A nurse on a postpartum unit is caring for a client. For each finding, click to specify if the finding is consistent with uterine atony or infection.

Exhibits

Each finding may support more than 1 disease process or none at all. There must be at least 1 selection in every column. There does not need to be a selection in every row. Note: Each column must have at least 1 response option selected

Rationale:

• Prolonged rupture of membranes: Membranes ruptured for over 24 hours (28 hr), increasing the risk for ascending bacterial infections such as endometritis or chorioamnionitis.
• Prenatal anemia: Anemia reduces immune function and tissue oxygenation, making the client more susceptible to postpartum infections, including uterine and systemic infections.
• Polyhydramnios: Excessive amniotic fluid causes uterine overdistension, which weakens uterine contractility and increases the risk of atony and postpartum hemorrhage.
• High parity: Repeated stretching of the uterus in grand multiparity reduces muscle tone, making the uterus less responsive to postpartum contraction and more prone to atony.

Rationale:

A. "Preventing readmissions will decrease overutilization of services.": Preventing avoidable hospital readmissions reduces repeated use of costly healthcare resources, improves patient outcomes, and avoids financial penalties tied to excessive readmissions.

B. "Hiring travel nurses is an effective method of cost containment.": While travel nurses fill staffing gaps, they often come at a higher cost due to agency fees, housing, and incentives. Relying on them long-term is generally not considered cost-effective.

C. "Purchasing more expensive items will improve quality health outcomes.": Higher cost does not always translate to better outcomes. Cost-effectiveness involves achieving the best results at the lowest possible cost, not simply spending more on supplies or equipment.

D. "Planning a 10-year budget will ensure cost-effective care.": Long-term planning is helpful, but health care demands and costs change rapidly. Effective cost management requires regular review and adjustment, not just extended projections.