The nurse is reviewing the client’s chart.
Click to highlight areas of client history and physical that increase the risk for postpartum hemorrhage.
Client was middle aged and married.
She was in labor for 25 hours and forceps were used to assist with the delivery.
She was given an epidural for anesthesia that was effective.
The labor and delivery nurse reported that the client had a 4th degree laceration, and her pain was currently at a 4 on a 0 to 10 pain scale.
Her vital signs were stable, and she was catheterized for 500 mL of light-yellow urine just prior to delivery.
Her spouse was at the bedside for delivery.
Client was middle aged
forceps were used to assist with the delivery
client had a 4th degree laceration
She was in labor for 25 hours
The Correct Answer is ["B","C","D"]
Choice A rationale
Age of the client is not a significant risk factor for postpartum hemorrhage. While age can influence overall health and pregnancy complications, it is not directly linked to an increased risk of postpartum hemorrhage. Therefore, the age of the client, in this case, does not increase the risk for postpartum hemorrhage.
Choice B rationale
The use of forceps during delivery can increase the risk of postpartum hemorrhage. Forceps delivery is an assisted delivery method which can cause trauma to the birth canal, leading to increased bleeding after delivery. In this case, the client had a forceps-assisted delivery, which could increase her risk for postpartum hemorrhage.
Choice C rationale
A 4th degree laceration is a severe tear that occurs during delivery, extending to the anal sphincter and rectal mucosa. This type of laceration can lead to significant blood loss and increase the risk of postpartum hemorrhage. In this case, the client had a 4th degree laceration, which increases her risk for postpartum hemorrhage.
Choice D rationale
A long labor duration can increase the risk of postpartum hemorrhage. Prolonged labor can lead to uterine atony, a condition where the uterus does not contract properly after delivery, leading to increased bleeding. In this case, the client was in labor for 25 hours, which could increase her risk for postpartum hemorrhage.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","C","D"]
Explanation
Choice A rationale
Age of the client is not a significant risk factor for postpartum hemorrhage. While age can influence overall health and pregnancy complications, it is not directly linked to an increased risk of postpartum hemorrhage. Therefore, the age of the client, in this case, does not increase the risk for postpartum hemorrhage.
Choice B rationale
The use of forceps during delivery can increase the risk of postpartum hemorrhage. Forceps delivery is an assisted delivery method which can cause trauma to the birth canal, leading to increased bleeding after delivery. In this case, the client had a forceps-assisted delivery, which could increase her risk for postpartum hemorrhage.
Choice C rationale
A 4th degree laceration is a severe tear that occurs during delivery, extending to the anal sphincter and rectal mucosa. This type of laceration can lead to significant blood loss and increase the risk of postpartum hemorrhage. In this case, the client had a 4th degree laceration, which increases her risk for postpartum hemorrhage.
Choice D rationale
A long labor duration can increase the risk of postpartum hemorrhage. Prolonged labor can lead to uterine atony, a condition where the uterus does not contract properly after delivery, leading to increased bleeding. In this case, the client was in labor for 25 hours, which could increase her risk for postpartum hemorrhage.
Correct Answer is A
Explanation
Choice A rationale
As labor begins, the cervix starts to soften, shorten and thin (efface). This process is often expressed in percentages¹. This is a sign of true labor².
Choice B rationale
The station of the presenting part refers to the position of the baby's head in relation to the mother's pelvis. While it can indicate progress in labor, it is not a definitive sign of true labor.
Choice C rationale
Rupture of the membranes, or water breaking, can occur before or during labor. However, it is not a reliable sign of true labor as it can also occur in preterm labor or even without contractions.
Choice D rationale
The pattern of contractions can be a sign of labor. True labor contractions are regular, increase in intensity, and do not ease up with change in activity or position². However, contractions alone are not a definitive sign of true labor as they can also occur in false labor (Braxton Hicks contractions).
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