ANSWERS 100% CORRECT
During d/c teaching w/ a pt who has experienced a DVT during labor and delivery & has
been described Warfarin, the nurse should be sure to emphasize avoiding which of the
following and why?
1. Excessive alcohol consumption
2. MMR vaccine
3. Ibuprofen
4. Large amounts of leafy, green veggies
5. Vitamin C - ANSWER-MMR Vaccine - it interacts w/ the Warfarin
What is Endometritis? - ANSWER--During the immediate PP period
-Most common site of infection is the endometrium (lining of the uterus)
-Inflammation of uterine lining that usually starts @ placental site & spreads to
endometrium
-Can extend to fallopian tubes, ovaries, perineum, pelvic veins or pelvic connective
tissue
Signs of Endometritis - ANSWER--temp over 101
-develops within 24-48 hrs after birth
-tachycardia
-uterine tenderness
-suprapubic pain
-subinvolution
-malaise
-heavy, FOUL SMELLING lochia (later sign = entire endometrium is involved) when
anaerobic organisms are present
-scant, odorless lochia is noted when beta-hemolytic strep is present
RN is performing assessment on mom 44 hours after uneventful delivery. Which of the
following would cause the RN to suspect the pt is developing endometritis?
1. Deviated fundus
2. Temp of 101.2
3. Suprapubic pain
4. Foul smelling lochia
5. Scant, odorless lochia - ANSWER-2, 3, 4, 5
Mom is 42 wks & is being induced with oxytocin d/t postdate. Her medical hx shows that
she takes Levothyroxine for hypothyroidism, she had an ectopic pregnancy 5 years ago,
and her BMI is 23%. Which part of this info would indicate to the nurse that she is @
risk for a PPH?
1. Hypothyroidism
, 2. Induction
3. BMI
4. Ectopic pregnancy - ANSWER-2
PP c-section mom calls to nurses station and says it is painful to breathe and she feels
like her heart is racing. RN enters the room to find mom holding her chest & coughing.
Mom says she's scared & can't catch her breath. What complication should the RN
expect?
1. Flu
2. Endometritis
3. Pulmonary embolism
4. PPH - ANSWER-3
The first line of treatment for uterine atony is __________________________ -
ANSWER-fundal massage
The failure of the uterus to return to its pregpregnancy state is called ____________ -
ANSWER-subinvolution
A mom came into the ER c/o body aches, fatigue, breast pain, fever & chills. What dx
would the RN expect the MD to give this pt?
1. Flu
2. Clogged milk duct
3. Mastitis
4. Endometritis - ANSWER-3
During a morning assessment, mom who delivered a healthy baby girl 2 days ago, tells
the RN that the devil told her the baby will never be healthy unless she leaves her in a
bathtub of water. What should the RN do @ this time?
1. Finish the assessment & charge moms statement for MD to follow up on during
rounds
2. Ask mom what drugs she is taking in case they need to be adjusted
3. Push the call light for the charge RN and MD to come into room immediately
4. Nothing - ANSWER-3
Nurse is caring for a G3P1 mom while she is in labor. She is 38 wks, med hx of 36%
BMI, chronic hypertension, gallbladder removal 2 yrs ago, and uneventful past
pregnancies. She had a reactive NST in triage when she arrived 14 hrs ago. She
delivered approx 15 mins ago and is showing signs of PPH with a QBL of 1600ml.
Which of the follow orders from the MD should the RN question and why?
1. Methergine 0.2mg IV Q2H x3 doses
2. Oxytocin 40 units IV bolus
3.Indwelling urinary cath & monitor I&Os
4. Monitor v/s Q15 mins x2 hrs - ANSWER-1 - pt's who have HTN cannot have
Methergine