After birth, the nurse monitors the mother for postpartum ...

[Mr3Hunna]

After birth, the nurse monitors the mother for postpartum hemorrhage secondary to uterine atony. What would increase the nurse's concern about this risk?
 
  a. Hypovolemia
  b. Iron deficiency anemia
  c. Prolonged use of oxytocin
  d. Uteroplacental insufficiency

Question 2

The labor nurse is developing a plan of care for a patient admitted in active labor with spontaneous rupture of the membranes 6 hours prior to admission with clear fluid. On admission, vital signs were as follows: maternal heart rate (HR) 92 bpm;
 
  fetal rate (FHR) baseline, 150 to 160 bpm; blood pressure, 124/76 mm Hg; temperature 99 F 37.2 C. What is the priority nursing action for this patient?
 
  a. Fetal acoustic stimulation
  b. Assess temperature every 2 hours
  c. Change absorption pads under her hips every 2 hours
  d. Review white blood cell count (WBC) drawn at admission

[maaaaaaaaaa]

Answer to Question 1

ANS: C
Postpartum uterine atony is more likely if she has received oxytocin for a long time because the uterine muscle becomes fatigued and does not contract effectively to compress vessels at the placental site.

Answer to Question 2

ANS: B
The woman's temperature should be assessed at least every 2 to 4 hours after the membranes rupture. Elevations above 38 C (100.4 F) should be reported. A rising FHR and fetal tachycardia (above 160 bpm) may precede maternal fever. The fetal heart rate is at the high end of the acceptable range and the maternal temperature is slightly above normal. These parameters warrant watching closely with more frequent vital signs. The WBC is often falsely elevated in labor, largely related to the stress of labor. The FHR with a baseline of 150 to 160 bpm demonstrates moderate variability, and fetal acoustic stimulation is not warranted. Amniotic fluid is emitted from the vagina at variable rates and the underpad needs to be changed as needed.

[Mr3Hunna]

Excellent

[aruss1303]

TYSM