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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Urine output of 40 mL in 8 hours indicates oliguria, suggesting inadequate renal perfusion. Normal urine output is 30 mL/hour or greater. This could signify hypovolemia or renal compromise post-hemorrhage.
Choice B rationale
A drop in hematocrit of 2% may be expected postpartum and is not immediately concerning unless accompanied by hemodynamic instability or symptoms of anemia like dizziness or fatigue.
Choice C rationale
A 2 lb weight decrease postpartum is normal due to fluid shifts and diuresis. It does not indicate an emergent condition requiring immediate reporting to the obstetrician.
Choice D rationale
A pulse rate of 68 beats per minute is within the normal adult range of 60 to 100 beats per minute and is not typically concerning post-delivery.
Correct Answer is ["A","C","D"]
Explanation
Choice A rationale
Postpartum hemorrhage may occur weeks after delivery due to subinvolution of the uterus or retained placental fragments. Educating about late risks ensures patients monitor symptoms and seek timely care.
Choice B rationale
Breastfeeding is encouraged even after postpartum hemorrhage as it helps stimulate uterine contractions, reducing bleeding risk. Recommending avoidance could delay recovery and is scientifically unsupported unless contraindicated.
Choice C rationale
Oxytocin may be prescribed for ongoing uterine atony or to prevent late postpartum hemorrhage. It is essential to educate patients about its purpose and correct administration for safety and effectiveness.
Choice D rationale
Saturating a peri-pad within 1 hour may indicate active bleeding. Reporting this promptly ensures swift intervention to prevent further complications, aligning with standard postpartum care protocols.
Choice E rationale
Postpartum hemorrhage is not limited to 24–48 hours after birth; late-onset hemorrhage, occurring up to weeks later, is a known complication. Misleading patients with this incorrect timeframe can delay critical interventions.
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