What are thromboembolic conditions that are of concern during the postpartum period?

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What is postpartum thromboembolic disorders?
What factors places the postpartum client at risk for thromboembolism?
What are the thromboembolic disorders?
Why are postpartum mothers prone to thrombophlebitis?

Oxford University Press makes no representation, express or implied, that the drug dosages in this book are correct. Readers must therefore always … More Oxford University Press makes no representation, express or implied, that the drug dosages in this book are correct. Readers must therefore always check the product information and clinical procedures with the most up to date published product information and data sheets provided by the manufacturers and the most recent codes of conduct and safety regulations. The authors and the publishers do not accept responsibility or legal liability for any errors in the text or for the misuse or misapplication of material in this work. Except where otherwise stated, drug dosages and recommendations are for the non-pregnant adult who is not breastfeeding.

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What are thromboembolic conditions that are of concern during the postpartum period?

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Question	Answer
Which risk factors are associated with postpartum hemorrhage?	obesity, chorioamnionitis, placental abruption
Which are considered signs of the postpartum blues	crying spells, loss of appetite, difficult sleeping
Which intrapartal factors can contribute to a postpartum infection?	Hematomas Prolonged labor Epidural analgesia
Which are characteristics of postpartum venous thrombosis?	Pain Warmth Redness
A patient who had a postpartum hemorrhage is being discharged. What discharge instructions should the nurse give the patient?	Limit your physical activity." Alternate activity and rest periods. Increase dietary iron and protein."
After reviewing a patient’s medical reports, the nurse finds that the patient has multifetal gestation. What is the most likely complication associated with this?	Postpartum hemorrhage (PPH)
The nurse is caring for a patient during labor. While examining the patient, the nurse palpates a smooth mass through the dilated cervix. The patient also shows signs of hypovolemic shock. What must be the immediate nursing intervention?	Giving intravenous fluids
When reviewing a patient's medical reports, the nurse finds that the patient has submucosal uterine fibroids. Which postpartum complication of pregnancy is the patient likely to have?	Placenta accreta
Two hours after giving birth, a primiparous woman becomes anxious and complains of intense perineal pain with a strong urge to have a bowel movement. Her fundus is firm, at the umbilicus and midline. Her lochia is moderate rubra with no clots.	Hematoma formation
The nurse is teaching a pregnant patient with venous thromboembolism (VTE) about measures to prevent aggravation of her symptoms. Which instruction given by the nurse needs to be rectified?	"Place your knees in a sharp flexed position."
What are thromboembolic conditions that are of concern during the postpartum period? Select all that apply.	Superficial venous thrombosis. Deep vein thrombosis. Pulmonary embolism.
A patient has a hypotonic uterus and continuous bleeding despite the administration of oxytocin (Pitocin). The primary health care provider replaced the oxytocin with another medication. The patient has hypertension, headache, and vomiting after the new m	Methyl prostaglandin F2α (Hemabate)
The primary health care provider prescribed desmopressin (DDAVP) to a postpartum patient. What does the nurse expect the patient to have?	von Willebrand disease
Upon reviewing the ultrasound reports, the nurse finds that a patient's placenta has completely penetrated the myometrium, causing the patient to have persistent uterine bleeding. Which is the most suitable surgical procedure to be performed by the obstet	Uterine artery ligation
The nurse is caring for a patient during labor. Despite a firm and contracted uterine fundus, the patient has frank vaginal bleeding. Which action should the nurse take first?	Identify whether there are lacerations in the birth canal.
The nurse suspects that a postpartum patient has deep vein thrombosis (DVT). Which diagnostic test should the nurse expect the health care provider to prescribe to confirm DVT?	Venous ultrasonography
Which postpartum infection is most often contracted by first-time mothers who are breastfeeding?	mastitis
Which medication should not be given to a patient on anticoagulant therapy?	Aspirin
Which intervention does the nurse expect to be the most effective and least expensive for reducing the risk of urinary tract infections (UTIs) in the patient after the labor?	Maintaining aseptic conditions during labor
The nurse is assessing a patient with postpartum hemorrhage (PPH). During the physical assessment, the nurse finds that there are deep lacerations in the cervix. Which observation allows the nurse to conclude that the PPH is caused by cervical lacerations	Bright red blood
A postpartum patient has uterine atony. What medication does the nurse expect the primary health care provider to prescribe to the patient?	Oxytocin (Pitocin)
It has been determined after ultrasound that a small piece of the placenta remains in the uterus over an hour after birth, causing the fundus not to be firm and excessive bleeding to continue. Because the patient delivered a large infant with a small dose	Preparing the patient for the removal of the retained placental fragment, including the use of anesthesia
For which symptoms does the nurse monitor the postpartum patient with bipolar disorder? Select all that apply.	Increased energy Changes in mood Increased activity
After delivery the nurse finds that the patient has a retained placenta. The primary health care provider instructs the nurse to remove the placenta by manual separation without administering anesthesia to the patient. What patient clinical condition is t	The patient was administered regional anesthesia before delivery.
The nurse is caring for a patient whose placenta was removed manually. The nurse finds that the patient has developed an infection. Which category of medication does the nurse expect to be prescribed for the patient?
The nurse is caring for a postpartum patient who had a cesarean delivery. Following the assessment, the nurse reports that the patient has secondary postpartum hemorrhage. Based on which patient findings did the nurse come to this conclusion?	Loss of 1250 mL of blood 48 hours after the delivery
Following the assessment of a postpartum patient, the nurse suspects that the patient requires removal of uterine contents using a vacuum suction. Which patient clinical findings led the nurse to this conclusion?	Uterus feels boggy. Excessive bleeding. Placental fragments.
The nurse is caring for a postpartum patient with venous thrombosis. What instructions related to precautions to take with anticoagulant therapy should the nurse give to the patient at the time of discharge?	"Practice site rotation for administration through the subcutaneous (SC) route."
A primary health care provider prescribed 15-methyl prostaglandin F2α (Carboprost) to a patient. What history does the nurse check before administering this drug to the patient to prevent complications?	Asthma
Which postpartum conditions are considered medical emergencies that require immediate treatment?	Inversion of the uterus and hypovolemic shock
When a nurse observes profuse postpartum bleeding, what is the first and most important nursing intervention	Palpate the uterus and massage it if it is boggy
After removal of the retained placental fragment, the patient is recovering on the mother-baby (postpartum) unit. What should the nurse identify as the priority of care?	Checking the perineum frequently.
A pregnant patient with idiopathic thrombocytopenic purpura (ITP) who is receiving corticosteroid therapy is scheduled for a splenectomy. In what clinical situation would this surgery be beneficial to the patient?	The patient had no improvement from the administration of corticosteroids.
During the assessment of a postpartum patient, the nurse finds the patient has endometritis. Which medication should be administered in the treatment plan for this patient?	Clindamycin (Cleocin) `
After massaging the boggy fundus of a patient who delivered a large baby after a prolonged labor with a forceps-assisted birth, the nurse is unable to obtain a firm fundus. What nursing action is indicated at this time?	Massage the fundus while another nurse notifies the obstetrician.
A 28-year-old multipara delivered a 9-pound, 3-ounce baby girl an hour ago after a 22-hour labor with a forceps-assisted birth. As the patient is holding her daughter, she keeps shifting position and is becoming increasingly irritable and annoyed with eve	Check her perineum.
The nurse is caring for a postpartum patient who has deep vein thrombosis and is receiving warfarin (Coumadin) therapy. What instruction should the nurse give to the patient?	"Keep changing positions in the bed."
A patient who has postpartum bleeding caused by uterine subinvolution has not recovered with drug therapy. Moreover, the patient is not willing to undergo surgery for this condition. Which procedure would be helpful in managing the bleeding in this patien	Inserting a fist into the vagina
A patient who has undergone cesarean surgery reports to the nurse persistent perineal pain and feeling pressure in the vagina. The nurse finds that the patient is in shock. What clinical condition should the nurse suspect based on this assessment?	Retroperitoneal hematoma
A patient diagnosed with placenta accreta has uncontrolled bleeding, despite medications. What is the best choice for treatment in this situation?	Perform a hysterectomy.
A deceased fetus has been removed from a patient through cesarean section. What critical assessment should the nurse continuously monitor in the patient?	Blood Pressure
There is an increased risk for postpartum hemorrhage from birth until 4 weeks postpartum as levels of von Willebrand factor (vWf) and factor VIII decrease. What treatment should be considered first for the woman with von Willebrand disease who experiences	Desmopressin
What statement by the nurse should be included in the teaching for a patient prescribed sertraline for postpartum depression?	"Continue to take your prenatal vitamins."
A patient who is a gravida 5 para 4, 38 weeks gestation is being treated with magnesium sulfate for preeclampsia and is close to delivery. For what potential postpartum complication should the nurse prepare?	Postpartum hemorrhage
The nurse is caring for a postpartum patient who has expelled the placenta spontaneously. The patient is bleeding excessively and has a boggy uterus. What are the most effective nursing interventions in this situation? Select all that apply	Remove the placental fragments manually. Remove intrauterine contents using a vacuum suction. Perform ultrasonography to detect placental fragments.
Upon assessment the nurse finds that a patient who had a cesarean delivery is at risk for postpartum hemorrhage (PPH). What would be the most likely cause of PPH in this patient?	Anethesia
The nurse is administering a rapid intravenous (IV) infusion of a crystalloid solution in a postpartum patient who has an estimated blood loss of 1800 mL. Based on the estimated blood loss, how much crystalloid solution should be infused	5400
A patient receiving magnesium sulfate for preeclampsia experiences postpartum hemorrhage due to uterine atony. The uterine atony is unresponsive to oxytocin. What is the nurse’s priority action?	Administer misoprostol rectally.
The nurse is caring for a postpartum patient who is diagnosed with superficial venous thrombosis. What initial treatment should be given to this patient?	Administering nonsteroidal antiinflammatory drugs (NSAIDs)
Two hours after giving birth, a primiparous woman becomes anxious and complains of intense perineal pain with a strong urge to have a bowel movement. Her fundus is firm, at the umbilicus and midline. Her lochia is moderate rubra with no clots. What would	Hematoma formation
After physical assessment of a patient during labor, the nurse finds that the fetal head is exerting pressure on the patient's vaginal mucosa. Which postpartum complication does the nurse expect in the patient?	Deep vaginal lacerations and hematomas
Postpartum women experience an increased risk for urinary tract infection. What is a prevention measure the nurse could teach the postpartum woman?	Perform perineal care on a regular basis.
A postpartum patient experiencing hemorrhagic shock has been administered an intravenous (IV) infusion of crystalloid solution. reviewing the patient's laboratory reports, platelet count and clotting factor levels have not improved. What is the best trea	Infuse fresh frozen plasma.
A patient with venous thromboembolism is given intravenous heparin as prescribed by the primary health care provider (PHP). After 3 days the patient is prescribed oral anticoagulants. What duration of oral anticoagulant therapy does the nurse expect the P	3 months
The nurse finds that a patient has excessive postpartum bleeding. The patient also has bronchial asthma. Which medication does the nurse expect the primary health care provider to prescribe to the patient?	Oxytocin (Pitocin
A postpartum patient who had a cesarean section reports to the nurse a fever, loss of appetite, pelvic pain, and foul-smelling lochia. Upon assessment, the nurse finds that the patient has an increased pulse rate and uterine tenderness. The laboratory rep	Endometritis
While caring for a postpartum patient, the nurse finds that the patient has spurts of blood with clots. What does the nurse infer about the patient's clinical condition from this sign?	Partial separation of the placenta
The nurse caring for a patient finds excessive postpartum bleeding caused by uterine atony. Upon further assessment, the nurse finds no improvement in the bleeding after administration of oxytocin (Pitocin). What does the primary health care provider pres	Misoprostol (Cytotec)
During an assessment the nurse finds that a patient is multiparous, has multifetal gestation, and has polyhydramnios. What does the nurse expect the patient to be at risk for after the delivery?	Uterine atony
The primary health care provider prescribed desmopressin (DDAVP) to a postpartum patient. What does the nurse expect the patient to have?	von Willebrand disease
Upon reviewing the ultrasound reports, the nurse finds that a patient's placenta has completely penetrated the myometrium, causing the patient to have persistent uterine bleeding. Which is the most suitable surgical procedure to be performed by the obstet	Uterine artery ligation

What is postpartum thromboembolic disorders?

In thromboembolic disorders. Typically, blood clots occur in the... read more , blood clots (thrombi) form in blood vessels. An embolus is a blood clot that travels through the bloodstream and blocks an artery. In the United States, thromboembolic disorders are a common cause of death in pregnant women.

What factors places the postpartum client at risk for thromboembolism?

Risk Factors for DVT During the Postpartum Period Deliveries ≥2, preeclampsia/eclampsia, postpartum hemorrhage, and birth weight especially <2500 g (low birth weight) were statistically significant characteristics that were associated with postpartum DVT (all P < . 05).

What are the thromboembolic disorders?

A thromboembolism is a circulating blood clot that gets stuck and causes an obstruction. Both deep vein thrombosis and pulmonary embolism are included under the umbrella term of venous thromboembolic diseases because both have the potential to obstruct blood flow in your veins.

Why are postpartum mothers prone to thrombophlebitis?

Why is deep vein thrombosis (DVT) more common in pregnancy and postpartum? DVT may be more common during pregnancy because nature, wisely wanting to limit bleeding at childbirth, tends to increase the blood's clotting ability around birth — occasionally too much.

What are thromboembolic conditions that are of concern during the postpartum period?

What is postpartum thromboembolic disorders?

What factors places the postpartum client at risk for thromboembolism?

What are the thromboembolic disorders?

Why are postpartum mothers prone to thrombophlebitis?

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