CH 22 OB

Review of a primiparous woman's labor and birth record reveals a prolonged second stage of labor and extended time in the stirrups. Based on an interpretation of these findings, the nurse would be especially alert for which condition?

• retained placental fragments
• hypertension
• thrombophlebitis
• uterine subinvolution

The nurse is conducting a class for postpartum women about mood disorders. The nurse describes a transient, self-limiting mood disorder that affects mothers after birth. The nurse determines that the women understood the description when they identify the condition as postpartum:

• depression.
• psychosis.
• bipolar disorder.
• blues.

A woman who is 2 weeks postpartum calls the clinic and says, "My left breast hurts." After further assessment on the phone, the nurse suspects the woman has mastitis. In addition to pain, the nurse would question the woman about which symptom?

• an inverted nipple on the affected breast
• no breast milk in the affected breast
• an ecchymotic area on the affected breast
• hardening of an area in the affected breast

A nurse is developing a program to help reduce the risk of late postpartum hemorrhage in clients in the labor and birth unit. Which measure would the nurse emphasize as part of this program?

• administering broad-spectrum antibiotics
• inspecting the placenta after delivery for intactness
• manually removing the placenta at birth
• applying pressure to the umbilical cord to remove the placenta

A multipara client develops thrombophlebitis after birth. Which assessment findings would lead the nurse to intervene immediately?

• dyspnea, diaphoresis, hypotension, and chest pain
• dyspnea, bradycardia, hypertension, and confusion
• weakness, anorexia, change in level of consciousness, and coma
• pallor, tachycardia, seizures, and jaundice

A client experienced prolonged labor with prolonged premature rupture of membranes. The nurse would be alert for which condition in the mother and the newborn?

• infection
• hemorrhage
• trauma
• hypovolemia

When assessing the postpartum woman, the nurse uses indicators other than pulse rate and blood pressure for postpartum hemorrhage because:

• these measurements may not change until after the blood loss is largest
• the body's compensatory mechanisms activate and prevent any changes.
• they relate more to change in condition than to the amount of blood lost.
• maternal anxiety adversely affects these vital signs.

A nurse is assessing a postpartum client. Which finding would be a concern?

• leg pain on ambulation with mild ankle edema
• cause the nurse the greatest
• calf pain with dorsiflexion of the foot
• perineal pain with swelling along the episiotomy
• sharp, stabbing chest pain with shortness of breath

A woman who is experiencing postpartum hemorrhage is extremely apprehensive and diaphoretic. The woman's extremities are cool and her capillary refill time is increased. Based on this assessment, the nurse suspects that the client is experiencing approximately how much blood loss?

• 20%
• 30%
• 40%
• 60%

A postpartum client is prescribed medication therapy as part of the treatment plan for postpartum hemorrhage. Which medication would the nurse expect to administer in this situation?

• Magnesium sulfate
• methylergonovine
• Indomethacin
• nifedipine