A nursing instructor has just completed a lecture on postpartum ...

[KWilfred]

A nursing instructor has just completed a lecture on postpartum hemorrhage. The instructor asks the students to identify the risk factors for uterine atony.
 
  Which of the following responses by the students would indicate that further teaching is needed? (Select all that apply.) a. Small clots
  b. History of drug dependence
  c. Adherence of placental fragments
  d. Overdistention of the uterus
  e. Induction or augmentation of labor
  f. Uterine anomaly such as the presence of fibroids

Question 2

A client experiencing a postpartum hemorrhage refuses blood transfusions despite the danger to her life. The physician's orders reflect a compliance with the client's wishes. This ethical decision is based on
 
  a. nonmaleficence c. paternalism
  b. beneficence d. respect for autonomy

[Jossy]

Answer to Question 1

A, B
The instructor would recognize that further teaching is needed if the students responded small clots or a history of drug dependence. Risk factors for uterine atony include overdistention of the uterus (polyhydramnios, multiple gestation, macrosomia); uterine anomaly (bicornuate uterus, presence of fibroids); poor uterine muscle tone (high parity, rapid or prolonged labor, induction or augmentation of labor, chorioamnionitis, magnesium sulfate, general anesthesia); adherence of placental fragments; and large blood clots.

Answer to Question 2

D
This is an example of respecting the client's right to individual independence and making choices and taking action based on values and beliefs. Nonmaleficence suggests that health care providers must exercise due care to prevent client harm. Beneficence is an ethical principle focusing on promoting the welfare of others. Paternalism is taking action against the wishes of the client in order to provide for the client's welfare.