OB Exam 3 Part 1 Questions with Solved Correct Answers
1. what is the time frame for primary postpartum hemorrhage?: - within 24 hours of birth or 1st day but most
occur within 4 hours
2. what is the time frame for delayed (late) postpartum hemorrhage?: - 24 hours to 12 weeks after birth
3. what can delayed postpartum hemorrhage be caused by?: delayed involution like no compliance with exercise
limitations causing subinvolution
4. what is considered PPH blood loss for vaginal birth?: >500 ml
5. what is considered PPH blood loss for caesarean birth?: >1000ml
6. what are the "four T's" of PPH?: tone, tissue, trauma, and thrombin
7. why is tone a main cause of PPH?: - uterine atony
8. what is uterine atony?: - most common cause of primary PPH
- failure of uterus to contract during involution causing boggy uterus
9. causes of tone/uterine atony PPH:: - over distention: from multiples, a big baby, amniotic fluid, wont be able to
clamp up bleeding arteries
- tired uterus: many pregnancies, prolonged labor, post dates
- distended bladder: pushes uterus
10.why is tissues a cause of PPH?: retained placenta and clots cause subinvolu- tion because its not working well
11.why is trauma a cause of PPH?: - vaginal, cervical, or uterine injury from forceps or pushing before 10cm
12.causes of trauma for PPH:: - episiotomies/lacerations to cervix not sutured adequately
, - hematoma
- uterine inversion
13.what is a hematoma?: collection of blood that doesnt come out
14.what can be expected if PPH from hematoma?: - bright red bleeding, firm uterus
- client report increasing pain and pressure pinpoint and not respond to meds
- surgically corrected
15.what is uterine inversion?: - turn inside out from rubbing or massaging uterus too much
- surgery or hysterectomy
16.why is thrombin a cause of PPH?: - coagulopathy
- prevent clotting
- ITP: autoimmune platelet destruction/replacement
17.PPH therapeutic management:: - Focus on underlying cause
- Uterine massage: if atony but not too much, help with tone issues
- Removal of retained placental fragments
- Antibiotics for infection
- Repair of lacerations
18.Nursing assessment of PPH: risk factors: - PN records
- red hair/heads bleed more
19.nursing assessment of PPH:: - fundal check
1. what is the time frame for primary postpartum hemorrhage?: - within 24 hours of birth or 1st day but most
occur within 4 hours
2. what is the time frame for delayed (late) postpartum hemorrhage?: - 24 hours to 12 weeks after birth
3. what can delayed postpartum hemorrhage be caused by?: delayed involution like no compliance with exercise
limitations causing subinvolution
4. what is considered PPH blood loss for vaginal birth?: >500 ml
5. what is considered PPH blood loss for caesarean birth?: >1000ml
6. what are the "four T's" of PPH?: tone, tissue, trauma, and thrombin
7. why is tone a main cause of PPH?: - uterine atony
8. what is uterine atony?: - most common cause of primary PPH
- failure of uterus to contract during involution causing boggy uterus
9. causes of tone/uterine atony PPH:: - over distention: from multiples, a big baby, amniotic fluid, wont be able to
clamp up bleeding arteries
- tired uterus: many pregnancies, prolonged labor, post dates
- distended bladder: pushes uterus
10.why is tissues a cause of PPH?: retained placenta and clots cause subinvolu- tion because its not working well
11.why is trauma a cause of PPH?: - vaginal, cervical, or uterine injury from forceps or pushing before 10cm
12.causes of trauma for PPH:: - episiotomies/lacerations to cervix not sutured adequately
, - hematoma
- uterine inversion
13.what is a hematoma?: collection of blood that doesnt come out
14.what can be expected if PPH from hematoma?: - bright red bleeding, firm uterus
- client report increasing pain and pressure pinpoint and not respond to meds
- surgically corrected
15.what is uterine inversion?: - turn inside out from rubbing or massaging uterus too much
- surgery or hysterectomy
16.why is thrombin a cause of PPH?: - coagulopathy
- prevent clotting
- ITP: autoimmune platelet destruction/replacement
17.PPH therapeutic management:: - Focus on underlying cause
- Uterine massage: if atony but not too much, help with tone issues
- Removal of retained placental fragments
- Antibiotics for infection
- Repair of lacerations
18.Nursing assessment of PPH: risk factors: - PN records
- red hair/heads bleed more
19.nursing assessment of PPH:: - fundal check
