A nurse is caring for a client who is at 37 weeks of gestation and is being tested for group B streptococcus B-hemolytic (GBS). The client is multigravida and multipara with no history of GBS. She asks the nurse why the test was not conducted earlier in her pregnancy. Which of the following is an appropriate response by the nurse?

Explanation

Choice A Reason:

Newborn weight 2.948 kg (6 lb. 8 oz) is incorrect. Newborn weight is not a direct risk factor for postpartum hemorrhage. While larger babies may lead to increased uterine distention, which could potentially contribute to uterine atony, this alone does not significantly increase the risk of PPH.

Choice B Reason:

History of human papillomavirus is incorrect. A history of human papillomavirus (HPV) infection is not directly associated with an increased risk of postpartum hemorrhage. HPV infection primarily affects the cervix and is not typically associated with uterine atony or other factors contributing to PPH.

Choice C Reason:

Labor induction with oxytocin is correct. Labor induction with oxytocin increases the risk of postpartum hemorrhage due to uterine hyperstimulation, which can lead to uterine atony, the most common cause of PPH.

Choice D Reason:

History of uterine atony is correct. Uterine atony is the failure of the uterus to contract adequately after childbirth. It is a significant risk factor for postpartum hemorrhage because effective uterine contractions are necessary to prevent excessive bleeding by compressing the blood vessels at the placental site.

Choice E Reason:

Vacuum-assisted delivery is correct. Vacuum-assisted delivery is associated with an increased risk of postpartum hemorrhage due to potential trauma to the birth canal, including lacerations and hematoma formation. Additionally, vacuum extraction may increase the risk of uterine atony by interfering with the normal process of uterine contractions.

Explanation

Choice A Reason:

"Limit visitors to your immediate family." This statement is appropriate. While limiting visitors to immediate family members can help control access to the newborn, it may not fully address security concerns. Some hospitals have specific visitor policies in place, but this instruction alone may not cover all aspects of newborn security.

Choice B Reason:

"Send the newborn to the nursery while you are sleeping." This statement is inappropriate. Sending the newborn to the nursery while the parents are sleeping may seem like a security measure, but it can actually increase the risk of infant abduction or mix-ups. Rooming-in with the newborn allows the parents to maintain constant supervision and bonding with their baby, which is important for security.

Choice C Reason:

"Remove your newborn's electronic monitoring band for bathing." This statement is inappropriate. Removing the electronic monitoring band for bathing can disrupt the tracking system used to ensure the newborn's security within the hospital. It's important to keep the monitoring band on the newborn at all times to accurately track their location and prevent unauthorized removal from the maternity unit.

Choice D Reason:

"Check identification badges of staff who enter your room." This statement is appropriate. Maintaining newborn security is crucial in a hospital setting to ensure the safety of the newborn. Instructing parents to check identification badges of staff who enter the room helps verify that only authorized personnel are interacting with the newborn and reduces the risk of unauthorized individuals gaining access to the baby.