Patient Data
Click to highlight areas of client history and physical that increase the risk for postpartum hemorrhage.
36-year-old client who is gravida 5, para 5, transferred to the postpartum unit 1 hour after delivery of a 9 lb 1 oz (4.1 kg) female. She was in labor for 25 hours and forceps were used to assist with the delivery. She was given an epidural for anesthesia that was effective. The labor and delivery nurse reported that the client had a 4th degree laceration, and her pain was currently at a 4 on a 0 to 10 pain scale. Her vital signs were stable, and she was catheterized for 500 mL of light-yellow urine just prior to delivery. Her spouse was at the bedside for delivery and appeared supportive. Blood type A+. Estimated blood loss was 600 mL after delivery
gravida 5, para 5,
delivery of a 9 lb 1 oz (4.1 kg) female
labor for 25 hours
epidural for anesthesia
4th degree laceration
Estimated blood loss was 600 mL after delivery
forceps were used to assist with the delivery
catheterized for 500 mL of light-yellow urine
spouse was at the bedside for delivery
pain was currently at a 4 on a 0 to 10 pain scale
The Correct Answer is ["A","B","C","D","E","F","G"]
Correct choices;
Gravida 5, para 5 (G5P5)
This means the client has been pregnant 5 times and has given birth 5 times. Multiparity (having had multiple pregnancies and deliveries) is a risk factor for PPH due to uterine overdistension, which can lead to poor uterine tone and difficulty in contracting effectively after delivery.
Delivery of a 9 lb 1 oz (4.1 kg) baby
Larger babies are associated with an increased risk of PPH. The weight of the baby suggests a potentially larger placental surface area and increased uterine distension during pregnancy, which can contribute to uterine atony post-delivery.
Labor for 25 hours
Prolonged labor can lead to uterine exhaustion, where the uterus may not contract effectively after delivery, predisposing the client to PPH.
Forceps-assisted delivery
Instrumental deliveries, including forceps, can cause trauma to the birth canal, including the cervix, vagina, and perineum, increasing the risk of lacerations and bleeding.
Epidural anesthesia
Epidurals can mask the pain associated with uterine atony, which may delay the diagnosis of PPH. It's important to closely monitor uterine tone and blood loss in clients who have had epidurals.
4th degree laceration
Explanation: A 4th degree laceration involves the perineum and extends through the anal sphincter complex. Such extensive trauma increases the risk of significant bleeding postpartum.
Estimated blood loss of 600 mL
Although this is within the normal range of blood loss immediately after delivery, it still signifies that the client has experienced significant hemorrhage, putting her at higher risk for ongoing bleeding.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["12.5"]
Explanation
To calculate the dosage of amoxicillin suspension to be administered every 8 hours, one must first determine the total daily dosage in milligrams. Since 1 gram equals 1000 milligrams, 1.5 grams is equivalent to 1500 milligrams. This total daily dosage needs to be divided into three doses, as it will be administered every 8 hours.
Therefore, each dose will be 1500 mg divided by 3, which equals 500 mg per dose. The medication bottle states that there are 200 mg of amoxicillin in every 5 mL of suspension. To find out how many mL correspond to a 500 mg dose, set up a proportion: 200 mg/5 mL = 500 mg/x mL. Solving for x gives x = (500 mg * 5 mL) / 200 mg, which equals 12.5 mL
Therefore, the nurse should administer 12.5 mL of the amoxicillin suspension every 8 hours.
Correct Answer is A
Explanation
Rationale
A. This action helps maintain adequate cerebral perfusion pressure and venous drainage, which is important in suspected stroke cases. It supports optimal cerebral blood flow and reduces the risk of increased intracranial pressure. However, it's not the immediate intervention required for this client. The primary focus initially is on diagnostic evaluation and stabilization.
B. Elevating the joints on the affected side can help reduce dependent edema and promote circulation. This intervention is part of ongoing nursing care to prevent complications like deep vein thrombosis (DVT) in stroke patients who may have reduced mobility. While important, it is not the immediate priority in the acute phase of management.
C. Gathering a focused history is crucial to understanding potential causes or exacerbating factors contributing to the client's symptoms While important, it is not the immediate priority in the acute phase of management.
D. Intermittent pneumatic compression devices (IPC) are used to prevent deep vein thrombosis (DVT) by enhancing venous return and preventing stasis in the lower extremities. While DVT prevention is important in stroke patients, it is not the immediate intervention required for the client's acute neurological symptoms.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.