NUR114 CH23

Card Set Information

Author:
TomWruble
ID:
186823
Filename:
NUR114 CH23
Updated:
2012-12-04 17:32:18
Tags:
nur114f Postpartum Complications
Folders:

Description:
Postpartum Complications
Show Answers:

Home > Flashcards > Print Preview

The flashcards below were created by user TomWruble on FreezingBlue Flashcards. What would you like to do?


  1. Causes of postpartum hemorrhage include ___, ___, ___, ___, and ___.
    • uterine atony
    • genital tract lacerations
    • retained placenta
    • inversion of the uterus
    • subinvolution of the uterus, i.e. failure to return to its normal size and condition
  2. The classic signs of hemorrhagic shock may not appear until the postpartum woman has lost as much as ___% of her blood volume.
    40

    Note vitals signs maty noit be relaiable in the 2-hour period after birth. Overt bleeding, cappilary refill, skin warmth and dryness and a contracted fundus at umbillicus may be best assessment aids.
  3. When postpartum bleeding continues and the source cannot be identified, the woman’s ___ should be assessed.
    coagulation status
  4. The most common postpartum infection is ___. Other infections include wound infections, ___, and ___.
    • endometritis
    • urinary tract infections
    • mastitis
  5. Two hours after giving birth, a primiparous woman becomes anxious and complains of intense perineal pain with a strong urge to have a bowel movement. Her fundus is firm, at the umbilicus, and midline. Her lochia is moderate rubra with no clots. The nurse would suspect:

    A. Bladder distention.
    B. Constipation.
    C. Hematoma formation.
    D. Uterine atony.
    C. Hematoma formation.

    Increasing perineal pressure along with a firm fundus and moderate lochial flow are characteristic of hematoma formation.
    (this multiple choice question has been scrambled)
  6. T/F: Two hours after giving birth, a primiparous woman becomes anxious and complains of intense perineal pain with a strong urge to have a bowel movement. Her fundus is firm, at the umbilicus, and midline. Her lochia is moderate rubra with no clots. The nurse would suspect bladder distention.
    False: Bladder distension would result in an elevation of the fundus above the umbilicus and deviation to the right or left of midline.
  7. Postpartum women experience an increased risk for urinary tract infection. A prevention measure the nurse could teach the postpartum woman would be to:

    A. Acidify the urine by drinking 3 glasses of orange juice each day.
    B. Maintain a fluid intake of 1 to 2 L/day.
    C. Empty bladder every 4 hours throughout the day.
    D. Perform perineal care on a regular basis.
    D. Perform perineal care on a regular basis.
    (this multiple choice question has been scrambled)
  8. T/F: Postpartum women experience an increased risk for urinary tract infection. Teach - Acidify the urine by drinking 3 glasses of orange juice each day.
    False: Urine is acidified with cranberry juice.
  9. T/F: Postpartum women experience an increased risk for urinary tract infection. Teach -Maintain a fluid intake of 1 to 2 L/day.
    False: The woman should drink at least 3 L of fluid each day.
  10. T/F: Postpartum women experience an increased risk for urinary tract infection. Teach - Empty bladder every 4 hours throughout the day.
    False: The woman should empty her bladder every 2 hours to prevent stasis of urine.
  11. Which woman is at greatest risk for early postpartum hemorrhage (PPH)?

    A. A primigravida in spontaneous labor with preterm twins
    B. A multiparous woman (G 3 P 2 0 0 2) with an 8-hour labor
    C. A primiparous woman (G 2 P 1 0 0 1) being prepared for an emergency cesarean birth for fetal distress
    D. A woman with severe preeclampsia on magnesium sulfate whose labor is being induced
    D. A woman with severe preeclampsia on magnesium sulfate whose labor is being induced

    Magnesium sulfate administration during labor poses a risk for PPH. Magnesium acts as a smooth muscle relaxant, thereby contributing to uterine relaxation and atony.
    (this multiple choice question has been scrambled)
  12. The first and most important nursing intervention when a nurse observes profuse postpartum bleeding is to:

    A. Call the woman’s primary health care provider.
    B. Administer the standing order for an oxytocic.
    C. Palpate the uterus and massage it if it is boggy.
    D. Assess maternal blood pressure and pulse for signs of hypovolemic shock.
    C. Palpate the uterus and massage it if it is boggy.

    The other actions ARE all appropriate, but are secondary to assessing for a boggy uterus and firm massage if found.
    (this multiple choice question has been scrambled)
  13. ___ is the leading cause of postpartum hemorrhage (PPH).
    Uterine atony
  14. What PPH conditions are considered medical emergencies that require immediate treatment?

    A. Subinvolution of the uterus and idiopathic thrombocytopenic purpura (ITP)
    B. Inversion of the uterus and hypovolemic shock
    C. Hypotonic uterus and coagulopathies
    D. Uterine atony and disseminated intravascular coagulation (DIC)
    B. Inversion of the uterus and hypovolemic shock

    All others are "serious conditions, [but] they do not necessarily constitute a medical emergency that requires immediate treatment."
    (this multiple choice question has been scrambled)
  15. What infection is contracted mostly by first-time mothers who are breastfeeding?

    A. Wound infections
    B. Urinary tract infections
    C. Endometritis
    D. Mastitis
    D. Mastitis

    None of the other conditions are limited to first-timers.
    (this multiple choice question has been scrambled)
  16. A mother in late middle age who is certain she is not pregnant tells the nurse during an office visit that she has urinary problems and sensations of bearing down and of something in her vagina. The nurse would realize that the woman most likely is suffering from:

    A. Uterine displacement.
    B. Pelvic relaxation.
    C. Cystoceles and/or rectoceles.
    D. Genital fistulas.
    C. Cystoceles and/or rectoceles.

    Cystoceles are protrusions of the bladder downward into the vagina; rectoceles are herniations of the anterior rectal wall through a relaxed or ruptured vaginal fascia. Both can present as a bearing down sensation with urinary dysfunction. They occur more often in older women who have borne children.
    (this multiple choice question has been scrambled)
  17. To provide adequate postpartum care, the nurse should be aware that postpartum depression (PPD) with psychotic features:

    A. May include bipolar disorder (formerly called “manic depression”).
    B. Although serious, is not likely to need psychiatric hospitalization.
    C. Is more likely to occur in women with more than two children.
    D. Is rarely delusional and then usually about someone trying to harm her (the mother).
    A. May include bipolar disorder (formerly called “manic depression”).
    (this multiple choice question has been scrambled)
  18. PPD is more likely to occur in A/B and occur within ___ of birth. It affects ___ of nw mothers and rarely disappears without outside help.

    A. first-time mothers.
    B. women with more than two children.
    A. first-time mothers.

    • 4 weeks
    • 10-15%
  19. T/F: Postpartum depression (PPD) with psychotic features is rarely delusional and then usually about someone trying to harm her (the mother).
    False: Delusions may be present in 50% of women with PPD, usually involving something being wrong with the infant.
  20. PPD with psychotic features affects ___ to ___ births per 1000 and once a has had one episode, she is ___ to ___ likely to reoccur with each subsequent birth.
    • 1 or 2
    • 30%-50%
  21. T/F: PPD with psychosis is a psychiatric emergency that requires hospitalization.
    True
  22. Possible alternative and complementary therapies for postpartum depression (PPD) for breastfeeding mothers include (choose all that apply):

    A.Acupressure.
    B. Aromatherapy.
    C. St. John's wort.
    D. Wine consumption.
    E. Yoga.
    A, B, E

    • St. John's wort has not been proven to be safe for women who are breastfeeding.
    • Women who are breastfeeding and/or have a history of PPD should not consume alcohol.
  23. Pospartum hemorrhage (PPH) is traditionally defned as a loss of ___ after a vaginal birth and ___ after a cesarean.
    • 500mL
    • 1000mL
  24. T/F: PPH is the leading cause of maternal morbidity and mortality in the U.S. and worldwide.
    True
  25. If fundal massage does not abate PPH, ___ may be added via IV. If this also fails, ___ or ___ may be given intramuscularly, although the prostaglandine derivitive ___ is more common. 

    Note: Ergotrate or Methergine are contraindicated for ___ or ___, and the Prostaglandin derivative should be used cautiously for women with ___ or ___.
    • oxytocin
    • Ergotrate or Methergine
    • Carboprost tromethamine
    • HTN or CVD
    • CVD or asthma

What would you like to do?

Home > Flashcards > Print Preview