ATI RN
Complications of Postpartum Questions
Question 1 of 5
The nurse is taking the postpartum patient’s vital signs. The newborn is across the room in the bassinet, and the postpartum person refuses to hold the newborn. What should the nurse do?
Correct Answer: B
Rationale: The correct answer is B. The nurse should ask the postpartum person if they are feeling depressed, hopeless, afraid, or overwhelmed. This is important because it can help assess the person's mental and emotional state, which could be contributing to their refusal to hold the newborn. It also shows empathy and support for the person's feelings. Choice A is incorrect because calling Child Protective Services (CPS) would be premature and could escalate the situation unnecessarily. Choice C is incorrect as starting an antidepressant should only be considered after a thorough evaluation by a healthcare provider. Choice D is incorrect because it does not address the underlying issue of the person's emotional state and may come off as judgmental.
Question 2 of 5
The nurse is admitting a 38-year-old patient to triage in early labor with ruptured membranes. Her history includes a previous vaginal delivery 4 years ago and the presence of a uterine fibroid. What interventions are appropriate based on the hemorrhage risk for this patient?
Correct Answer: A
Rationale: Step 1: The patient is in early labor with ruptured membranes, which increases the risk of hemorrhage. Step 2: The presence of a uterine fibroid also contributes to the hemorrhage risk. Step 3: Previous vaginal delivery 4 years ago does not significantly alter the hemorrhage risk. Step 4: Ordering a type and screen will allow for rapid access to blood products if needed in case of hemorrhage. Step 5: This is a moderate hemorrhage risk situation, warranting the need for preparing for potential blood transfusion. Summary: - Choice B is incorrect as ordering 4 units of packed red blood cells is excessive for a moderate hemorrhage risk. - Choice C is incorrect as a hold tube will not provide immediate access to blood products in case of hemorrhage. - Choice D is incorrect as blood should be drawn to be prepared for potential hemorrhage in a moderate risk situation.
Question 3 of 5
A woman is 1 hour postcesarean delivery with nausea and an estimated blood loss of 1,200 mL. She is currently experiencing heavy vaginal bleeding and has a uterus that firms with massage. She has a history of asthma with a current O2 saturation of 89%. The licensed provider has ordered Cytotec 800 mcg and Methergine 0.2 mg. What collaborative communication should occur between the nurse and provider?
Correct Answer: D
Rationale: The correct answer is D: Recommend that the patient not get Methergine because she has a history of asthma. Methergine is contraindicated in patients with a history of asthma due to its potential to cause bronchospasm and worsen respiratory function. As the patient has a history of asthma with a current low O2 saturation, administering Methergine could exacerbate her respiratory status. Collaborative communication between the nurse and provider is crucial to ensure patient safety and avoid potential complications. Summary of other choices: A: Delaying administration of Cytotec and Methergine is not appropriate as the patient is experiencing heavy vaginal bleeding and needs prompt management. B: Giving Cytotec rectally and considering the route for Methergine do not address the contraindication of Methergine in a patient with asthma. C: Removing the abdominal dressing to inspect for incisional bleeding may be necessary but does not address the contraindication of Methergine in a
Question 4 of 5
A postpartum patient calls the clinic 4 days after the birth of her newborn because she is extremely tired and her vaginal bleeding is heavier. Which does the nurse anticipate when advising her to come in to the office right now?
Correct Answer: A
Rationale: The correct answer is A. The nurse anticipates that a hematocrit will be drawn and the provider will check for retained placental fragments because heavy vaginal bleeding and extreme fatigue could indicate postpartum hemorrhage due to retained placental tissue. This is a serious complication that requires immediate medical attention to prevent further complications such as infection or hemorrhagic shock. Choice B is incorrect because prescribing sleeping medication does not address the underlying cause of the symptoms. Choice C is incorrect because lacerations would typically have been evaluated and repaired during delivery, and would not likely be missed. Choice D is incorrect because reassuring the client without further evaluation could lead to potential serious consequences if the underlying issue of retained placental fragments is not addressed promptly.
Question 5 of 5
The nurse is assessing a patient who is 12 hours postpartum. The uterus is firm to palpation, at midline, and is 1 cm below the umbilicus with continuous heavy vaginal bleeding. What is the nurse’s first action?
Correct Answer: A
Rationale: The correct answer is A: Massage the uterus and resume the IV Pitocin drip. The patient is showing signs of uterine atony with heavy vaginal bleeding. Massaging the uterus helps stimulate contractions, controlling bleeding. Resuming IV Pitocin enhances uterine contractions further. Choices B, C, and D are incorrect. Changing the peri-pad does not address the underlying cause of bleeding. Checking for a cervical laceration may be needed later but is not the immediate priority. Administering iron supplement and ibuprofen does not address the acute issue of uterine atony and bleeding.