A nurse is assessing a client who had a cesarean birth and is experiencing postpartum hemorrhage due to uterine dehiscence.

Which of the following manifestations should alert the nurse to this complication?

Abdominal pain and tenderness

Foul-smelling lochia and fever

Absent or decreased bowel sounds and distension

Heavy vaginal bleeding and clots

Answer and Explanation

The Correct Answer is D

Heavy vaginal bleeding and clots are symptoms of postpartum hemorrhage due to uterine dehiscence. Uterine dehiscence is the opening of the incision line after cesarean section and it is a rare complication. It can be caused by infection, hematoma, suture technique or trauma.

Choice A is wrong because abdominal pain and tenderness are more likely to be caused by other postpartum complications such as endometritis, wound infection, hematoma or uterine rupture.

Choice B is wrong because foul-smelling lochia and fever are signs of postpartum infection such as endometritis or wound abscess.

Choice C is wrong because absent or decreased bowel sounds and distension are not specific to postpartum hemorrhage. They can be caused by ileus, bowel obstruction, peritonitis or other abdominal disorders.

Normal ranges for blood loss after delivery are less than 500 mL for vaginal delivery and less than 1000 mL for cesarean delivery. Normal ranges for vital signs after delivery are pulse 50 to 90 beats/minute, blood pressure 85/60 to 140/90 mm Hg, respiratory rate 12 to 20 breaths/minute and temperature 36.2 to 37.6 °C.

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Correct Answer is B

Explanation

This is because a boggy uterus that is displaced to the right of midline indicates that the bladder is full and pushing the uterus out of place.A full bladder can prevent the uterus from contracting effectively after delivery, leading to excessive bleeding and postpartum hemorrhage (PPH).

Emptying the bladder can help the uterus return to its normal position and tone.

Choice A is wrong because applying ice packs to the perineum may help reduce swelling and pain, but it will not address the underlying cause of the boggy uterus.

Choice C is wrong because increasing the rate of IV fluids may worsen the bleeding by diluting the blood and reducing its clotting ability.

Choice D is wrong because administering carboprost, a medication that stimulates uterine contractions, may be indicated if other measures fail to restore uterine tone, but it is not the first action to take.Carboprost also has side effects such as fever, nausea, vomiting, and diarrhea.

Normal ranges for uterine size and position after delivery are:

• Immediately after delivery: at or slightly below the level of the umbilicus (navel)

• 6 hours after delivery: 1 fingerbreadth above the umbilicus

• 12 hours

A. Methylergonovine maleate (Methergine) B. Magnesium sulfate (MgSO4) C. Oxytocin (Pitocin) D. Carboprost tromethamine (Hemabate) E. Misoprostol (Cytotec)

Correct Answer is ["A","C","D","E"]

Explanation

The correct answer is choice A, C, D and E. These medications are all uterotonic agents that can stimulate uterine contractions and reduce bleeding.

They act on different receptors in the uterus and have different side effects and contraindications.

Choice B is wrong because magnesium sulfate is a tocolytic agent that can relax uterine muscles and prevent preterm labor.

It is not indicated for postpartum hemorrhage and can worsen uterine atony.

Normal ranges for postpartum blood loss are less than 500 mL for vaginal delivery and less than 1000 mL for cesarean delivery.

Uterine atony is the most common cause of postpartum hemorrhage and occurs when the uterus fails to contract adequately after delivery.

Risk factors include prolonged or rapid labor, overdistension of the uterus, multiparity, retained placenta, infection and anesthesia.

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A nurse is assessing a client who had a cesarean birth and is experiencing postpartum hemorrhage due to uterine dehiscence. Which of the following manifestations should alert the nurse to this complication?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who delivered vaginally 4 hours ago and has a boggy uterus that is displaced to the right of midline. Which of the following actions should the nurse take first?

Correct Answer is B

Explanation

A nurse is caring for a client who has just delivered a baby and is experiencing postpartum hemorrhage due to uterine atony. Which of the following medications should the nurse anticipate administering? Select all that apply:

Correct Answer is ["A","C","D","E"]

Explanation

A nurse is caring for a client who experienced a postpartum hemorrhage after delivering a large baby following oxytocin induction of labor. Which of the following factors put this client at risk for developing postpartum hemorrhage? (Select all that apply)

A nurse is caring for a client who has postpartum hemorrhage and is receiving IV fluids and blood products. Which of the following interventions should the nurse include in the plan of care? (Select all that apply.)

A nurse is assessing a client who had a cesarean birth and is experiencing postpartum hemorrhage due to uterine dehiscence. Which of the following manifestations should alert the nurse to this complication?

A nurse is caring for a client who delivered vaginally 4 hours ago and has saturated two perineal pads in 15 minutes. The nurse identifies this as which of the following types of postpartum hemorrhage?

Which of the following is a risk factor for postpartum hemorrhage?

A nurse is preparing to administer methylergonovine to a client who has a postpartum hemorrhage due to uterine atony. Which of the following assessments should the nurse perform prior to administration?

A nurse is caring for a client who has just delivered her baby and is at risk for postpartum hemorrhage (PPH). Which intervention should be included in this client’s plan of care?

A nurse is evaluating the effectiveness of interventions for a client who has postpartum hemorrhage due to retained placental fragments. Which of the following outcomes indicates that the interventions are successful?

A nurse is assessing a client who had a cesarean birth and is experiencing postpartum hemorrhage due to uterine dehiscence.

Which of the following manifestations should alert the nurse to this complication?