PPH-(Fatime Sanogo) Post-Sim Questions and answers 2021/2022

QUESTION 1: Ms. Sanogo is Muslim and she has been in the United States for 7 months. She speaks limited English. During patient care, she expresses that she is feeling sad because she is away from her family in Mali, West Africa. What are some methods that the nurse would take to establish therapeutic communication with Ms. Sanogo? (Select all that apply) Your Response: Correct Response: Explanation: Nurses can be more aware of another person’s cultural differences by understanding what has shaped their own values and beliefs. To gain the patient’s and her husband’s trust and encourage them to share important information, the nurse would use active listening skills. The nurse would incorporate a translator in person or over telecommunications to give the patient and her family member information in several different ways, to ensure their understanding and overcome any cultural barriers that may be present. While most female patients prefer women to provide care, the Muslim culture does allow for a male provider to attend to female patients. The husband is allowed to be present during the birth of a child and while his wife is being assessed for birth complications. It is not a therapeutic intervention to share experiences that are personal or from other patients, because each person’s situation is individual and it could break privacy practices. QUESTION 2: What were the identifiable risk factors that indicated postpartum hemorrhage for Ms. Sanogo? (Select all that apply) Your Response: Correct Response: Explanation: The risk factors notable for Ms. Sanogo were that she delivered within the past 24 hours, she delivered a large-forgestation infant, and her second stage of labor was prolonged. The postpartum woman benefits by breastfeeding after delivery due to the natural release of oxytocin. A multiparous woman would be at risk for postpartum hemorrhage. QUESTION 3: Oxytocin is administered to Ms. Sanogo in order to minimize blood loss. Which of the following measures would the nurse take to evaluate the effectiveness of the oxytocin administration? (Select all that apply) Your Response: Correct Response: Explanation: Oxytocin is a uterotonic medication that leads to contraction of the uterine muscles. This contraction could lead to the patient experiencing significant pain; thus, obtaining the patient’s pain level is important in determining the drug’s efficacy. Monitor the patient’s vital signs to identify any adverse effects due to oxytocin administration. Fundal and lochia assessments are important to determine if the oxytocin therapy is effective at minimizing the blood loss. Auscultation of lung and bowel sounds would not identify if oxytocin was minimizing uterine blood loss. This study source was downloaded by from CourseH on :37:04 GMT -05:00  Correct! Capillary refill 3½ seconds Correct! Misoprostol (Cytotec) Correct! Permit the use of beads or amulets as they will allow the parents to express their spirituality Correct! Place one hand above the symphysis pubis and gently massage the fundus in a circular motion with the other hand Ricci, S. Essentials of Maternity, Newborn, and Women’s Health Nursing, 4th Edition, p. 806  Lippincott Procedures, Oxytocin administration, postpartum Ricci, S. Essentials of Maternity, Newborn, and Women’s Health Nursing, 4th Edition, p. 805  Lippincott Advisor, Shock (hypovolemic) Ricci, S. Essentials of Maternity, Newborn, and Women’s Health Nursing, 4th Edition, p. 800 Ricci, S. Essentials of Maternity, Newborn, and Women’s Health Nursing, 4th Edition, p. 45 Ricci, S. Essentials of Maternity, Newborn, and Women’s Health Nursing, 4th Edition, pp. 806-807 QUESTION 4: During the fourth stage of labor, Ms. Sanogo, who delivered vaginally, experiences excessive blood loss. Which patient finding would indicate that Ms. Sanogo is experiencing a mild degree of shock? Your Response: Correct Response: Explanation: Capillary refill is prolonged at more than 3 seconds and is an indication of mild shock, along with diaphoresis, cool extremities, and maternal anxiety. A urinary output of 30 mL (1 oz) per hour or greater and heart rate between 50 and 100 bpm are normal. A late sign of shock is narrowing pulse pressure and drop in blood pressure below 90 mm Hg systolic and 40 mm Hg diastolic. QUESTION 5: Which of the following uterotonic drugs would the nurse anticipate being used after oxytocin (Pitocin) to manage postpartum hemorrhage? Your Response: Correct Response: Explanation: The nurse would anticipate the use of misoprostol following oxytocin when there is continued vaginal blood loss. Methylergonovine maleate and carboprost tromethamine are uterotonic agents, but they would be given after oxytocin and misoprostol to control early postpartum hemorrhage. Terbutaline sulfate is a tocolytic agent that prevents uterine muscle contraction, which could lead to further uterine hemorrhage. QUESTION 6: Ms. Sanogo’s husband explained that their culture believes in placing beads or amulets at the female’s waist. What is a culturally competent measure that the nurse can provide to this family during the event of postpartum hemorrhage? Your Response: Correct Response: Explanation: The patient’s husband expressed that their culture uses beads or amulets to provide the mother with spiritual strength and/or for medicinal purposes. Because these items are not causing any harm to the patient’s condition, she should be allowed to use them. Postpartum hemorrhage can be a serious complication of delivery, and the patient’s needs must be incorporated into the plan of care. The nurse would take measures to promote family-centered care by collaborating with the patients’ family members.