Review Nursing Diagnosis

Postpartum Hemorrhage > Maternal & Newborn

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Nursing Diagnosis

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Total Questions : 5

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Question 1:

A nurse is caring for a client who had a vaginal delivery and is experiencing postpartum hemorrhage due to uterine atony.

Which of the following actions should the nurse take first?

A. Administer oxytocin as prescribed B. Massage the uterine fundus gently C. Start an intravenous line with a large bore catheter D. Place the client in a side lying position

Answer and Explanation

Choice A:

Administering oxytocin as prescribed is a secondary action that can be taken after massaging the uterine fundus if bleeding persists.Oxytocin is a medication that promotes uterine contraction and reduces blood loss.

Choice B:

Massaging the uterine fundus gently is the first action that the nurse should take to stimulate uterine contractions and control bleeding due to uterine atony.Uterine atony is the most common cause of postpartum hemorrhage and occurs when the uterus fails to contract after delivery.

Choice C:

Starting an intravenous line with a large bore catheter is a tertiary action that can be taken after massaging the uterine fundus and administering oxytocin if bleeding continues.An intravenous line can provide fluid replacement and blood transfusion if needed.

Choice D:

Placing the client in a side lying position is not a priority action for postpartum hemorrhage due to uterine atony.This position may help reduce pressure on the vena cava and improve blood flow, but it does not address the underlying cause of bleeding.

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Question 2:

A nurse is reviewing the laboratory results of a client who had a significant postpartum hemorrhage.

Which of the following findings indicates a need for blood transfusion?

A. Hemoglobin 10 g/dL B. Hematocrit 30% C. Platelets 150,000/mm3 D. Potassium 4 mEq/L.

Answer and Explanation

Choice A:

This indicates a need for blood transfusion because it is below the normal range of 12 to 16 g/dL for women.

Hemoglobin is the protein in red blood cells that carries oxygen to the tissues.A low hemoglobin level can cause symptoms of anemia, such as fatigue, weakness, shortness of breath, and dizziness.

Choice B:

Hematocrit 30% is within the normal range of 37 to 47% for women.

Hematocrit is the percentage of red blood cells in the blood.A low hematocrit can indicate blood loss, but it is not a criterion for blood transfusion by itself.

Choice C:

Platelets 150,000/mm3 are within the normal range of 150,000 to 450,000/mm3 for both men and women.

Platelets are the cells that help with blood clotting.A low platelet count can increase the risk of bleeding, but it is not a criterion for blood transfusion by itself.

Choice D:

Potassium 4 mEq/L is within the normal range of 3.5 to 5 mEq/L for both men and women.

Potassium is an electrolyte that helps with nerve and muscle function.

A high or low potassium ...

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Question 3:

A nurse is teaching a client who is at risk for postpartum hemorrhage about the signs and symptoms of hypovolemic shock.

Which of the following should the nurse include in the teaching? (Select all that apply)

A. Tachycardia B. Hypertension C. Pallor D. Oliguria E. Confusion

Answer and Explanation

Choice A:

These are the signs and symptoms of hypovolemic shock, which is a life-threatening condition caused by severe blood loss. Hypovolemic shock can occur in postpartum women who have postpartum hemorrhage (PPH), which is excessive bleeding after childbirth.

Choice B:

Hypertension is not a sign of hypovolemic shock. In fact, hypotension (low blood pressure) is one of the signs of hypovolemic shock.

Choice C:

Choice D:

Choice E:

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Question 4:

A nurse is preparing to administer methylergonovine to a client who has postpartum hemorrhage due to retained placental fragments.

Which of the following assessments should the nurse perform before giving the medication?

A. Blood pressure B. Temperature C. Respiratory rate D. Oxygen saturation

Answer and Explanation

Choice A:

Methylergonovine is a medication that stimulates uterine contractions and helps prevent or treat postpartum hemorrhage due to uterine atony or retained placental fragments.However, it can also cause an increase in blood pressure, so the nurse should monitor the client’s blood pressure before and after giving the medication.

Normal ranges for blood pressure are 120/80 mmHg or lower for systolic and diastolic pressures respectively.

Normal ranges for temperature are 36.5°C to 37.5°C or 97.7°F to 99.5°F.

Normal ranges for respiratory rate are 12 to 20 breaths per minute.Normal ranges for oxygen saturation are 95% to 100%.

Choice B:

Temperature is wrong because methylergonovine does not affect the client’s temperature.

Choice C:

Respiratory rate is wrong because methylergonovine does not affect the client’s respiratory rate.

Choice D:

Oxygen saturation is wrong because methylergonovine does not affect the client’s oxygen saturation.

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Question 5:

A nurse is evaluating the effectiveness of oxytocin infusion for a client who has postpartum hemorrhage.

Which of the following findings indicates that the medication is working?

A. The uterine fundus is firm and at the level of the umbilicus B. The lochia flow is moderate and bright red C. The blood pressure is 90/60 mm Hg and pulse is 110/min D. The urine output is 25 mL/hr and specific gravity is 1.030

Answer and Explanation

Choice A:

This indicates that the uterus has contracted well and the bleeding has stopped.Oxytocin is a drug that helps the uterus to contract and prevent postpartum hemorrhage (PPH), which is excessive bleeding after childbirth.

Choice B:

Lochia flow should be moderate and dark red, not bright red.Bright red blood suggests active bleeding and possible PPH.

Choice C:

The blood pressure is low and the pulse is high, which are signs of shock due to blood loss.PPH can cause a dangerous drop in blood pressure and lead to shock or death.

Choice D:

The urine output is low and the specific gravity is high, which are signs of dehydration due to blood loss.PPH can cause fluid imbalance and kidney damage.

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Nursing Diagnosis

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