A nurse is teaching a client who has postpartum hemorrhage about the risk factors for this condition.

Which of the following statements by the client indicates a need for further teaching?

Massaging the fundus stimulates uterine contractions and helps to stop the bleeding.

This is the first action the nurse should take to manage uterine atony.

Choice B is wrong because administering oxytocin is a pharmacological intervention that can be used after massaging the fundus if bleeding persists.

Oxytocin is a hormone that also stimulates uterine contractions and reduces blood loss.

Choice C is wrong because inserting an indwelling urinary catheter is not a priority action for postpartum hemorrhage.

A full bladder can interfere with uterine contractions and cause displacement of the uterus, but it is not the main cause of uterine atony.

Choice D is wrong because starting an IV infusion of lactated Ringer’s solution is a supportive measure that can be used to replace fluid loss and maintain blood pressure in postpartum hemorrhage.

However, it does not address the underlying cause of bleeding and should not be done before massaging the fundus.

Having a history of fibroids can increase the risk of bleeding, but not postpartum hemorrhage.Fibroids are benign tumors that grow in the uterus and can cause heavy menstrual bleeding, but they do not affect the placenta or the uterus after delivery.

Choice A is wrong because having a large baby can increase the risk of postpartum hemorrhage.

A large baby can overstretch the uterine muscle and cause atony, which is the failure of the uterus to contract properly after delivery.Atony is the most common cause of postpartum hemorrhage.

Choice B is wrong because having a prolonged labor can increase the risk of postpartum hemorrhage.

A prolonged labor can exhaust the uterine muscle and impair its ability to contract after delivery.This can also lead to atony and excessive bleeding.

Choice D is wrong because having a low-lying placenta can increase the risk of postpartum hemorrhage.

A low-lying placenta, also called placenta previa, is when the placenta covers part of the cervix. This condition can increase the risk of postpartum hemorrhage, which is excessive bleeding after childbirth.