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CH 21 MATERNAL CHILD NURSING PERRY 4TH EDITION

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CH 21 MATERNAL CHILD NURSING PERRY 4TH EDITION A 25-year-old gravida 2, para 2-0-0-2 gave birth 4 hours ago to a 9-pound, 7-ounce boy after augmentation of labor with Pitocin. She puts on her call light and asks for her nurse right away, stating, "I'm bleeding a lot." The most likely cause of postpartum hemorrhage in this woman is: a. Retained placental fragments. c. Uterine atony. b. Unrepaired vaginal lacerations. d. Puerperal infection. - CORRECT ANSWER -ANS: C This woman gave birth to a macrosomic boy after Pitocin augmentation. The most likely cause of bleeding 4 hours after delivery, combined with these risk factors, is uterine atony. Although retained placental fragments may cause postpartum hemorrhage, this typically would be detected in the first hour after delivery of the placenta and is not the most likely cause of hemorrhage in this woman. Although unrepaired vaginal lacerations may cause bleeding, they typically would occur in the period immediately after birth. Puerperal infection can cause subinvolution and subsequent bleeding, but it typically would be detected 24 hours after delivery. On examining a woman who gave birth 5 hours ago, the nurse finds that the woman has completely saturated a perineal pad within 15 minutes. The nurse's first action is to: a. Begin an intravenous (IV) infusion of Ringer's lactate solution. b. Assess the woman's vital signs. c. Call the woman's primary health care provider. d. Massage the woman's fundus. - CORRECT ANSWER -ANS: D The nurse should assess the uterus for atony. Uterine tone must be established to prevent excessive blood loss. The nurse may begin an IV infusion to restore circulatory volume, but this would not be the first action. Blood pressure is not a reliable indicator of impending shock from impending hemorrhage; assessing vital signs should not be the nurse's first action. The physician would be notified after the nurse completes the assessment of the woman. A woman gave birth vaginally to a 9-pound, 12-ounce girl yesterday. Her primary health care provider has written orders for perineal ice packs, use of a sitz bath TID, and a stool softener. What information is most closely correlated with these orders? a. The woman is a gravida 2, para 2. b. The woman had a vacuum-assisted birth. c. The woman received epidural anesthesia. d. The woman has an episiotomy. - CORRECT ANSWER -ANS: D These orders are typical interventions for a woman who has had an episiotomy, lacerations, and hemorrhoids. A multiparous classification is not an indic

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Lisa Keenan-Lindsay, Cheryl A Sams, Constance L. O\'Connor, Shannon E. Perry, Marilyn J. Hockenberry, Deitra Leonard Lowdermilk, David Wilson Study Guide for Perry’s Maternal Child Nursing Care in Canada,E-Book
Publisher: 2021 ISBN: 9780323799027 Edition: Unknown

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