Which of the following would be essential to implement to prevent late postpartum hemorrhage? Select one:
Inspecting the placenta after delivery for intactness.
Manually removing the placenta at delivery.
Administering broad-spectrum antibiotics prophylactically.
Applying traction on the umbilical cord to speed up separation of the placenta.
The Correct Answer is A
Choice A Reason: Inspecting the placenta after delivery for intactness. This is because inspecting the placenta after delivery for intactness is a nursing intervention that can prevent late postpartum hemorrhage, which is excessive bleeding from the uterus or genital tract that occurs more than 24 hours but less than 12 weeks after delivery. Late postpartum hemorrhage can be caused by retained placental fragments, subinvolution of the uterus, infection, or coagulation disorders. Inspecting the placenta after delivery for intactness can help identify and remove any retained placental fragments that may interfere with uterine contraction and involution, which are essential for hemostasis.
Choice B Reason: Manually removing the placenta at delivery. This is an incorrect answer that indicates an inappropriate and risky intervention that can cause late postpartum hemorrhage. Manually removing the placenta at delivery is a procedure that involves inserting a hand into the uterus and detaching the placenta from the uterine wall. Manually removing the placenta at delivery is indicated only for a retained or adherent placenta that does not separate spontaneously or with gentle traction within 30 minutes after delivery. Manually removing the placenta at delivery can cause trauma, infection, or incomplete removal of the placenta, which can increase the risk of late postpartum hemorrhage.
Choice C Reason: Administering broad-spectrum antibiotics prophylactically. This is an incorrect answer that suggests an unnecessary and ineffective intervention that can prevent late postpartum hemorrhage. Administering broad- spectrum antibiotics prophylactically is a pharmacological intervention that involves giving antibiotics to prevent or treat infection. Administering broad-spectrum antibiotics prophylactically is indicated for women with risk factors or signs of infection during or after delivery, such as prolonged rupture of membranes, chorioamnionitis, fever, or foul- smelling lochia. Administering broad-spectrum antibiotics prophylactically may reduce the risk of infection-related late postpartum hemorrhage, but it does not address other causes of late postpartum hemorrhage such as retained placental fragments or subinvolution of the uterus.
Choice D Reason: Applying traction on the umbilical cord to speed up separation of the placenta. This is an incorrect answer that refers to a different intervention that can prevent early postpartum hemorrhage, not late postpartum hemorrhage. Applying traction on the umbilical cord to speed up separation of the placenta is a technique that involves pulling on the umbilical cord while applying counter pressure on the uterus to facilitate placental expulsion. Applying traction on the umbilical cord to speed up separation of the placenta is indicated for active management of the third stage of labor, which can prevent early postpartum hemorrhage, which is excessive bleeding from the uterus or genital tract that occurs within 24 hours after delivery. Early postpartum hemorrhage can be caused by uterine atony, retained placenta, lacerations, or coagulation disorders.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A Reason: Enhance uterine contractions. This is an incorrect answer that contradicts the effect of narcotic analgesia on uterine activity. Narcotic analgesia can reduce uterine contractions by decreasing maternal catecholamine levels, which can prolong labor or increase bleeding.
Choice B Reason: Be used in place of preoperative sedation. This is an irrelevant answer that does not apply to this scenario. Preoperative sedation is a medication given before surgery to reduce anxiety, pain, or nausea. Narcotic analgesia can be used as a preoperative sedative, but it is not related to labor or delivery.
Choice C Reason: Result in neonatal respiratory depression. This is because narcotic analgesia can cross the placenta and affect the fetal central nervous system, which can cause decreased respiratory drive, apnea, bradycardia, or hypotonia in the newborn. The risk of neonatal respiratory depression is higher when narcotic analgesia is administered close to delivery, as there is less time for placental clearance or maternal metabolism.
Choice D Reason: Prevent the need for anesthesia with an episiotomy. This is an inaccurate answer that overestimates the effect of narcotic analgesia on perineal pain. Narcotic analgesia can provide some relief of labor pain, but it does not block pain sensation completely or locally. An episiotomy is a surgical incision made in the perineum to enlarge the vaginal opening during delivery, which requires local anesthesia or regional anesthesia (such as epidural or spinal). Narcotic analgesia does not prevent or replace anesthesia with an episiotomy.
Correct Answer is D
Explanation
Choice A Reason: Partial placenta previa is a condition where the placenta partially covers the cervix. It usually does not resolve and may cause bleeding and complications during labor and delivery.
Choice B Reason: Complete placenta previa is a condition where the placenta completely covers the cervix. It is a serious condition that requires cesarean delivery and may cause life-threatening hemorrhage.
Choice C Reason: Marginal placenta previa is a condition where the edge of the placenta reaches the margin of the cervix. It may also cause bleeding and complications during labor and delivery.
Choice D Reason: Low-lying placenta previa is a condition where the placenta is near the cervix, but not covering it. It may resolve spontaneously as the uterus grows and the placenta moves upward.
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