During a significant postpartum hemorrhage, the physician orders the nurse to administer 1000 mcg Misoprostol per rectum STAT. The nurse has on hand Misoprostol 200 mcg tablets. How many tablets should the nurse administer?

Choice A rationale

Keeping the infant in the mother’s room without further evaluation increases the risk of missed complications like hypoglycemia. Monitoring and interventions are crucial for infants at risk due to macrosomia or difficult delivery.

Choice B rationale

Immediate nursery transfer without specific monitoring or intervention overlooks the infant’s risk for hypoglycemia and its symptoms, such as jitteriness or poor feeding. Further evaluation is more appropriate.

Choice C rationale

Macrosomic infants are at higher risk for hypoglycemia due to increased insulin levels post-birth. Frequent glucose monitoring and vigilance for signs like jitteriness or lethargy are crucial for timely intervention.

Choice D rationale

While gestational age assessment confirms LGA status, it does not address the immediate risk of hypoglycemia. Focus should remain on monitoring and stabilizing glucose levels in at-risk macrosomic infants.

Choice A rationale

Manually removing the placenta can introduce infection and cause uterine injury, which are not preventive measures for postpartum hemorrhage but treatments for retained placenta requiring sterile conditions and medical indication.

Choice B rationale

Administering antibiotics does not directly prevent postpartum hemorrhage, as it focuses on managing infections like endometritis. Hemorrhage prevention is better addressed by uterine tone management and avoiding excessive bleeding.

Choice C rationale

Applying pressure to the umbilical cord can lead to uterine inversion, worsening hemorrhage. Controlled cord traction during active management of the third stage is safer and reduces hemorrhage risk effectively.

Choice D rationale

Frequent urination prevents bladder distension, which enhances uterine contraction. A contracted uterus reduces hemorrhage risk by compressing blood vessels. Distended bladder inhibits proper uterine contraction, increasing hemorrhage likelihood.