Nursing · NCLEX-RN

Nursing: Postpartum and Newborn Care

Postpartum hemorrhage risk, involution assessment, and newborn transition-to-extrauterine-life care priorities.

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What is the definition of postpartum hemorrhage (PPH) after a vaginal birth?
Blood loss greater than 500 mL
What is the definition of postpartum hemorrhage (PPH) after a cesarean birth?
Blood loss greater than 1000 mL
What is the most common cause of postpartum hemorrhage?
Uterine atony
What do the 4 T's of postpartum hemorrhage causes stand for?
Tone, Trauma, Tissue, Thrombin
A nurse finds a postpartum client's fundus soft and boggy. What is the first action?
Massage the fundus
What is the first-line medication given to treat uterine atony?
Oxytocin
Methylergonovine (Methergine) is contraindicated in clients with which condition?
Hypertension
Carboprost (Hemabate) is contraindicated in clients with which condition?
Asthma
By what route can misoprostol be given to control postpartum hemorrhage?
Rectally (also oral or sublingual)
Early postpartum hemorrhage occurs within what time frame after birth?
Within the first 24 hours
Late postpartum hemorrhage occurs within what time frame?
24 hours to 6 weeks after birth
Retained placental fragments correspond to which of the 4 T's of PPH?
Tissue
Why can heart rate rise before blood pressure drops during early postpartum hemorrhage?
Pregnancy-related blood volume expansion masks early blood loss, so tachycardia appears before hypotension
What is uterine involution?
The process of the uterus returning to its prepregnancy size and position after birth
Where is the fundus normally located immediately after birth?
At the level of the umbilicus

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