Which of the following is a risk factor for postpartum hemorrhage?

The client has a firm and midline uterus at the umbilicus.This indicates that the interventions for postpartum hemorrhage due to retained placental fragments are successful because the uterus has contracted and expelled the fragments, and there is no excessive bleeding.

Choice A is wrong because minimal cramping and discomfort are not specific signs of successful interventions for postpartum hemorrhage.

They may also occur in normal postpartum recovery.

Choice C is wrong because passing small clots with moderate lochia rubra may indicate that there are still some retained placental fragments or that the uterus is not contracting adequately.

Choice D is wrong because a pulse rate of 100 beats/min and a blood pressure of 110/70 mm Hg are not normal ranges for an adult.A pulse rate of 60 to 100 beats/min and a blood pressure of less than 120/80 mm Hg are considered normal.A high pulse rate and a low blood pressure may indicate hypovolemia or shock due to blood loss.

The correct answer is choice B, D and E. The nurse should include the following information in the teaching:

• Increase iron-rich foods in the diet.This can help replenish the blood loss and prevent anemia.

• Report any signs of infection, such as fever or foul-smelling lochia.These can indicate a serious complication that needs immediate medical attention.

• Resume sexual intercourse as soon as desired.There is no evidence that sexual activity increases the risk of bleeding or infection after postpartum hemorrhage.

Choice A is wrong because increasing fluid intake to at least 3 L per day is not necessary for postpartum hemorrhage recovery.Fluid intake should be based on thirst and urine output.

Choice C is wrong because avoiding strenuous activities for 6 weeks is not a specific recommendation for postpartum hemorrhage.The nurse should advise the client to gradually resume normal activities as tolerated and to rest when needed.