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: The correct answer is B: Performing fundal massage. Fundal massage helps to stimulate contractions of the uterus, which can help control bleeding in cases of uterine atony. This is a primary nursing responsibility to address the immediate cause of the hemorrhage. Establishing venous access (choice A) is important but not the primary responsibility in this situation. Preparing for surgical intervention (choice C) may be necessary if conservative measures fail, but it is not the initial step. Catheterizing the bladder (choice D) is not directly related to managing obstetric hemorrhage associated with uterine atony.

Correct Answer: C

Rationale: Rationale: Choice C is correct because strict aseptic technique, including hand washing, is crucial in preventing puerperal infection by minimizing the transmission of pathogens. Proper hand hygiene is a fundamental practice in infection control. Choices A, B, and D are incorrect because large doses of vitamin C, prophylactic antibiotics, and limited protein and fat intake do not directly address the primary mode of infection transmission and prevention for puerperal infection. Vitamin C, antibiotics, and dietary restrictions are not the primary strategies in preventing puerperal infections compared to the importance of proper hand hygiene and aseptic technique.

Correct Answer: B

Rationale: The correct answer is B because it accurately defines the criteria for postpartum hemorrhage (PPH). PPH is traditionally defined as losing more than 1000 ml of blood after vaginal birth and 2500 ml after cesarean birth. This definition helps healthcare providers recognize and manage PPH effectively. Now, let's analyze why the other choices are incorrect: A: This statement is incorrect because PPH may not always be easy to recognize early based solely on visible bleeding. Other signs and symptoms, such as tachycardia and hypotension, also play a crucial role in identifying PPH. C: This statement is incorrect because underestimating, rather than overestimating, the amount of blood loss in PPH can lead to delayed intervention and potentially worsen the patient's condition. D: This statement is incorrect because PPH is not classified based on timing (early or late PPH), but rather on the amount of blood loss as defined in choice B.

Correct Answer: D

Rationale: The correct answer is D: Placenta abruptio. Placenta abruptio is not a type of abnormal adherence pattern; instead, it refers to the premature detachment of a normally implanted placenta. Placenta accreta, increta, and percreta are abnormal adherence patterns where the placenta attaches too deeply into the uterine wall. Accreta is when it attaches but does not penetrate, increta is when it penetrates into the myometrium, and percreta is when it penetrates through the myometrium. Therefore, Placenta abruptio is the correct answer as it does not fall under the category of abnormal adherence patterns like the other choices.

Correct Answer: C

Rationale: The correct initial treatment for vWD client with PPH is desmopressin (Choice C) because it stimulates the release of von Willebrand factor and factor VIII from storage sites, helping to improve clotting. Cryoprecipitate (Choice A) contains multiple clotting factors and is usually reserved for severe bleeding. Factor VIII and vWf (Choice B) can be used for severe cases but are not typically the initial treatment. Hemabate (Choice D) is a medication used for postpartum hemorrhage due to uterine atony, not specifically for vWD-related bleeding.