Which of the following circumstances is most likely to cause uterine Atony?
Postpartum hemorrhage (also called PPH) is a serious but rare condition when a woman has heavy bleeding after giving birth.If you think you’re having PPH, call your health care provider or 911 immediately.You may have PPH if you have heavy bleeding from the vagina that doesn’t slow or stop, blurred vision or chills, or if you feel weak or like you’re going to faint.You’re more likely to have PPH if you’ve had it in the past or if you have certain medical conditions, especially conditions that affect the uterus (womb) or the placenta or conditions that affect how your blood clots.Practice Mode – Questions and choices are randomly arranged, the answer is revealed instantly after each question, and there is no time limit for the exam. Show
Postpartum Hemorrhage Practice Exam (PM)*Please wait while the activity loads. If loading fails, click here to try again Choose the letter of the correct answer. Good luck! Start Congratulations - you have completed Postpartum Hemorrhage Practice Exam (PM)*. You scored %%SCORE%% out of %%TOTAL%%. Your performance has been rated as %%RATING%% Your answers are highlighted below. Question 1 A nurse is monitoring a new mother in the PP period for signs of hemorrhage. Which of the following signs, if noted in the mother, would be an early sign of excessive blood loss? A A temperature of 100.4*F B An increase in the pulse from 88 to 102 BPM C An increase in the respiratory rate from 18 to 22 breaths per minute D A blood pressure change from 130/88 to 124/80 mm Hg Question 1 Explanation: During the 4th stage of labor, the maternal blood pressure, pulse, and respiration should be checked every 15 minutes during the first hour. A rising pulse is an early sign of excessive blood loss because the heart pumps faster to compensate for reduced blood volume.
Question 2 The 4 “T’s” of PPH are:
A 1, 4, 6 & 8 B 1, 5 7 & 8 C 1, 2, 3 & 6 D 3, 4, 5 & 6 Question 3 Methergine or Pitocin are prescribed for a client with PP hemorrhage. Before administering the medication(s), the nurse contacts the health provider who prescribed the medication(s) in which of the following conditions is documented in the client’s medical history? A Peripheral vascular disease B Hypothyroidism C Hypotension D Type 1 diabetes Question 3 Explanation: These medications are avoided in clients with significant cardiovascular disease, peripheral disease, hypertension, eclampsia, or preeclampsia. These conditions are worsened by the vasoconstriction effects of these medications. Question 4 Atonic bleeding is due to a lack of tone in the uterus. A True B False Question 5 Which measure would be least effective in preventing postpartum hemorrhage? A Administer Methergine 0.2 mg every 6 hours for 4 doses as ordered B Encourage the woman to void every 2 hours C Massage the fundus every hour for the first 24 hours following birth D Teach the woman the importance of rest and nutrition to enhance healing Question 5 Explanation: The fundus should be massaged only when boggy or soft. Massaging a firm fundus could cause it to relax.
Question 6 Methergine or Pitocin is prescribed for a woman to treat PP hemorrhage. Before administration of these medications, the priority nursing assessment is to check the: A Amount of lochia B Blood pressure C Deep tendon reflexes D Uterine tone Question 6 Explanation: Methergine and pitocin are agents that are used to prevent or control postpartum hemorrhage by contracting the uterus. They cause continuous uterine contractions and may elevate blood pressure. A priority nursing intervention is to check blood pressure. The physician should be notified if hypertension is present. Question 7 To be considered a PPH, what would the estimated blood loss have to be for a C-section? A < 550 ML B > 600 ML C > 1000 ML D < 900 ML Question 8 What types of trauma during labour and birth would lead to PPH risk? A Instrumental assisted birth (vacuum or forceps) B C-Section C Lacerations of the cervix or vaginal wall D All of the above Question 9 Which of the following complications is most likely responsible for a delayed postpartum hemorrhage? A Cervical laceration B Clotting deficiency C Perineal laceration D Uterine subinvolution Question 9 Explanation: Late postpartum bleeding is often the result of subinvolution of the uterus. Retained products of conception or infection often cause subinvolution.
Question 10 Which of the following circumstances is most likely to cause uterine atony and lead to PP hemorrhage? A Hypertension B Cervical and vaginal tears C Urine retention D Endometritis Question 10 Explanation: Urine retention causes a distended bladder to displace the uterus above the umbilicus and to the side, which prevents the uterus from contracting. The uterus needs to remain contracted if bleeding is to stay within normal limits. Cervical and vaginal tears can cause PP hemorrhage but are less common occurrences in the PP period. Once you are finished, click the button below. Any items you have not completed will be marked incorrect. Get Results There are 10 questions to complete. ← List → Return Shaded items are complete. 12345678910EndReturn You have completed questions question Your score is Correct Wrong Partial-Credit You have not finished your quiz. If you leave this page, your progress will be lost. Correct Answer You Selected Not Attempted Final Score on Quiz Attempted Questions Correct Attempted Questions Wrong Questions Not Attempted Total Questions on Quiz Question Details Results Date Score Hint Time allowed minutes seconds Time used Answer Choice(s) Selected Question Text All done Need more practice! Keep trying! Not bad! Good work! Perfect! Exam ModeExam Mode – Questions and choices are randomly arranged, time limit of 1 min per question, answers and grade will be revealed after finishing the exam. Postpartum Hemorrhage Practice Exam (EM)*Please wait while the activity loads. If loading fails, click here to try again Choose the letter of the correct answer. You have 10 mins to finish this exam. Good luck! Start Congratulations - you have completed Postpartum Hemorrhage Practice Exam (EM)*. You scored %%SCORE%% out of %%TOTAL%%. Your performance has been rated as %%RATING%% Your answers are highlighted below. Question 1 To be considered a PPH, what would the estimated blood loss have to be for a C-section? A < 550 ML B > 600 ML C > 1000 ML D < 900 ML Question 2 What types of trauma during labour and birth would lead to PPH risk? A Instrumental assisted birth (vacuum or forceps) B C-Section C Lacerations of the cervix or vaginal wall D All of the above Question 3 Methergine or Pitocin are prescribed for a client with PP hemorrhage. Before administering the medication(s), the nurse contacts the health provider who prescribed the medication(s) in which of the following conditions is documented in the client’s medical history? A Peripheral vascular disease B Hypothyroidism C Hypotension D Type 1 diabetes Question 3 Explanation: These medications are avoided in clients with significant cardiovascular disease, peripheral disease, hypertension, eclampsia, or preeclampsia. These conditions are worsened by the vasoconstriction effects of these medications. Question 4 Methergine or Pitocin is prescribed for a woman to treat PP hemorrhage. Before administration of these medications, the priority nursing assessment is to check the: A Amount of lochia B Blood pressure C Deep tendon reflexes D Uterine tone Question 4 Explanation: Methergine and pitocin are agents that are used to prevent or control postpartum hemorrhage by contracting the uterus. They cause continuous uterine contractions and may elevate blood pressure. A priority nursing intervention is to check blood pressure. The physician should be notified if hypertension is present. Question 5 Which of the following complications is most likely responsible for a delayed postpartum hemorrhage? A Cervical laceration B Clotting deficiency C Perineal laceration D Uterine subinvolution Question 5 Explanation: Late postpartum bleeding is often the result of subinvolution of the uterus. Retained products of conception or infection often cause subinvolution.
Question 6 A nurse is monitoring a new mother in the PP period for signs of hemorrhage. Which of the following signs, if noted in the mother, would be an early sign of excessive blood loss? A A temperature of 100.4*F B An increase in the pulse from 88 to 102 BPM C An increase in the respiratory rate from 18 to 22 breaths per minute D A blood pressure change from 130/88 to 124/80 mm Hg Question 6 Explanation: During the 4th stage of labor, the maternal blood pressure, pulse, and respiration should be checked every 15 minutes during the first hour. A rising pulse is an early sign of excessive blood loss because the heart pumps faster to compensate for reduced blood volume.
Question 7 Which measure would be least effective in preventing postpartum hemorrhage? A Administer Methergine 0.2 mg every 6 hours for 4 doses as ordered B Encourage the woman to void every 2 hours C Massage the fundus every hour for the first 24 hours following birth D Teach the woman the importance of rest and nutrition to enhance healing Question 7 Explanation: The fundus should be massaged only when boggy or soft. Massaging a firm fundus could cause it to relax.
Question 8 Which of the following circumstances is most likely to cause uterine atony and lead to PP hemorrhage? A Hypertension B Cervical and vaginal tears C Urine retention D Endometritis Question 8 Explanation: Urine retention causes a distended bladder to displace the uterus above the umbilicus and to the side, which prevents the uterus from contracting. The uterus needs to remain contracted if bleeding is to stay within normal limits. Cervical and vaginal tears can cause PP hemorrhage but are less common occurrences in the PP period. Question 9 Atonic bleeding is due to a lack of tone in the uterus. A True B False Question 10 The 4 “T’s” of PPH are:
A 1, 4, 6 & 8 B 1, 5 7 & 8 C 1, 2, 3 & 6 D 3, 4, 5 & 6 Once you are finished, click the button below. Any items you have not completed will be marked incorrect. Get Results There are 10 questions to complete. ← List → Return Shaded items are complete. 12345678910EndReturn You have completed questions question Your score is Correct Wrong Partial-Credit You have not finished your quiz. If you leave this page, your progress will be lost. Correct Answer You Selected Not Attempted Final Score on Quiz Attempted Questions Correct Attempted Questions Wrong Questions Not Attempted Total Questions on Quiz Question Details Results Date Score Hint Time allowed minutes seconds Time used Answer Choice(s) Selected Question Text All done Need more practice! Keep trying! Not bad! Good work! Perfect! Text ModeText Mode – Text version of the exam 1. A nurse is monitoring a new mother in the PP period for signs of hemorrhage. Which of the following signs, if noted in the mother, would be an early sign of excessive blood loss?
2. Methergine or Pitocin is prescribed for a woman to treat PP hemorrhage. Before administration of these medications, the priority nursing assessment is to check the:
3. Methergine or Pitocin are prescribed for a client with PP hemorrhage. Before administering the medication(s), the nurse contacts the health provider who prescribed the medication(s) in which of the following conditions is documented in the client’s medical history?
4. Which of the following complications is most likely responsible for a delayed postpartum hemorrhage?
5. Which of the following circumstances is most likely to cause uterine atony and lead to PP hemorrhage?
6. Which measure would be least effective in preventing postpartum hemorrhage?
7. To be considered a PPH, what would the estimated blood loss have to be for a C-section?
8. What types of trauma during labour and birth would lead to PPH risk?
9. Atonic bleeding is due to a lack of tone in the uterus.
10. The 4 “T’s” of PPH are:
Answer and Rationale1. B. An increase in the pulse from 88 to 102 BPM. During the 4th stage of labor, the maternal blood pressure, pulse, and respiration should be checked every 15 minutes during the first hour. A rising pulse is an early sign of excessive blood loss because the heart pumps faster to compensate for reduced blood volume.
2. B. Blood pressure. Methergine and pitocin are agents that are used to prevent or control postpartum hemorrhage by contracting the uterus. They cause continuous uterine contractions and may elevate blood pressure. A priority nursing intervention is to check blood pressure. The physician should be notified if hypertension is present. 3. A. Peripheral vascular disease. These medications are avoided in clients with significant cardiovascular disease, peripheral disease, hypertension, eclampsia, or preeclampsia. These conditions are worsened by the vasoconstriction effects of these medications. 4. D. Uterine subinvolution. Late postpartum bleeding is often the result of subinvolution of the uterus. Retained products of conception or infection often cause subinvolution.
5. C. Urine retention. Urine retention causes a distended bladder to displace the uterus above the umbilicus and to the side, which prevents the uterus from contracting. The uterus needs to remain contracted if bleeding is to stay within normal limits. Cervical and vaginal tears can cause PP hemorrhage but are less common occurrences in the PP period. 6. C. Massage the fundus every hour for the first 24 hours following birth. The fundus should be massaged only when boggy or soft. Massaging a firm fundus could cause it to relax. What is the most common cause of uterine atony?What causes uterine atony? Uterine atony is caused by the inability of the myometrium to contract sufficiently in response to oxytocin, a hormone the body releases before and during childbirth to stimulate uterine contractions.
What conditions cause uterine atony?What are the risk factors for uterine atony?. This is your first baby or you've had more than five babies.. You're having twins, triplets and more.. Your baby is larger than average (fetal macrosomia).. You're older than 35.. You have too much amniotic fluid (polyhydramnios).. You have obesity.. You have uterine fibroids.. Which of the following circumstance is most likely to cause uterine atony and lead to postpartum hemorrhage?The most common cause of PPH is uterine atony. Patients at increased risk for uterine atony include those with high parity, overdistended uterus (e.g., multiple gestation, polyhydramnios), prolonged or rapid labor, use of oxytocin for induction or augmentation, and use of magnesium sulfate.
In which of the following is uterine atony likely to happen postpartum?Women with a medium risk factor for uterine atony-related postpartum hemorrhage include prior uterine surgery, multiple gestation, grand multiparity, prior PPH, large fibroids, macrosomia, body mass index greater than 40, anemia, chorioamnionitis, prolonged second stage, oxytocin longer than 24 hours, and magnesium ...
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