What assessment data increases the risk of postpartum infection?

Correct Answer: A

Rationale: In the context of pharmacology, understanding postpartum complications is crucial for healthcare professionals. The correct answer is A) precipitous labor. This is because precipitous labor, defined as labor lasting less than 3 hours from the onset of contractions to delivery, can lead to increased risk of postpartum infection due to potential tissue trauma, increased exposure to vaginal flora, and inadequate time for proper cleansing and disinfection. Option B) urinary retention is not directly related to an increased risk of postpartum infection. While urinary retention can lead to urinary tract infections, it is not a direct risk factor for postpartum infections. Option C) breast-feeding, on the contrary, can actually help reduce the risk of postpartum infection by promoting uterine contractions, which aids in expelling placental remnants and reducing the risk of infection. Option D) intact perineum also does not directly increase the risk of postpartum infection. In fact, a perineum that is intact and well-healed can lower the risk of infection compared to a perineum with lacerations or tears. Educationally, it is important for healthcare providers to recognize the risk factors for postpartum infections to provide appropriate care and interventions to prevent complications. Understanding how different factors such as labor duration can impact the risk of infection is essential for pharmacology students and practitioners to ensure safe and effective patient care during the postpartum period.

Correct Answer: A

Rationale: In the context of postpartum endometritis, which is an infection of the uterine lining following childbirth, the correct nursing intervention of monitoring for signs of sepsis (Option A) is crucial. Endometritis can lead to systemic infection, including sepsis, which is a life-threatening condition. By monitoring for signs of sepsis such as fever, rapid heart rate, low blood pressure, and altered mental status, the nurse can promptly identify and initiate appropriate treatment to prevent further complications. Option B, discouraging breastfeeding, is incorrect. Breastfeeding is not contraindicated in cases of endometritis unless there are specific reasons such as the mother being on medications that are unsafe for the baby. Option C, avoiding fundal assessment, is also incorrect. Fundal assessment is important postpartum to monitor uterine involution and to detect any abnormalities such as excessive bleeding that may indicate complications like hemorrhage, not specifically related to endometritis. Option D, increasing family visiting hours, is not a priority intervention for a person with postpartum endometritis. While family support is important, the immediate focus should be on monitoring for and managing the infection to prevent further complications. In an educational context, understanding the rationale behind each nursing intervention is crucial for providing safe and effective care to patients. Nurses need to prioritize interventions based on the patient's condition and the potential risks involved to ensure optimal outcomes. Monitoring for signs of sepsis in a person with postpartum endometritis is a critical nursing intervention that can ultimately save lives by enabling early detection and treatment of a potentially life-threatening complication.

Correct Answer: B

Rationale: In the context of postpartum hemorrhage (PPH), a late (secondary) PPH typically occurs 24 hours to 12 weeks after delivery. The correct answer, option B, stating that it is caused by subinvolution of the uterus, is accurate. Subinvolution refers to the delayed return of the uterus to its normal non-pregnant size after childbirth, leading to prolonged bleeding. Option A is incorrect because PPH that occurs within the first 24 hours is classified as an early (primary) PPH. Option C is incorrect as late PPH can occur after any type of delivery, including cesarean births. Option D is also incorrect as Methergine is a common medication used to treat PPH, including late PPH, as it helps in uterine contraction to control bleeding. Understanding the timing and causes of different types of PPH is crucial for healthcare providers involved in maternal care. Recognizing the characteristics of late PPH helps in early identification and appropriate management to prevent complications and ensure maternal well-being.

Correct Answer: C

Rationale: In the context of postpartum complications, uterine atony is a significant concern due to its association with postpartum hemorrhage. Uterine atony occurs when the uterus fails to contract effectively after childbirth, leading to excessive bleeding. Multiple gestation (Option C) is a risk factor for uterine atony because the uterus is often distended and larger in multiple gestations, making it more difficult for the uterus to contract effectively and leading to an increased risk of atony. Options A, B, and D are not directly related to uterine atony. Being small for gestational age (Option A) does not inherently increase the risk of uterine atony. Primiparity (Option B), or being a first-time mother, is not a direct risk factor for uterine atony, although primiparas may have a slightly higher risk of postpartum hemorrhage in general. Intrauterine growth restriction (Option D) is a condition where a fetus does not reach its growth potential in the uterus, but it is not a direct risk factor for uterine atony. Understanding risk factors for postpartum complications like uterine atony is crucial for healthcare providers involved in maternal care. By recognizing these risk factors, healthcare professionals can implement preventive measures and interventions to manage and reduce the incidence of complications, ensuring better outcomes for both mother and baby.

Correct Answer: D

Rationale: In this scenario, the correct intervention is option D: Massage the fundus and assess the lochia. This is the appropriate action because a boggy uterus combined with a full bladder can indicate uterine atony, which is a common postpartum complication leading to excessive bleeding. Massaging the fundus helps the uterus contract, controlling bleeding, while assessing the lochia provides information about the amount and character of postpartum bleeding, aiding in the evaluation of the patient's condition. Option A (Call for help) is not the immediate action needed in this situation. While help may eventually be required, addressing the physiological issue should be the priority. Option B (Start IV bolus) is also not the first step because the primary concern is managing the uterine atony and potential hemorrhage. Fluid resuscitation may be necessary later, but it is not the initial intervention. Option C (Get the person out of bed to walk to restroom) is incorrect as it does not address the urgent need to manage the uterine atony and assess for postpartum hemorrhage. Moving the patient could potentially worsen the bleeding if the uterine atony is not addressed first. This scenario highlights the critical importance of prompt assessment and intervention in the postpartum period to prevent and manage complications effectively. Nurses need to be knowledgeable about postpartum complications and skilled in recognizing and addressing them promptly to ensure positive outcomes for both the mother and the newborn.