The nurse is assessing a client who has been diagnosed with an ...

[lracut11]

The nurse is assessing a client who has been diagnosed with an early postpartum hemorrhage. Which findings would the nurse expect? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
 
  1. A boggy fundus that does not respond to massage
  2. Small clots and a moderate amount of lochia rubra on the pad
  3. Decreased pulse and increased blood pressure
  4. Hematoma formation or bulging/shiny skin in the perineal area
  5. Rise in the level of the fundus of the uterus

Question 2

The client has experienced a postpartum hemorrhage at 6 hours postpartum. After controlling the hemorrhage, the client's partner asks what would cause a hemorrhage. How should the nurse respond?
 
  1. Sometimes the uterus relaxes and excessive bleeding occurs.
  2. The blood collected in the vagina and poured out when your partner stood up.
  3. Bottle-feeding prevents the uterus from getting enough stimulation to contract.
  4. The placenta had embedded in the uterine tissue abnormally.

[wilsonbho]

Answer to Question 1

1, 4, 5
Explanation: 1. A boggy fundus indicates that the uterus is not contracted and will continue to bleed.
4. Shiny or bulging skin could indicate the presence of a hematoma.
5. The uterine cavity can distend with up to 1000 mL or more of blood causing the fundus to rise.

Answer to Question 2

1
Explanation: 1. Uterine atony (relaxation of the uterus) is the leading cause of early postpartum hemorrhage, accounting for over 50 of postpartum hemorrhage cases.