Which factor in a clients history indicates an increased risk for postpartum hemorrhage Quizlet

Massage the fundus of the uterus.

If the uterus is not firmly contracted, the first intervention is to massage the fundus until it is firm and to express clots that may have accumulated in the uterus. One hand is placed just above the symphysis pubis to support the lower uterine segment, while the other hand gently but firmly massages the fundus in a circular motion. Clots that may have accumulated in the uterine cavity interfere with the ability of the uterus to contract effectively. They are expressed by applying firm but gentle pressure on the fundus in the direction of the vagina. If the uterus does not remain contracted as a result of uterine massage or if the fundus is displaced, the bladder may be distended. A full bladder lifts the uterus, moving it up and to the side, preventing effective contraction of the uterine muscles. Assist the mother to urinate or catheterize her to correct uterine atony caused by bladder distention. Note the urine output. When the fundus is boggy, begin uterine massage. Check the woman's bladder for distention and have her empty it if necessary. If she is not able to void and the bladder is distended, catheterize the woman. Weigh blood-soaked pads.

PTS: 1 DIF: Cognitive Level: Applying REF: 599, 600

Retroperitoneal hematoma.

Accumulation of blood in the retroperitoneal space is called retroperitoneal hematoma. It is caused by the rupture of the cesarean scar during labor. Retroperitoneal hematoma is characterized by such symptoms as persistent perineal pain, a feeling of pressure in the vagina, and shock. Therefore it is evident that the client has this condition. Persistent perineal pain, a feeling of pressure in the vagina, and shock are not associated with rectocele, endometritis, and impaired lactation. Rectocele is the herniation of the anterior rectal wall through the relaxed or ruptured vaginal fascia and rectovaginal septum. Endometritis is characterized by fever, increased pulse rate, chills, anorexia, nausea, fatigue, pelvic pain, uterine tenderness, and foul-smelling lochia. Because the client did not report these symptoms, the client does not have endometritis. Perineal pain, a feeling of pressure in the vagina, and shock do not affect lactation, so the client does not have impaired lactation.

The parents of an infant with tetralogy of Fallot ask the nurse to explain what is wrong with their baby's heart. Before explaining the problem in a way that they will understand, the nurse remembers that tetralogy of Fallot includes:
1
Tricuspid atresia, ventricular septal defect, atrioventricular canal, and coarctation of the aorta
2
Overriding of the aorta, aortic stenosis, patent ductus arteriosus, and mitral valve insufficiency
3
Atrial septal defect, right ventricular hypertrophy, patent ductus, and mitral valve insufficiency
4
Right ventricular hypertrophy, ventricular septal defect, pulmonic stenosis, and overriding of the aorta

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Lethargy reflects the lack of physical and emotional energy that is associated with depression. Ambivalence, the coexistence of contradictory feelings about an object, person, or idea, is associated with postpartum depression. Emotional lability is associated with postpartum depression. Anorexia, rather than increased appetite, is associated with postpartum depression; the client lacks the physical and emotional energy to eat. Insomnia, rather than long periods of sleep, is associated with depression.

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Late postpartum hemorrhage is typically seen after a patient has returned home. Patients should be monitored when there are complaints of fatigue, general malaise, backache, pelvic pain, a feeling of heaviness in the pelvic area, and any lingering discharge of lochia. For a patient with potential late postpartum hemorrhage, the nurse would conduct a bimanual examination to obtain more data, assess bleeding amounts in pads and linens, and assess lochia, and review the patient's history for any hemorrhage risk factors. Heparin would dangerously exacerbate bleeding, and lab tests must be performed before the health care provider prescribes fibrinogen and the nurse can administer it.

4

Accumulation of blood in the retroperitoneal space is called retroperitoneal hematoma. It is caused by the rupture of the cesarean scar during labor. Retroperitoneal hematoma is characterized by such symptoms as persistent perineal pain, a feeling of pressure in the vagina, and shock. Therefore it is evident that the patient has this condition. Persistent perineal pain, a feeling of pressure in the vagina, and shock are not associated with rectocele, endometritis, and impaired lactation. Rectocele is the herniation of the anterior rectal wall through the relaxed or ruptured vaginal fascia and rectovaginal septum. Endometritis is characterized by fever, increased pulse rate, chills, anorexia, nausea, fatigue, pelvic pain, uterine tenderness, and foul-smelling lochia. Because the patient did not report these symptoms, the patient does not have endometritis. Perineal pain, a feeling of pressure in the vagina, and shock do not affect lactation, so the patient does not have impaired lactation.

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The nurse should measure vital signs, including oxygen levels and capillary return, every 15 to 20 minutes to ensure optimal organ function. All pads, linens, and bed liners should be measured before and after use to accurately determine amount of blood loss. Likewise, the areas under the back, buttocks, and legs should be assessed for drainage and pooling of lochia to have an accurate determination of blood loss. The fundus should be firmly contracted and therefore must be monitored to confirm for normal return to this state. Ensuring the patient remains free of infection is an outcome for a postpartum patient, not an intervention. Emptying the bladder is unrelated to postpartum blood loss.

Which factor in a client's history indicates an increased risk for postpartum hemorrhage?

What factor in a client's history places the client at greatest risk for postpartum endometritis?

Which of the following conditions in a postpartum client is most likely to cause hemorrhage?

What are the 4 most common causes of postpartum hemorrhage?