A nurse is caring for a client who experienced a postpartum hemorrhage after delivering a large baby following oxytocin induction of labor.

Which of the following factors put this client at risk for developing postpartum hemorrhage? (Select all that apply)

Grand multiparity

Uterine overdistention

Precipitous labor

Oxytocin use

Chorioamnionitis

Answer and Explanation

Correct Answer : B,D,E

The correct answer is choice B, D and E. These are the factors that put this client at risk for developing postpartum hemorrhage:

• Uterine overdistention: This occurs when the uterus is stretched too much by a large baby, multiple babies, or excess amniotic fluid. This can impair the normal contraction of the uterus after delivery and lead to bleeding.

• Oxytocin use: This is a hormone that stimulates uterine contractions during labor. However, prolonged or excessive use of oxytocin can cause uterine atony, which is the failure of the uterus to contract and compress the blood vessels after delivery.

• Chorioamnionitis: This is an infection of the membranes and amniotic fluid that surround the baby. It can cause inflammation and damage to the uterine lining, which can interfere with blood clotting and increase the risk of bleeding.

Choice A and C are wrong because:

• Grand multiparity: This means having given birth five or more times. It is not a risk factor for postpartum hemorrhage by itself, but it may be associated with other risk factors such as uterine overdistention, oxytocin use, or placental abnormalities.

• Precipitous labor: This means having a very fast labor, lasting less than three hours. It is not a risk factor for postpartum hemorrhage by itself, but it may be associated with other risk factors such as trauma to the birth canal, retained placenta, or coagulation disorders.

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Correct Answer is ["A","B","C","E"]

Explanation

The correct answer is choices A, B, C, and E.These are all medications that can help contract the uterus and stop the bleeding caused by retained placental fragments.Oxytocin (Pitocin) is the most effective and commonly used uterotonic agent.Methylergonovine maleate (Methergine) and carboprost tromethamine (Hemabate) are alternative drugs that can be used if oxytocin is ineffective or unavailable.Misoprostol (Cytotec) is a prostaglandin analogue that can also help reduce blood loss.

Choice D is wrong because manual removal of placenta fragments is not an intervention that the nurse should anticipate.Manual removal of placenta fragments is a last resort option that can cause more bleeding and infection, and should only be performed by a skilled provider.

A. Administering oxytocin after delivery B. Encouraging frequent voiding C. Assessing vital signs every 4 hours D. Encouraging ambulation as soon as possible E. Massaging fundus

Correct Answer is ["A","B"]

Explanation

The correct answer is choice A and B. Administering oxytocin after delivery and encouraging frequent voiding are interventions that can help prevent or treat PPH due to uterine atony.Uterine atony is the most common cause of PPH and it occurs when the uterus fails to contract after birth, leading to excessive bleeding.Oxytocin is a medication that stimulates uterine contractions and reduces blood loss.Frequent voiding can help empty the bladder and allow the uterus to contract more effectively.

Choice C is wrong because assessing vital signs every 4 hours is not frequent enough for a client who is at risk for PPH.Vital signs should be monitored more closely to detect signs of hypovolemia and shock.

Choice D is wrong because encouraging ambulation as soon as possible can increase the risk of bleeding in a client who has uterine atony.Ambulation should be delayed until the uterus is firm and the bleeding is controlled.

Choice E is wrong because massaging the fundus is not an intervention for PPH due to uterine atony, but rather for PPH due to retained placental fragments.Massaging the fundus can help expel any remaining tissue from the uterus and prevent infection.

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A nurse is caring for a client who experienced a postpartum hemorrhage after delivering a large baby following oxytocin induction of labor. Which of the following factors put this client at risk for developing postpartum hemorrhage? (Select all that apply)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has just delivered a baby and is experiencing postpartum hemorrhage due to retained placental fragments. Which of the following interventions should the nurse anticipate? Select all that apply:

Correct Answer is ["A","B","C","E"]

Explanation

A nurse is caring for a client who has just delivered her baby and is at risk for PPH due to uterine atony.Which interventions should be included in this client’s plan of care? (Select all that apply)

Correct Answer is ["A","B"]

Explanation

A nurse is providing discharge instructions to a client who had postpartum hemorrhage due to placenta accreta and underwent hysterectomy. Which of the following statements by the client indicates an understanding of the teaching?

A nurse is assisting with an emergency cesarean delivery for a client who has placenta previa and is experiencing profuse bleeding. Which of the following medications should the nurse anticipate administering to this client after delivery?

A nurse is performing fundal massage for a client who has uterine atony and postpartum hemorrhage. Which of the following actions should the nurse take when performing this procedure?

A nurse is caring for a client who has just delivered her baby and is at risk for PPH due to retained placental fragments. Which interventions should be included in this client’s plan of care? (Select all that apply.)

A nurse is preparing to administer methylergonovine to a client who has a postpartum hemorrhage due to uterine atony. Which of the following assessments should the nurse perform prior to administration?

Postpartum hemorrhage is classified into two groups: early postpartum hemorrhage and late postpartum hemorrhage. What is the most common cause of early postpartum hemorrhage?

Which of the following laboratory tests should the nurse report to the obstetrician when monitoring a client who is one day postpartum and has experienced significant postpartum hemorrhage?

A nurse is caring for a client who delivered vaginally 4 hours ago and has a boggy uterus that is displaced to the right of midline. Which of the following actions should the nurse take first?

A nurse is caring for a client who experienced a postpartum hemorrhage after delivering a large baby following oxytocin induction of labor.

Which of the following factors put this client at risk for developing postpartum hemorrhage? (Select all that apply)