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 D
Explanation
Choice A rationale
While surgical closure is a common treatment for myelomeningocele, it is not typically performed immediately after birth.
Choice B rationale
Cleansing the site with povidone-iodine is not typically the first step in caring for a newborn with a myelomeningocele.
Choice C rationale
Monitoring the rectal temperature every 4 hours is not specifically related to the care of a newborn with a myelomeningocele.
Choice D rationale
This is the correct answer. Administering broad-spectrum antibiotics can help prevent infection in a newborn with a myelomeningocele.
Correct Answer is B
Explanation
Choice A rationale
A hematocrit level of 37% is within the normal range for a pregnant woman, which is 33% to 46%. Therefore, this result does not need to be reported to the provider.
Choice B rationale
A fasting blood glucose level of 180 mg/dL is significantly higher than the normal range of 74 to 106 mg/dL. This could indicate gestational diabetes, which can lead to various complications for both the mother and the baby. Therefore, this finding should be reported to the provider.
Choice C rationale
A creatinine level of 0.9 mg/dL is within the normal range of 0.5 to 1 mg/dL for a female client aged 18 to 40 years.
Choice D rationale
A WBC count of 11,000/mm is slightly above the normal range of 5,000 to 10,000/mm. However, it’s common for the WBC count to increase during pregnancy due to physiological changes. Therefore, this result does not need to be reported to the provider.
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