
The nurse continues to monitor a patient after a vaginal delivery with an estimated blood loss of 1,000 mL. Which assessment finding does the nurse recognize as requiring Stage 3 hemorrhage protocol?
Correct Answer: C
Rationale: The correct answer is C: Development of abnormal vital signs. Stage 3 hemorrhage protocol is initiated when vital signs such as tachycardia, hypotension, and tachypnea are present, indicating severe blood loss. Increased patient restlessness (choice A) and manifestations of severe pain (choice B) are important but do not specifically indicate Stage 3 hemorrhage. Patient requesting water for extreme thirst (choice D) is not a typical sign of hemorrhage. Abnormal vital signs are the key indicator for initiating Stage 3 hemorrhage protocol as they reflect the body's compensatory mechanisms in response to significant blood loss.
Question 3 of 5
The nurse is closely monitoring a patient who is postpartum and at risk for PPH. Which assessment finding will cause the nurse to contact the primary care provider immediately?
Correct Answer: D
Rationale: The correct answer is D. A peripad weighing 100 g within 15 minutes indicates excessive postpartum bleeding, requiring immediate intervention to prevent hypovolemic shock. A displaced uterus (choice A) and small clots with massage (choice C) are expected findings after delivery and can be managed with appropriate interventions. A boggy uterine fundus (choice B) may indicate uterine atony but does not necessarily require immediate notification unless accompanied by excessive bleeding.
Question 4 of 5
The nurse is providing postpartum care for a patient after a vaginal delivery. Which assessment finding causes the nurse to suspect endometritis from beta-hemolytic streptococcus?
Correct Answer: D
Rationale: The correct answer is D, an elevated temperature greater than 100.4°F. Endometritis, an infection of the uterine lining, commonly caused by beta-hemolytic streptococcus, often presents with a fever. This is a key sign of infection, indicating the presence of an inflammatory process. The other choices are incorrect because: A: Scant amount of odorless lochia is indicative of normal postpartum discharge, not necessarily endometritis. B: Headache, malaise, and chills are non-specific symptoms that could be present in various conditions, not specific to endometritis. C: Pain or discomfort in the midline lower abdomen could be related to postpartum uterine contractions or other causes, but it is not a specific finding for endometritis.
Question 5 of 5
The nurse is preparing discharge teaching for a postpartum patient who exhibits signs and symptoms of an episiotomy infection and is on oral antibiotic therapy. Which discharge teaching will the nurse provide regarding pain management?
Correct Answer: B
Rationale: The correct answer is B: Information applicable to medication therapy. The rationale is that proper pain management is crucial for patient comfort and healing. The nurse should educate the patient on the importance of taking the prescribed pain medication as directed to manage pain effectively. This includes information on dosage, frequency, and potential side effects. Hot packs (Choice A) may not be recommended for an infected episiotomy as heat can exacerbate the infection. Ambulation (Choice C) is important for circulation, but it may not directly address pain management. Medicating for pain above level 4 (Choice D) is vague and does not provide specific guidance on when to take pain medication.