ATI RN
Complication Postpartum Questions
Question 1 of 5
The nurse is assisting the primary care provider with the third stage of a vaginal delivery. The patient is multiparous, experienced a precipitous birth, and has a history of hypertension. Which medical prescription does the nurse anticipate for this patient?
Correct Answer: C
Rationale: In this scenario, the correct answer is C) Carboprost-tromethamine. The rationale behind this choice lies in understanding the pharmacology of these medications in managing postpartum complications. Carboprost-tromethamine is a prostaglandin analog that is used to prevent or treat postpartum hemorrhage, which is a significant risk in this patient due to her multiparity, precipitous birth, and history of hypertension. This medication helps in uterine contractions and vasoconstriction, thus aiding in controlling excessive bleeding during the third stage of labor. Regarding why the other options are incorrect: A) Methylergonovine is a uterotonic agent but is contraindicated in patients with hypertension due to its vasoconstrictive effects, which could exacerbate hypertension. B) Fresh frozen plasma is not indicated for postpartum hemorrhage. It is used to replace clotting factors in conditions like disseminated intravascular coagulation. D) Magnesium sulfate is used for conditions like preeclampsia and eclampsia to prevent seizures, not for managing postpartum hemorrhage. In an educational context, understanding the rationale behind choosing the correct medication is crucial for nurses caring for postpartum patients. It emphasizes the importance of considering the patient's history, risk factors, and the pharmacological effects of each medication to provide safe and effective care. This case highlights the critical role of pharmacology knowledge in nursing practice to ensure optimal patient outcomes.
Question 2 of 5
The lactation nurse takes a phone call from a mother who is breastfeeding her 2-month-old infant. The mother reports an area of redness and warmth on the breast and a painful burning sensation when breastfeeding. Which statement by the nurse is correct if mastitis is suspected?
Correct Answer: D
Rationale: In this scenario, the correct answer is D) Continuing to breastfeed will help clear up the condition. This statement is accurate because in the case of mastitis, continuing to breastfeed is crucial. Breastfeeding helps to drain the affected breast, preventing the build-up of milk that can worsen the infection. It also helps maintain milk production and prevent complications like engorgement or blocked ducts. Option A is incorrect because stopping breastfeeding can lead to decreased milk supply and potentially worsen the condition. Option B is also incorrect as it is unnecessary to throw away breast milk unless advised by a healthcare provider. Option C is incorrect because mastitis is not transmitted from the baby; it is usually caused by a blocked milk duct or bacteria entering the breast through a cracked nipple. From an educational standpoint, it is essential for healthcare professionals to provide accurate information to breastfeeding mothers to promote successful breastfeeding and address common concerns like mastitis. Understanding the importance of continued breastfeeding in managing mastitis is crucial for both the mother's health and the infant's well-being. Supporting mothers with correct information can help them navigate challenges and continue breastfeeding successfully.
Question 3 of 5
The nurse on a postpartum unit observes a patient who delivered 2 days ago. The nurse notices extreme agitation and depressed mood. The patient states, “I think that my baby is deformed inside and we have to fix him.” Which risk factor is most strongly related to possible postpartum psychosis (PPP)?
Correct Answer: B
Rationale: The correct answer is B) Personal history of bipolar disorder. Postpartum psychosis (PPP) is a severe form of postpartum mental illness that can manifest with symptoms such as extreme agitation, delusions, and hallucinations. Women with a personal history of bipolar disorder are at a significantly higher risk for developing PPP due to the underlying vulnerability to mood disturbances and psychotic symptoms. Option A) Separation from the baby’s father is not directly linked to PPP. While support from the baby's father can be beneficial, it is not a primary risk factor for PPP. Option C) Prolonged labor resulting in cesarean is a physical risk factor and is not strongly associated with the development of PPP. Option D) Loss of the first child from a heart defect is a traumatic event but is not as strongly related to PPP as a personal history of bipolar disorder, which directly affects the individual's mental health. Educationally, understanding the risk factors for postpartum complications like PPP is crucial for healthcare providers working in maternal health to identify and support women at risk. Proper screening, early intervention, and appropriate referral to mental health professionals are essential in managing postpartum mental health issues effectively.
Question 4 of 5
The nurse is aware of concern about the increasing numbers of severe maternal morbidity (SMM). It is believed to be related to changes in the overall health of the population of women giving birth. Which reasons does the nurse identify as causes of SMM? Select all that apply.
Correct Answer: B
Rationale: Documented increases in maternal age is a likely cause for SMM; older women have increased risk. Obesity is a general health risk in the United States; prepregnancy obesity causes increased incidences of SMM. Cesarean deliveries are increasing, and surgical procedures always carry a risk for complications. Preexisting chronic medical conditions are a contributor to the increasing rates of SMM.
Question 5 of 5
A postpartum patient informs the nurse of a frequent urge and burning when attempting to urinate. The nurse reviews the patient’s medical record and associates which risk factors related to a possible urinary tract infection (UTI)? Select all that apply.
Correct Answer: C
Rationale: Neonatal macrosomia, which can cause edema around the urethra, is a risk factor for UTI. Operative vaginal deliveries, forceps, or vacuum extractor, which can cause edema around the urethra, is a risk factor for UTI. Poor oral fluid intake and urinary catheter insertion during the labor process are also risk factors.