The initial nursing intervention when caring for a woman experiencing an obstetric hemorrhage associated with uterine atony is to:
Prepare the woman for surgical intervention.
Perform fundal massage.
Establish venous access.
Catheterize the bladder.
The Correct Answer is B
Choice A rationale
Surgical intervention is not the initial step for uterine atony as conservative measures, such as fundal massage, are prioritized to encourage uterine contraction and reduce bleeding.
Choice B rationale
Fundal massage stimulates uterine contraction by mechanically compressing the myometrium, which helps to constrict the spiral arteries and reduce hemorrhage caused by uterine atony.
Choice C rationale
Establishing venous access is critical for fluid resuscitation but does not directly address the underlying cause of hemorrhage, which requires mechanical or pharmacological uterine contraction.
Choice D rationale
Catheterizing the bladder can prevent displacement of the uterus but does not directly address uterine atony. An empty bladder supports fundal massage by allowing proper uterine positioning.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","C","D"]
Explanation
Choice A rationale
Postpartum hemorrhage may occur weeks after delivery due to subinvolution of the uterus or retained placental fragments. Educating about late risks ensures patients monitor symptoms and seek timely care.
Choice B rationale
Breastfeeding is encouraged even after postpartum hemorrhage as it helps stimulate uterine contractions, reducing bleeding risk. Recommending avoidance could delay recovery and is scientifically unsupported unless contraindicated.
Choice C rationale
Oxytocin may be prescribed for ongoing uterine atony or to prevent late postpartum hemorrhage. It is essential to educate patients about its purpose and correct administration for safety and effectiveness.
Choice D rationale
Saturating a peri-pad within 1 hour may indicate active bleeding. Reporting this promptly ensures swift intervention to prevent further complications, aligning with standard postpartum care protocols.
Choice E rationale
Postpartum hemorrhage is not limited to 24–48 hours after birth; late-onset hemorrhage, occurring up to weeks later, is a known complication. Misleading patients with this incorrect timeframe can delay critical interventions.
Correct Answer is D
Explanation
Choice A rationale
Uterine prolapse involves the descent of the uterus into the vaginal canal and is not a direct fatal complication of postpartum hemorrhage. It primarily stems from weakened pelvic floor muscles or ligament damage.
Choice B rationale
Von Willebrand’s disease is a hereditary bleeding disorder related to factor VIII and von Willebrand factor deficiencies, predisposing individuals to bleeding. It is not a direct result of prolonged postpartum hemorrhage.
Choice C rationale
Preeclampsia is a hypertensive disorder associated with proteinuria and organ dysfunction during pregnancy, not a postpartum hemorrhage complication. It can lead to significant morbidity but is unrelated to hemorrhagic complications.
Choice D rationale
Disseminated Intravascular Coagulation (DIC) is a life-threatening condition involving widespread coagulation and fibrinolysis, leading to uncontrolled bleeding, often triggered by severe postpartum hemorrhage. Laboratory findings may include low platelets, prolonged PT/INR, and elevated D-dimer.
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