ATI RN
Complications of Postpartum Questions
Question 1 of 5
Which is the initial treatment for the client with vWD who experiences a PPH?
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.
Question 2 of 5
Lacerations of the cervix, vagina, or perineum are also causes of PPH. Which factors influence the causes and incidence of obstetric lacerations of the lower genital tract? (Select all that apply.)
Correct Answer: A
Rationale: The correct answer is A because operative and precipitate births increase the risk of obstetric lacerations due to the rapid delivery or use of instruments. Operative births involve interventions like forceps or vacuum extraction, which can cause trauma. Precipitate births, characterized by rapid labor and delivery, may lead to tearing of the lower genital tract. Choices B, C, and D are incorrect as they do not directly influence the causes and incidence of obstetric lacerations. Adherent retained placenta, abnormal fetal presentation, and congenital abnormalities of maternal soft tissue are not primary factors contributing to lacerations during childbirth.
Question 3 of 5
The nurse is aware the greatest source of bleeding during childbirth occurs following detachment of the placenta. Which physiological change takes place immediately after the expulsion of the placenta to decrease the amount of blood loss?
Correct Answer: A
Rationale: The correct answer is A: Contractions of the uterine myometrium. After the placenta is expelled, the uterine myometrium contracts, causing compression of blood vessels at the site of placental detachment, which helps to decrease blood loss. This contraction also helps to close off blood vessels and reduce the risk of postpartum hemorrhage. Summary of other choices: B: Factor VIII complex increases during gestation - Factor VIII is involved in blood clotting, but its increase during gestation is not directly related to decreasing blood loss after placental expulsion. C: Platelet activity increases before labor and delivery - While platelet activity is important for blood clotting, the increase before labor and delivery does not specifically address the immediate decrease in blood loss after placental expulsion. D: Fibrin formation increases before the birth occurs - Fibrin formation is part of the clotting process, but its increase before birth does not directly address the immediate decrease in blood loss post
Question 4 of 5
The nurse continues to monitor a patient after a vaginal delivery with an estimated blood loss of 1,000 mL. Which assessment finding does the nurse recognize as requiring Stage 3 hemorrhage protocol?
Correct Answer: C
Rationale: The correct answer is C: Development of abnormal vital signs. Stage 3 hemorrhage protocol is initiated when vital signs such as tachycardia, hypotension, and tachypnea are present, indicating severe blood loss. Increased patient restlessness (choice A) and manifestations of severe pain (choice B) are important but do not specifically indicate Stage 3 hemorrhage. Patient requesting water for extreme thirst (choice D) is not a typical sign of hemorrhage. Abnormal vital signs are the key indicator for initiating Stage 3 hemorrhage protocol as they reflect the body's compensatory mechanisms in response to significant blood loss.
Question 5 of 5
The nurse is closely monitoring a patient who is postpartum and at risk for PPH. Which assessment finding will cause the nurse to contact the primary care provider immediately?
Correct Answer: D
Rationale: The correct answer is D. A peripad weighing 100 g within 15 minutes indicates excessive postpartum bleeding, requiring immediate intervention to prevent hypovolemic shock. A displaced uterus (choice A) and small clots with massage (choice C) are expected findings after delivery and can be managed with appropriate interventions. A boggy uterine fundus (choice B) may indicate uterine atony but does not necessarily require immediate notification unless accompanied by excessive bleeding.