A nurse is caring for a client who has just delivered her baby and is at risk for postpartum hemorrhage (PPH).

Which intervention should be included in this client’s plan of care?

Administering oxytocin after delivery

Encouraging frequent voiding

Assessing vital signs every 4 hours

Encouraging ambulation as soon as possible

Answer and Explanation

The Correct Answer is A

Oxytocin is a medication that helps the uterus contract and prevent excessive bleeding after birth. It is the most effective treatment for postpartum hemorrhage, even if already used for labor induction or augmentation or as part of active management of the third stage of labor.

Choice B) Encouraging frequent voiding is wrong because it does not directly affect the risk of postpartum hemorrhage. However, a full bladder can interfere with uterine contraction and cause bleeding, so voiding should be encouraged as part of routine care.

Choice C) Assessing vital signs every 4 hours is wrong because it is not enough to detect and treat postpartum hemorrhage early. Vital signs should be monitored more frequently in the first hour after delivery, when most cases of postpartum hemorrhage occur.

Choice D) Encouraging ambulation as soon as possible is wrong because it does not prevent postpartum hemorrhage.

Ambulation can help prevent thromboembolic complications and promote recovery, but it has no effect on uterine contraction

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Correct Answer is A

Explanation

Uterine atony is the most common cause of postpartum hemorrhage, accounting for up to 80% of cases.It occurs when the uterus does not contract enough to stop the bleeding from the placental site.Uterine atony can be caused by factors such as prolonged labor, multiple pregnancy, large baby, infection or use of certain medications.

The other statements are wrong because:

• B.Retained placenta is the second most common cause of postpartum hemorrhage, but it only accounts for about 10% of cases.It occurs when part or all of the placenta remains attached to the uterine wall and prevents the uterus from contracting properly.

• C.Lacerations are tears or cuts in the cervix, vagina or perineum that can cause bleeding after delivery.They are usually minor and can be repaired with stitches, but they can also be severe and require surgery.Lacerations are not very common causes of postpartum hemorrhage, and they usually occur along with other factors such as uterine atony or retained placenta.

• D.Hematomas are collections of blood under the skin or in the tissues that can result from trauma during delivery.They can cause pain, swelling and pressure in the affected area, but they are usually small and resolve on their own.Hematomas are rare causes of postpartum hemorrhage, and they usually occur along with other factors such as lacerations or coagulation disorders.

Normal ranges for blood loss after delivery are less than 500 mL for vaginal birth and less than 1000 mL for cesarean birth.Blood loss greater than these amounts can indicate postpartum hemorrhage and require immediate medical attention.

A. Monitor intake and output B. Elevate the head of the bed C. Apply oxygen via nasal cannula D. Insert a nasogastric tube E E. Administer pain medication as needed

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

Explanation

The correct answer is choice A, B and C. The nurse should monitor intake and output to assess the client’s fluid status and blood loss.

The nurse should elevate the head of the bed to reduce the risk of hypovolemic shock and improve tissue perfusion.

The nurse should apply oxygen via nasal cannula to increase oxygen delivery to the vital organs and prevent hypoxia.

Choice D is wrong because inserting a nasogastric tube is not indicated for a client who has postpartum hemorrhage.

A nasogastric tube is used to decompress the stomach or administer medications or feedings in some conditions.

Choice E is wrong because administering pain medication as needed is not a priority intervention for a client who has postpartum hemorrhage.

Pain medication can mask the signs of shock and lower the blood pressure further.

The nurse should focus on restoring the blood volume and preventing complications.

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A nurse is caring for a client who has just delivered her baby and is at risk for postpartum hemorrhage (PPH). Which intervention should be included in this client’s plan of care?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which of the following is the most common cause of postpartum hemorrhage?

Correct Answer is A

Explanation

A nurse is caring for a client who has postpartum hemorrhage and is receiving IV fluids and blood products. Which of the following interventions should the nurse include in the plan of care? (Select all that apply.)

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

Explanation

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

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 evaluating a client who had a postpartum hemorrhage and received fluid resuscitation and blood transfusion therapy. Which of the following findings indicates an improvement in the client’s condition?

What is the most common cause of late postpartum hemorrhage?

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 caring for a client who has just delivered her baby and is at risk for postpartum hemorrhage (PPH). Which intervention should be included in this client’s plan of care?

A nurse is evaluating the effectiveness of interventions for a client who has postpartum hemorrhage due to retained placental fragments. Which of the following outcomes indicates that the interventions are successful?

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 has just delivered her baby and is at risk for postpartum hemorrhage (PPH).

Which intervention should be included in this client’s plan of care?