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?

The client reports minimal cramping and discomfort

The client has a firm and midline uterus at the umbilicus

The client passes small clots with moderate lochia rubra

The client has a pulse rate of 100 beats/min and a blood pressure of 110/70 mm Hg

Answer and Explanation

The Correct Answer is B

The client has a firm and midline uterus at the umbilicus. This indicates that the interventions for postpartum hemorrhage due to retained placental fragments are successful because the uterus has contracted and expelled the fragments, and there is no excessive bleeding.

Choice A is wrong because minimal cramping and discomfort are not specific signs of successful interventions for postpartum hemorrhage.

They may also occur in normal postpartum recovery.

Choice C is wrong because passing small clots with moderate lochia rubra may indicate that there are still some retained placental fragments or that the uterus is not contracting adequately.

Choice D is wrong because a pulse rate of 100 beats/min and a blood pressure of 110/70 mm Hg are not normal ranges for an adult. A pulse rate of 60 to 100 beats/min and a blood pressure of less than 120/80 mm Hg are considered normal. A high pulse rate and a low blood pressure may indicate hypovolemia or shock due to blood loss.

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Correct Answer is C

Explanation

Hemoglobin, which is an indicator of the number of RBCs and decreases during hypovolemia and hemorrhage.

Hemoglobin is a protein that carries oxygen in the blood and is measured in grams per deciliter (g/dL).

A normal range for hemoglobin is 12 to 16 g/dL for women.

A low hemoglobin level indicates anemia, which can be caused by blood loss or other factors.

A postpartum hemorrhage is a loss of more than 500 mL of blood after delivery, which can lead to hypovolemia (low blood volume) and shock.

Choice A is wrong because urine output 200 mL for the past 8 hours is within the normal range for a postpartum woman.

The kidneys may retain fluid during pregnancy and release it after delivery, resulting in increased urine output.

A normal urine output is 30 to 50 mL per hour.

Choice B is wrong because weight decrease of 2 pounds since delivery is expected for a postpartum woman.

The weight loss reflects the loss of fluid, blood, and placental tissue during delivery.

A normal weight loss after delivery is 10 to 12 pounds.

Choice D is wrong because hematocrit, which is the percent of RBCs in the total blood volume, and decreases during hypovolemia, may not reflect the true extent of blood loss in a postpartum hemorrhage.

Hematocrit is measured as a percentage and a normal range for hematocrit is 37 to 47% for women.

However, hematocrit may be falsely elevated due to hemoconcentration (increased concentration of blood cells) caused by fluid loss.

Hematocrit may take several days to reflect the actual blood loss.

A. Retained placental fragments B. Uterine atony C. Trauma D. Lacerations

Correct Answer is A

Explanation

Retained placental fragments are the most common cause of late postpartum hemorrhage.Retained placental fragments can lead to infection and subinvolution of the placental site, which prevents the uterus from contracting and stopping the bleeding.

Choice B is wrong because uterine atony is the most common cause of early postpartum hemorrhage, not late postpartum hemorrhage.Uterine atony occurs when the uterus fails to contract after delivery.

Choice C is wrong because trauma is a rare cause of late postpartum hemorrhage.Trauma can occur during delivery and cause lacerations or hematomas that can bleed later, but this is uncommon.

Choice D is wrong because lacerations are also a rare cause of late postpartum hemorrhage.Lacerations can occur in the cervix, vagina or perineum during delivery and cause bleeding, but this usually happens immediately or within 24 hours after delivery.

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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?

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Naxlex Comprehensive Predictor Exams

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?

Correct Answer is C

Explanation

What is the most common cause of late postpartum hemorrhage?

Correct Answer is A

Explanation

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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?