A 25-year-old client experienced a severe postpartum hemorrhage following the vaginal birth of twins and is now transferred to the postpartum unit.
What complication should the nurse prioritize during the client’s assessment?
Hard, painful uterine afterpains.
Disseminated intravascular coagulation.
Postpartum psychosis.
Placenta accreta.
The Correct Answer is B
Choice A rationale
While hard, painful uterine afterpains can be uncomfortable for the patient, they are a normal part of the postpartum period and are not typically a priority complication following a severe postpartum hemorrhage16.
Choice B rationale
Disseminated intravascular coagulation (DIC) is a serious condition that can occur as a complication of severe postpartum hemorrhage. It involves an overactive clotting process leading to the formation of small blood clots that can block blood vessels and cause significant organ damage16.
Choice C rationale
Postpartum psychosis is a serious mental health disorder that can occur after childbirth. However, it is not directly related to postpartum hemorrhage and would not typically be the priority complication in this scenario16.
Choice D rationale
Placenta accreta is a condition where the placenta grows too deeply into the uterine wall. While it can cause severe bleeding after delivery, it would not typically be a priority complication to assess for following a severe postpartum hemorrhage16.
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Related Questions
Correct Answer is B
Explanation
Choice A rationale
While notifying the healthcare provider is important, it is not the first action to take. The nurse should first address the immediate issue of a potentially full bladder that could be displacing the uterus.
Choice B rationale
Encouraging the client to void can help if the bladder is full. A full bladder can displace the uterus and interfere with uterine contractions, leading to increased bleeding.
Choice C rationale
Administering ibuprofen can help with cramping, but it does not address the immediate issue of a potentially full bladder displacing the uterus.
Choice D rationale
Increasing the intravenous fluid rate is not the first action to take. The nurse should first address the immediate issue of a potentially full bladder displacing the uterus.
Correct Answer is B
Explanation
Choice A rationale
Cervical dilation is a sign of labor, but a dilation of 1 cm alone does not confirm active labor. It could be the early phase of labor or false labor.
Choice B rationale
Contractions that decrease with walking are typically associated with false labor. In true labor, contractions usually get stronger regardless of activity level.
Choice C rationale
While 2+ pitting edema in the lower extremities can be seen in pregnancy, it is not a reliable indicator of labor. It could be due to fluid retention or other conditions.
Choice D rationale
The status of the membranes (intact or ruptured) does not necessarily indicate whether a woman is in labor. Some women may experience membrane rupture before labor begins.
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