A 25-year-old gravida 2, para 2-0-0-2 gave birth 4 hours ago to a 9-lb, 7-ounce boy after augmentation of labor with Pitocin.
She puts on her call light and asks for her nurse right away, stating, “I’m bleeding a lot.” The most likely cause of afterbirth hemorrhage in this woman is:
Retained placental fragments.
Unrepaired vaginal lacerations.
Uterine atony
Puerperal infection
The Correct Answer is C
Uterine atony.
This is when the uterus does not contract enough to stop the bleeding from the placental site after delivery. It is the most common cause of postpartum hemorrhage, accounting for up to 80% of cases. Uterine atony can be caused by factors such as prolonged or augmented labor, large baby, multiple pregnancies, infection, or retained placenta.
The woman in question has some risk factors for uterine atony, such as a large baby and augmentation of labor with Pitocin.
The other choices are wrong because:
A . Retained placental fragments: This is when parts of the placenta remain attached to the uterine wall and prevent it from contracting properly. It is the second most common cause of postpartum hemorrhage.
However, there is no indication in the question that the woman had any difficulty with the delivery of the placenta or that it was incomplete
B. Unrepaired vaginal lacerations: This is when there are tears or cuts in the vagina or cervix that cause bleeding. It is a less common cause of postpartum hemorrhage.
However, there is no indication in the question that the woman had any trauma during delivery or that she was examined for lacerations
D. Puerperal infection: This is when there is an infection in the uterus or other parts of the reproductive tract after delivery.
It can cause fever, pain, and bleeding. It is a rare cause of postpartum hemorrhage.
However, there is no indication in the question that the woman had any signs or symptoms of infection, such as fever, chills, or foul-smelling discharge.
Normal ranges for blood loss after delivery are less than 500 mL for vaginal birth and less than 1000 mL for C-section.
Any amount above these thresholds can be considered postpartum hemorrhage and requires prompt evaluation and treatment.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Magnesium sulfate is given to women with preeclampsia and eclampsia to prevent and treat convulsions.
Magnesium sulfate is a mineral that reduces seizure risks in women with preeclampsia. A healthcare provider will give the medication intravenously. Sometimes, it’s also used to prolong pregnancy for up to two days. This allows drugs that speed up your baby’s lung development to be administered.
Choice A is wrong because magnesium sulfate does not improve patellar reflexes or increase respiratory efficiency. In fact, it may cause decreased or absent deep tendon reflexes and respiratory depression as side effects.
Choice B is wrong because magnesium sulfate does not shorten the duration of labor. It may actually prolong labor by inhibiting uterine contractions.
Choice D is wrong because magnesium sulfate does not prevent a boggy uterus or lessen the lochial flow. It has no effect on uterine tone or bleeding after delivery.
Correct Answer is B
Explanation
Swimming is one of the best sports for people with hemophilia because it strengthens the muscles without putting stress on the joints. Swimming is also recommended by most sports physicians and hematologists for patients with hemophilia.
Choice A is wrong because soccer is a contact sport that can cause injuries and bleeding episodes in people with hemophilia. Soccer is not recommended by most sports physicians or hematologists for patients with hemophilia.
Choice C is wrong because basketball is also a contact sport that can lead to injuries and bleeding episodes in people with hemophilia. Basketball may be safe for young children, but the risk increases with the intensity of the game.
Choice D is wrong because football is a collision sport that can cause severe injuries and bleeding episodes in people with hemophilia. Football is not recommended by most sports physicians or hematologists for patients with hemophilia.
Normal ranges for hemophilia are:
- Mild hemophilia: 5% to 40% of normal clotting factor
- Moderate hemophilia: 1% to 5% of normal clotting factor
Severe hemophilia: less than 1% of normal clotting factor
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