What is the primary nursing responsibility when caring for a client who is experiencing an obstetric hemorrhage associated with uterine atony?

Correct Answer: B

Rationale: Performing fundal massage is the primary nursing responsibility when caring for a client who is experiencing an obstetric hemorrhage associated with uterine atony. Uterine atony is a common cause of postpartum hemorrhage, where the uterus fails to contract and retract after childbirth, leading to excessive bleeding. Fundal massage helps stimulate uterine contractions and assists in controlling the bleeding. Establishing venous access, preparing the woman for surgical intervention, and catheterizing the bladder are important interventions as well, but fundal massage takes priority in managing uterine atony and preventing further blood loss.

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: B

Rationale: The most accurate statement regarding the basic definitions and incidence data of postpartum hemorrhage (PPH) is statement B. Traditionally, PPH is defined as losing more than 1000 ml of blood after vaginal birth and more than 2500 ml after cesarean birth. This definition helps healthcare providers recognize and diagnose PPH based on the amount of blood loss, which is crucial for prompt intervention and management.

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.