NUR 325 OB - Exam 3 Test Questions and Correct Answers
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Course
NUR 325
Institution
NUR 325
What is the definition of postpartum hemorrhage for both vaginal births and cesarean births? -Loss of 500 mL of blood after vaginal birth -Loss of 1000 mL of blood after c-section *Leading cause of maternal morbidity and mortality
What are some causes of postpartum hemorrhage? -Uterine Atony (loss...
NUR 325 OB - Exam 3 Test Questions
and Correct Answers
What is the definition of postpartum hemorrhage for both vaginal births and cesarean
births? ✅-Loss of 500 mL of blood after vaginal birth
-Loss of 1000 mL of blood after c-section
*Leading cause of maternal morbidity and mortality
What are some causes of postpartum hemorrhage? ✅-Uterine Atony (loss of uterine
tone/boggy uterus)
-Lacerations of genital tract/trauma to birth canal (slow trickle to a steady stream of
blood)
-Hematoma (trauma that caused collection of blood in vaginal canal)
-Inversion of the uterus (uterus turns inside out and protrudes thru cervix)
What are some factors that are associated with postpartum hemorrhage? ✅-High
parity (many babies)
-Hydramnios (excessive amniotic fluid)
-Macrosomic fetus (lg baby)
-Multifetal gestation
-Retained placenta parts (even the smallest piece can cause boggy uterus)
What is important to note about a vaginal hematoma due to trauma from birth during
assessment? ✅Women will complain of vaginal pressure and pain, but there is no
excessive bleeding noted. The uterus will be firm!
Why is it important to recognize postpartum hemorrhage early on and what are they key
assessment questions for PPH? ✅-It is a medical emergency that is life threatening if
not addressed
-Is the uterus firm or boggy?, Does she have a distended bladder?, Is there active,
visible bleeding?, Is there vaginal pressure or pain?
What are the interventions for postpartum hemorrhage due to uterine atony? ✅-
Massage fundus, empty bladder!
-Give oxytocin (IV or IM), Methergine (IM) OR Hemabate (IM)
-If there is retained placenta, go to surgery to remove it
What is hemorrhagic shock? ✅-Also called hypovolemic shock
-Emergency situation in which perfusion of organs may become severely compromised
and death may occur
What are the symptoms of hypovolemic shock? ✅-Increase pulse rate
-Increased RR
, -Decreased BP (loss of 30-40%)
-Decreased urinary output
-Pale color, skin cool and clammy
-Decreased LOC
-Anxious, scared and confused
What is the medical management for hypovolemic shock? ✅-MANAGE VOLUME
-Fluid or blood replacement therapy with IV bolus of LR or NS/Packed RBC's, platelets
Nursing interventions for hypovolemic shock? ✅-FOLLOW PROTOCOL!!
-Monitor pulse and blood pressure (vital signs every 5 minutes)
-Foley catheter to monitor output
-Oxygen at 10-12 L/min
-Pulse oximetry
What is postpartum infection? ✅-Clinical infection of the genital tract that occurs after
miscarriage, elective abortion or childbirth.
-Fever of 100.4 or higher on 2 days during the first 10 postpartum days (1st day doesn't
count, and they have to be consecutive days in a row)
What are risk factors for postpartum infection? ✅-Medical conditions that affect healing
-Procedures performed that increase risk of infections
-Foley catheters
What are the different types of postpartum infection? ✅-Endometritis
-Wound (incision/episiotomy)
-Mastitis (infection of breast)
What are the symptoms of Endometritis and what are the treatment options? ✅-This is
the infection of the uterine lining, and *it occurs more often after c-sections!
-SYMPTOMS: generalized infection symptoms (fever, fatigue), *PELVIC PAIN, *Foul
smelling and profuse lochia, and *Uterine tenderness
-TREATMENT: IV antibiotics, pain relief medications, rest
What are the symptoms of postpartum wound infections and what are the treatment
options? ✅-This is an infection of c-section incision, episiotomy or laceration site.
*Often develops after discharge
-Assess: REEDA (redness, ecchymosis, edema, drainage, approximation)
-Patient education: signs and symptoms of infection! This usually doesn't occur until
after she goes home
-TREATMENT: Antibiotics
What are the symptoms of mastitis and what are the treatment options? ✅-This is the
infection of the breast tissue. More common in first time breast feeding moms. *Usually
occurs in one breast and appears in the first 6 weeks postpartum
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