A nurse is reviewing the medical record of a patient who had a vaginal delivery 3 hours ago. Which findings place the patient at risk for postpartum hemorrhage? (Select all that apply)
Vacuum-assisted delivery
Newborn weight 2.948 kg (6 lb 8 oz)
Labor induction with oxytocin
History of uterine atony
History of human papillomavirus
Correct Answer : A,C,D
Choice A rationale
Vacuum-assisted delivery can increase the risk of postpartum hemorrhage. This is because the use of vacuum can cause trauma to the birth canal and uterus, leading to increased bleeding.
Choice B rationale
A newborn weight of 2.948 kg (6 lb 8 oz) is within the normal range and does not increase the risk of postpartum hemorrhage.
Choice C rationale
Labor induction with oxytocin can increase the risk of postpartum hemorrhage. Oxytocin can cause the uterus to contract too strongly or too frequently, leading to uterine atony (a condition where the uterus fails to contract after delivery), which can result in heavy bleeding.
Choice D rationale
A history of uterine atony places the patient at risk for postpartum hemorrhage. Uterine atony is a condition in which the uterus fails to contract after the delivery of the baby and the placenta, leading to heavy bleeding.
Choice E rationale
A history of human papillomavirus (HPV) does not increase the risk of postpartum hemorrhage. HPV is a sexually transmitted infection that can cause genital warts and cervical cancer, but it does not affect the uterus’s ability to contract after delivery.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Applying firm pressure on the client’s suprapubic area is not part of the McRoberts maneuver. This action is more associated with the suprapubic pressure technique, which is another method used to manage shoulder dystocia.
Choice B rationale
The McRoberts maneuver involves having the client flex her hips against her abdomen. This is achieved by assisting the client in pulling her knees toward her abdomen.
Choice C rationale
Applying pressure to the client’s fundus is not part of the McRoberts maneuver and can be contraindicated as it may cause additional complications.
Choice D rationale
Moving the client onto their hands and knees is not part of the McRoberts maneuver. This position is more associated with the all-fours maneuver, also known as the Gaskin maneuver.
Correct Answer is C
Explanation
Choice A rationale
Ensuring the newborn’s diaper is snug is not specific to the Plastibell circumcision technique. It is a general care tip for all newborns.
Choice B rationale
While it’s important to monitor the circumcision site for signs of infection, a dark red tip of the penis is not a specific concern related to the Plastibell circumcision technique.
Choice C rationale
Yellow exudate, which is a normal part of the healing process, will form at the surgical site within 24 hours. This is a normal part of the healing process and should not be mistaken for pus, which would indicate an infection.
Choice D rationale
The Plastibell device is not removed 4 hours after the procedure. Instead, it falls off naturally after about a week.
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