A mother of a preterm baby is performing skin-to-skin contact in the neonatal nursery. Which of the following responses would the nurse evaluate as a positive neonatal outcome?

Choice A rationale

Uterine prolapse involves the descent of the uterus into the vaginal canal and is not a direct fatal complication of postpartum hemorrhage. It primarily stems from weakened pelvic floor muscles or ligament damage.

Choice B rationale

Von Willebrand’s disease is a hereditary bleeding disorder related to factor VIII and von Willebrand factor deficiencies, predisposing individuals to bleeding. It is not a direct result of prolonged postpartum hemorrhage.

Choice C rationale

Preeclampsia is a hypertensive disorder associated with proteinuria and organ dysfunction during pregnancy, not a postpartum hemorrhage complication. It can lead to significant morbidity but is unrelated to hemorrhagic complications.

Choice D rationale

Disseminated Intravascular Coagulation (DIC) is a life-threatening condition involving widespread coagulation and fibrinolysis, leading to uncontrolled bleeding, often triggered by severe postpartum hemorrhage. Laboratory findings may include low platelets, prolonged PT/INR, and elevated D-dimer.

Choice A rationale

Hypoxia may contribute to tachypnea and distress, but it is unlikely the primary cause, as baseline fetal heart rate of 180 BPM indicates infection-related stress rather than isolated oxygen deprivation.

Choice B rationale

Respiratory distress syndrome predominantly affects preterm infants due to surfactant deficiency. At 37 weeks’ gestation, surfactant levels should be adequate, making this an unlikely cause of the newborn’s tachypnea and pallor.

Choice C rationale

Prolonged rupture of membranes increases the risk of neonatal sepsis. Signs such as tachypnea, pallor, and elevated fetal heart rate with marked variability suggest systemic infection requiring immediate evaluation and treatment.

Choice D rationale

Phrenic nerve injury typically causes diaphragmatic paralysis, leading to asymmetric chest movement and respiratory distress. However, it does not explain the systemic signs like pallor or elevated heart rate, making it an unlikely cause.