Which patient would be at the highest risk for postpartum hemorrhage?

One who births in the lithotomy position.

One who receives uterine massage postpartum.

One whose third stage lasts less than 10 minutes.

One who gives birth to an infant weighing 9 pounds (4310 grams).

Answer and Explanation

The Correct Answer is D

Choice A rationale

While lithotomy positioning can increase pressure on perineal tissues, it does not directly correlate with an elevated risk of postpartum hemorrhage. Other factors have stronger evidence for causing hemorrhage.

Choice B rationale

Uterine massage is a preventative measure against postpartum hemorrhage. It stimulates uterine contractions, promoting tone, and reducing atony, which is a primary cause of excessive postpartum bleeding.

Choice C rationale

A third stage lasting less than 10 minutes is within normal limits, reducing the likelihood of placental retention and subsequent bleeding. Prolonged stages, rather than shortened ones, increase risk.

Choice D rationale

Macrosomia, defined as infant birth weight over 4000 grams, increases uterine atony risk due to overdistension, impairing effective contractions post-delivery. Overdistension complicates placental separation, raising postpartum hemorrhage risk.

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Correct Answer is B

Explanation

Choice A rationale

Magnesium sulfate is primarily used for seizure prophylaxis in preeclampsia or eclampsia. It does not manage hemorrhagic conditions or uterine atony effectively, making it unsuitable for controlling postpartum hemorrhage.

Choice B rationale

Hemabate or Tranexamic Acid (TXA) addresses postpartum hemorrhage by promoting uterine contraction or inhibiting fibrinolysis. Hemabate is a prostaglandin, while TXA is an antifibrinolytic, both effective in hemorrhagic control.

Choice C rationale

Methergine (methylergonovine) induces uterine contraction to manage postpartum hemorrhage effectively but is contraindicated in hypertensive patients due to the risk of exacerbating hypertension or inducing stroke.

Choice D rationale

Nifedipine is a calcium channel blocker used to treat hypertensive disorders or preterm labor. It has no role in treating postpartum hemorrhage or enhancing uterine tone in such cases.

A. Parents are not allowed to hold infants who depend on oxygen. B. You may hold your baby during the feeding. C. You may hold only your baby’s hand during the feeding. D. Feedings cause more physiological stress, so the baby should not be held during feedings.

Correct Answer is B

Explanation

Choice A rationale

Denying parents the ability to hold their infant can interfere with bonding. Physiologically stable infants on oxygen benefit from being held, as it supports emotional well-being and parent-infant attachment without compromising oxygen delivery.

Choice B rationale

Holding a physiologically stable infant during gavage feeding fosters bonding, reduces parental anxiety, and stabilizes the infant's physiological parameters, as tactile stimulation aids neurodevelopment without causing stress to the infant's cardiorespiratory system.

Choice C rationale

Handholding alone is insufficient to support bonding and emotional connection. Physiologically stable infants benefit from full body contact during feeding to promote warmth, comfort, and the release of calming hormones like oxytocin.

Choice D rationale

Physiologically stable infants do not experience increased stress during feeding when held. Holding provides comfort and reduces stress, improving the feeding experience and supporting parent-infant bonding and attachment.

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Which patient would be at the highest risk for postpartum hemorrhage?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Your postpartum patient is experiencing a hemorrhage. Vital signs are 156/94, heart rate 87, O2 saturation 95%. You increase the Pitocin drip wide open and prepare to give what medication to the patient next?

Correct Answer is B

Explanation

On day 3 of life, a newborn continues to require 100% oxygen by nasal cannula. The parents ask whether they can hold their infant during his next gavage feeding. Given that this newborn is physiologically stable, what response would the nurse give?

Correct Answer is B

Explanation

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