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NUR 340 Exam 4 Questions and Complete Solutions
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  • NUR 340
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  • NUR 340

Post partum hemorrhage -bleeding of more than 500 mL after vaginal deliver -bleeding of more than 1000 mL after C-section Major obstetric hemorrhage blood loss of more than mL or bleeding that required more than 5 units of transfused blood Primary postpartum hemorrhage occurs in the firs...

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  • August 28, 2024
  • 23
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers

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  • nur 340 exam 4 questions and complete solutions
  • post partum hemorrhage bleeding of more than 500
  • major obstetric hemorrhage blood loss of more tha

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  • NUR 340
  • NUR 340

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NUR 340 Exam 4 Questions and
Complete Solutions
Post partum hemorrhage ✅-bleeding of more than 500 mL after vaginal deliver
-bleeding of more than 1000 mL after C-section

Major obstetric hemorrhage ✅blood loss of more than 1500-2500 mL
or
bleeding that required more than 5 units of transfused blood

Primary postpartum hemorrhage ✅occurs in the first 24 hours after delivery

Delayed postpartum hemorrhage ✅blood loss that occurs 24 hours to 12 weeks after
birth

Manifestations of shock due to blood loss: Mild, mod. severe shock, blood loss percent,
and the signs and symptoms ✅Mild: 20%
-diaphoresis, inc. capillary refilling, cool extremities, maternal anxiety

Moderate: 20-40%
-Tachycardia, postural hypotension, oliguria

Severe: >40%
-hypotension, agitation/confusion, hemodynamic instability

4 T's and causes of postpartum hemorrhage ✅-Tone: uterine atony, distended bladder
-Tissue: retained placenta and clots; uterine subinvolution
-Trauma: lacerations, hematoma, inversion, rupture
-Thrombin: coagulopathy (pre-existing or acquired)

Causes of subinvolution ✅-retained placental fragments
-distended bladder
-excessive maternal activity prohibiting proper recover
-uterine myoma
-infections

Uterine inversion ✅-when the top of the uterus collapses into the inner cavity
-due to excessive fundal pressure or pulling on the umbilical cord when the placenta is
still firmly attached to the fundus after the infant has been born

Thrombosis ✅Formation of a blood clot

,Complications associated with DIC ✅-abruptio placentae
-amniotic fluid embolism
-intrauterine fetal death with prolonged retention of the fetus
-acute fatty liver of pregnancy
-severe preeclampsia
-HELLP syndrome
-septicemia
-postpartum hemorrhage

Clinical features of DIC ✅-petechiae
-ecchymoses
-bleeding gums
-fever
-hypotension
-acidosis
-hematomas
-tachycardia
-proteinuria
-uncontrolled bleeding during birth
-acute renal failure

Finding: displaced soft and boggy uterus
What's the cause? ✅Distended bladder

Finding: Dark red bleeding mixed with clots
What's the cause? ✅placenta fragments remaining

Finding: Firm midline uterus with stead stream or trickle of blood
What's the cause? ✅Lacerations

Finding: Bulging area under skin surface
What's the cause? ✅Hematoma

Finding: Petechia or ecchymoses
What's the cause? ✅-thrombocytapenia purpura
*thrombin disorders in general

Finding: Bleeding from IV site, incision site, gums and/or bladder
What's the cause? ✅*thrombin disorders
-DIC

Finding: Prolonged, uncontrolled uterine bleeding
What's the cause? ✅Thrombin disorders

Conditions associated with overdistention of uterus

, *Factors increasing risk for PPH ✅Tone: abnormalities of uterine contractions

-Polyhydramnios
-Multifetal gestation
-Macrosomia

Conditions associated with uterine muscle exhaustion
*Factors increasing risk for PPH ✅Tone: abnormalities of uterine contractions

-Rapid labor
-Prolonged labor
-Oxytocin use

Conditions associated with uterine infection
*Factors increasing risk for PPH ✅Tone: abnormalities of uterine contractions

-maternal fever
-prolonged rupture of membranes

Conditions associated with products of conception
*Factors increasing risk for PPH ✅Tissue: retained uterus

-complete placenta at birth

Conditions associated with retained blood clots
*Factors increasing risk for PPH ✅Tissue: retained in uterus

-atonic uterus

Conditions associated with lacerations (anywhere)
*Factors increasing risk for PPH ✅Trauma: of the genital tract

-precipitate birth
-operative birth

Condition associated with laceration extensions
*Factors increasing risk for PPH ✅Trauma: of the genital tract

-malposition of the fetus
-previous uterine surgery

Conditions associated with Uterine inversion
*Factors increasing risk for PPH ✅Trauma: of the genital tract

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