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

Answer and Explanation

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.

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Correct Answer is C

Explanation

Choice A rationale
Massaging the client’s fundus is not indicated in this situation. Fundal massage is typically done after childbirth to help the uterus contract and prevent excessive bleeding.
Choice B rationale

Applying oxygen can help increase the client’s oxygen saturation levels, but it does not directly address the cause of the hypotension.
Choice C rationale
Turning the client to a side-lying position, specifically the left lateral position, can help improve blood flow to the heart, increasing cardiac output and blood pressure.
Choice D rationale
Assisting the client to empty their bladder is important in postpartum care, but it is not the immediate action to take when a client is hypotensive following the administration of epidural anesthesia.

A. Has your back labor improved? B. Are you feeling relief from your pelvic pressure? C. Does that lessen your suprapubic pain? D. Do your contractions feel further apart?

Correct Answer is A

Explanation

Choice A rationale
Asking if the client’s back labor has improved is a good way to evaluate the effectiveness of the hands-and-knees position. This position has been shown to reduce persistent back pain in laboring women with a fetus in the occipitoposterior position.
Choice B rationale

Feeling relief from pelvic pressure is not specifically associated with the hands-and-knees position.
Choice C rationale
Lessening of suprapubic pain is not specifically associated with the hands-and-knees position.
Choice D rationale
Contractions feeling further apart is not a specific outcome associated with the hands-and- knees position.

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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)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is hypotensive following the administration of epidural anesthesia. Which of the following actions should the nurse take?

Correct Answer is C

Explanation

A nurse is caring for a client who is in active labor with a fetus in the occipitoposterior position. The nurse assists the client into a hands-and-knees position.Which of the following Questions should the nurse ask to evaluate the effectiveness of this intervention?

Correct Answer is A

Explanation

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