The perinatal nurse is caring for a woman in the immediate postbirth period. Assessment reveals that the woman is experiencing profuse bleeding. The most likely etiology for the bleeding is:
Retained placenta fragments.
Vaginal hematoma.
Uterine atony.
Uterine inversion.
The Correct Answer is C
Choice A rationale
Retained placental fragments lead to delayed, not immediate, postpartum hemorrhage as they prevent complete uterine contraction over time.
Choice B rationale
Vaginal hematomas cause concealed, localized bleeding with minimal external blood loss, differing from profuse hemorrhage presentations.
Choice C rationale
Uterine atony, the most common cause, occurs when the uterus fails to contract effectively, leading to uncontrolled and excessive bleeding.
Choice D rationale
Uterine inversion, though serious, is rare and typically accompanied by visible uterine prolapse, not commonly causing profuse bleeding in the immediate postbirth period.
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Related Questions
Correct Answer is D
Explanation
Choice A rationale
A soft uterus indicates uterine atony, a complication rather than a normal finding. Daily fundal palpation ensures involution but should result in a firm, not soft, uterus.
Choice B rationale
Passage of clots is common postpartum, but ongoing monitoring for excessive clotting is crucial as it may indicate retained placental fragments or incomplete uterine involution.
Choice C rationale
Decreased lochia does not indicate complications unless it is completely absent, which may suggest uterine or cervical obstruction and warrants further evaluation.
Choice D rationale
Increased lochia or bright red bleeding signifies secondary postpartum hemorrhage, often caused by retained placental tissue or subinvolution, requiring immediate medical attention.
Correct Answer is A
Explanation
Choice A rationale
Chlorhexidine is a broad-spectrum antiseptic effective against gram-positive and gram-negative bacteria. It is safe for patients allergic to betadine and reduces infection risks during catheter insertion.
Choice B rationale
Betadine, containing povidone-iodine, is contraindicated in patients with allergies to iodine. Using it could trigger allergic reactions, including anaphylaxis, compromising patient safety.
Choice C rationale
Sterile water lacks antiseptic properties and does not provide necessary antimicrobial activity to minimize infection risks, making it unsuitable for catheter insertion.
Choice D rationale
Alcohol wipes can cause tissue irritation and discomfort during catheter insertion. They are less effective against bacterial spores, reducing their efficacy for preventing infections in this context.
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