What assessment finding suggests a possible infection?

Correct Answer: A

Rationale: In the context of postpartum complications, a painful fundal massage suggests a possible infection. This is because uterine tenderness and pain during fundal massage can be indicative of endometritis, which is a common postpartum infection. This assessment finding is crucial for early detection and timely intervention to prevent further complications. Option B, breast-feeding every 2-3 hours, is a normal postpartum activity and does not specifically suggest an infection. Option C, pulse 72, may be within normal range and is not a definitive sign of infection. Option D, WBCs 10, is a bit vague without a specified unit of measurement or reference range, so it does not conclusively point towards infection either. Educationally, understanding the signs and symptoms of postpartum complications, such as infection, is vital for healthcare providers working with postpartum patients. Recognizing subtle indications like a painful fundal massage can help in prompt diagnosis and appropriate management, ultimately improving maternal outcomes. It also emphasizes the importance of thorough assessments in postpartum care to ensure early detection of any potential issues.

Correct Answer: C

Rationale: In managing a perineal laceration infection, the nursing intervention of encouraging the use of a peri-bottle for cleaning front to back is crucial. This intervention promotes proper hygiene, reduces the risk of introducing new pathogens, and prevents the spread of infection. By using the peri-bottle, the patient can cleanse the perineal area effectively without causing further trauma to the laceration site. Option A, demonstrating the use of a urinary catheter, is incorrect as it is not a recommended intervention for treating a perineal laceration infection unless specifically indicated for urinary retention or other medical reasons. Using a catheter in this context may increase the risk of introducing bacteria and worsening the infection. Option B, providing an abdominal binder, is also incorrect as it is not directly related to managing a perineal laceration infection. An abdominal binder is typically used for providing support postpartum or after abdominal surgeries and does not address the specific care needs of a perineal laceration infection. Option D, discouraging the use of pain medications, is not appropriate as pain management is an essential aspect of care for a person with a perineal laceration infection. Pain medications help alleviate discomfort, promote rest, and improve the patient's overall well-being during the healing process. Educationally, understanding the rationale behind each intervention helps nurses provide evidence-based care tailored to the patient's needs. By prioritizing proper hygiene practices like using a peri-bottle, nurses can contribute to the effective management of perineal laceration infections and promote positive patient outcomes.

Correct Answer: C

Rationale: In pharmacology, understanding complications of postpartum hemorrhage (PPH) is crucial for healthcare professionals. The correct answer, option C, is characteristic of an early (primary) PPH because it often occurs due to uterine atony, which is the inability of the uterus to contract effectively after childbirth. This leads to excessive bleeding within 24 hours post-delivery. Option A is incorrect because an early PPH occurs within the first 24 hours, not after 12 weeks postpartum. Option B is incorrect because early PPH is indeed an emergency requiring prompt intervention to prevent severe consequences like hypovolemic shock. Option D is incorrect as the diagnosis of early PPH is made during the postpartum period before discharge due to clinical signs and symptoms such as excessive bleeding. Educationally, this question reinforces the importance of recognizing the causes and characteristics of early PPH, with a focus on uterine atony as a significant factor. Understanding the timing, risk factors, and management of PPH is essential for healthcare providers involved in maternal care to ensure timely interventions and prevent maternal morbidity and mortality.

Correct Answer: A

Rationale: In the context of postpartum hemorrhage (PPH), the 4 T's are a mnemonic used to categorize the potential causes of PPH: Tone, Trauma, Tissue, and Thrombin. When considering the "tissue" component, the correct answer is A) Placental tissue or membranes are retained. This is because retained placental tissue after delivery can lead to excessive bleeding and is a common cause of PPH. Option B) Tissue of the perineum is torn is incorrect as perineal tears, while they can contribute to bleeding, are not specifically categorized under the "tissue" component of the 4 T's. Option C) Tissue of the uterus is torn is also incorrect as uterine tears would typically fall under the "trauma" category. Option D) Tissue is not perfused is unrelated to the concept of tissue in the context of PPH. Understanding the 4 T's of PPH is crucial for healthcare providers involved in maternal care as it helps in systematic assessment and management of postpartum bleeding. Recognizing the specific causes under each category can guide appropriate interventions to address the underlying issue effectively and prevent serious complications for the mother.

Correct Answer: C

Rationale: In the context of pharmacology and the complications of postpartum, the correct answer to the question regarding a risk factor for PPH found in the prenatal record being von Willebrand disorder (option C) is based on the understanding of hemostasis and bleeding disorders. Von Willebrand disorder is a hereditary bleeding disorder characterized by a deficiency or dysfunction of von Willebrand factor, which plays a crucial role in primary hemostasis by mediating platelet adhesion. A) Primipara (option A) refers to a woman who is giving birth for the first time and while primiparity can be a risk factor for PPH due to uterine atony, it is not directly linked to von Willebrand disorder. B) Rubella nonimmune (option B) is not a risk factor for PPH. Rubella is a viral infection that can lead to congenital rubella syndrome if contracted during pregnancy but does not directly contribute to postpartum hemorrhage. D) History of appendectomy (option D) is not a known risk factor for PPH related to von Willebrand disorder. While surgical history can sometimes play a role in complications during childbirth, it is not specifically associated with von Willebrand disorder. Educationally, understanding the risk factors for postpartum hemorrhage is crucial for healthcare providers involved in maternal care to identify high-risk patients and provide appropriate interventions to prevent or manage complications effectively. Knowledge of conditions like von Willebrand disorder and their impact on hemostasis is essential for comprehensive prenatal and postpartum care.