What are the four Ts as they relate to postpartum hemorrhage?

Choice A rationale

Chlorhexidine is a broad-spectrum antiseptic effective against gram-positive and gram-negative bacteria. It is safe for patients allergic to betadine and reduces infection risks during catheter insertion.

Choice B rationale

Betadine, containing povidone-iodine, is contraindicated in patients with allergies to iodine. Using it could trigger allergic reactions, including anaphylaxis, compromising patient safety.

Choice C rationale

Sterile water lacks antiseptic properties and does not provide necessary antimicrobial activity to minimize infection risks, making it unsuitable for catheter insertion.

Choice D rationale

Alcohol wipes can cause tissue irritation and discomfort during catheter insertion. They are less effective against bacterial spores, reducing their efficacy for preventing infections in this context.

Choice A rationale

A soft uterus indicates uterine atony, a complication rather than a normal finding. Daily fundal palpation ensures involution but should result in a firm, not soft, uterus.

Choice B rationale

Passage of clots is common postpartum, but ongoing monitoring for excessive clotting is crucial as it may indicate retained placental fragments or incomplete uterine involution.

Choice C rationale

Decreased lochia does not indicate complications unless it is completely absent, which may suggest uterine or cervical obstruction and warrants further evaluation.

Choice D rationale

Increased lochia or bright red bleeding signifies secondary postpartum hemorrhage, often caused by retained placental tissue or subinvolution, requiring immediate medical attention.