09.01 Postpartum Hematoma

• Question 1 of 10

A nurse is caring for a postpartum client with a hematoma. What would be the most concerning development?

• Hemoglobin of 9.0 g/dL
• Urinary obstruction
• Perineal pressure
• Pain 5/10

• Question 2 of 10

A nurse is performing a postpartum assessment and notes bulging in the perineum, the patient reports a feeling of pressure in the area. Which intervention is the most appropriate?

• Sitz bath
• Numbing spray
• Foley catheter
• Ice

• Question 3 of 10

A nurse is assessing a postpartum client. Findings include a temperature of 100°F, a feeling of pressure in her vagina, and a pulse of 102. Which of the following conditions is the most likely cause of these findings?

• Episiotomy
• Endometritis
• Postpartum hematoma
• Postpartum hemorrhage

• Question 4 of 10

A nurse is working on a postpartum unit and is starting the day shift. The nurse is caring for the following clients. Which of the following clients should the nurse see first?

• A 24-year-old client who has had a large amount of lochia and has developed a hematoma on her perineum
• A 20-year-old client who just had her first baby and doesn't know how to breastfeed
• A 27-year-old diabetic client who delivered her second child yesterday and needs her morning dose of insulin
• A 30-year-old client who needs to take a shower and eat breakfast before the provider comes to dismiss her

• Question 5 of 10

A nurse is assessing a postpartum client who delivered a baby four hours ago. The client had a complicated delivery and suffered a third degree perineal laceration. The nurse notes that the client has a contracted uterus with excessive, bright red lochia. Which of the following actions is appropriate for the nurse to take?

• Notify the healthcare provider
• Perform a manual cervical assessment
• Apply an ice pack to the client's perineum
• Massage the client's uterus and locate the fundus

• Question 6 of 10

A nurse is caring for a postpartum client who underwent a vacuum assisted delivery. Which of the following findings would be the most concerning?

• Abdominal cramping
• Flushed, red skin
• Heart rate of 102
• Inability to void

• Question 7 of 10

A nurse has received report on 4 postpartum clients. Which of the following clients should be seen first?

• A client who has afterpains rated 6/10 even after treatment with ketorolac
• A client who is having difficulty breastfeeding her baby
• A client that delivered 6 hours ago and wants her assessment done so she can sleep
• A client who had an episiotomy at delivery and has a lot of swelling and pain that ice is not helping

• Question 8 of 10

The nurse is caring for a client who just delivered a healthy, 7lb 8 oz baby, assisted by forceps. Which of the following statements by the mother in the postpartum period is most concerning?

• "Right after I breastfeed him, my abdomen cramps terribly"
• "I feel like I'm bleeding a lot. I'm saturating about 1 pad ever 2 hours"
• "I don't want him to have the hep B shot"
• "I really have to pee, but I can't seem to get it out"

• Question 9 of 10

The nurse is prioritizing assessments on a client load in the postpartum unit. Which of the following clients will the nurse see first?

• The 41 year-old mother that delivered twins via c-section, reporting severe uterine pain after breastfeeding
• The 19 year-old mother who delivered via c-section, and is having a lot of trouble getting her baby to latch during breastfeeding
• The 32 year-old mother who had a forcep-assisted delivery in the middle of the night and mentioned during report that she has to pee, but can't get it out
• The 27 year-old mother who delivered vaginally without complication, saturating 1 pad every 1.5 hours

• Question 10 of 10

A nurse is caring for a postpartum mother who delivered a baby 3 days ago. On the first day following delivery, the provider ordered a hemoglobin level for the client. The result was 9.9 g/dL. The provider did not list any other orders in the client’s chart since that time. Which response of the nurse is most appropriate?

• Contact the laboratory and ask them to repeat the test
• Call the provider and ask about the possibility of a blood transfusion
• Ask the provider about the hemoglobin level during rounds
• Continue to monitor the client and document the result