The most effective and least expensive treatment of puerperal infection is prevention. What is the most important strategy for the nurse to adopt?

Correct Answer: C

Rationale: The most important strategy for the nurse to adopt in preventing puerperal infection is option C, which is the strict aseptic technique, including hand washing, by all health care personnel. Puerperal infection, also known as postpartum infection, is a serious complication following childbirth that can lead to severe consequences if not prevented. Maintaining proper hygiene practices, such as hand washing and using aseptic techniques, is crucial in preventing the spread of pathogens that can cause infections. This simple yet effective measure can significantly reduce the risk of puerperal infections among postpartum women. Large doses of vitamin C during pregnancy (option A) may have benefits for overall health but are not specifically proven to prevent puerperal infections. Prophylactic antibiotics (option B) may be used in certain cases but are not the primary strategy for prevention in all cases. Limiting protein and fat intake (option D) is not a recommended approach

Correct Answer: D

Rationale: Placenta abruptio, also known as abruptio placentae, is the premature separation of the placenta from the uterine wall before delivery. It is not classified as an abnormal adherence pattern like placenta accreta, increta, and percreta. Placenta accreta occurs when the placenta attaches too deeply into the uterine wall. Placenta increta is when the placenta invades the myometrium, and placenta percreta is when it penetrates through the myometrium and reaches the serosa. These abnormal adherence patterns are associated with risks and complications during pregnancy and delivery, while placenta abruptio is a separate condition related to premature placental separation.

Correct Answer: C

Rationale: Desmopressin (DDAVP) is the initial treatment for a client with von Willebrand disease (vWD) who experiences a postpartum hemorrhage (PPH). Desmopressin works by releasing von Willebrand factor (vWF) stored in the endothelial cells, increasing the levels of vWF and factor VIII. This can help improve clotting function in patients with vWD, thereby helping to stop the bleeding. It is a safe and effective treatment for many individuals with vWD and is often used as the first-line therapy in cases of bleeding episodes or surgeries. Cryoprecipitate may also be used in severe bleeding situations if desmopressin is ineffective. Hemabate is not indicated for the treatment of vWD and PPH.

Correct Answer: A

Rationale: Hysterectomy is a surgical procedure that involves the removal of the uterus. In cases where nonsurgical treatment for late postpartum hemorrhage (PPH) is ineffective, and the cause of the condition is related to the uterus (such as retained placental tissue, uterine atony, or placenta accreta), a hysterectomy may be necessary to stop the bleeding and correct the underlying issue. Hysterectomy is considered a definitive treatment for PPH when other interventions have failed to control the bleeding.

Correct Answer: A

Rationale: A. Operative and precipitate births: Obstetric lacerations of the lower genital tract are more likely to occur during operative deliveries (such as forceps or vacuum-assisted deliveries) and precipitate births (very rapid deliveries) due to the increased forces and speed involved during these types of deliveries.