A nurse is assessing a postpartum client for fundal height, location, and consistency. The fundus is found to be displaced laterally to the right, and there is uterine atony. Which of the following is the cause of the uterine atony?
Urinary retention
Poor involution
Infection
Hemorrhage
The Correct Answer is A
Choice A rationale
Uterine atony refers to a soft and weak uterus after childbirth. It happens when your uterine muscles don’t contract enough to clamp the placental blood vessels shut after childbirth. This can lead to life-threatening blood loss after delivery. One of the causes of uterine atony is urinary retention. When the bladder is full, it can displace the uterus, preventing it from contracting properly. This can lead to uterine atony and postpartum hemorrhage. Therefore, urinary retention can cause uterine atony and lateral displacement of the fundus.
Choice B rationale
Poor involution of the uterus is a condition where the uterus does not return to its normal size after childbirth. While poor involution can lead to prolonged bleeding, it does not directly cause uterine atony. Uterine atony is specifically a lack of muscle contraction, while poor involution is a failure of the uterus to reduce in size.
Choice C rationale
While infection can lead to many complications during the postpartum period, it is not a direct cause of uterine atony. Infections can cause endometritis, which is inflammation of the uterine lining, but this does not prevent the uterus from contracting.
Choice D rationale
Hemorrhage, or heavy bleeding, is a result of uterine atony, not a cause. When the uterus does not contract properly after childbirth, it can lead to excessive bleeding, or hemorrhage.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Cervical dilation is a key sign that labor has begun. During labor, the cervix dilates to allow the baby to pass through the birth canal. This is a physical change that can be measured during a pelvic exam.
Choice B rationale
Pain above the umbilicus is not typically a sign of labor. During labor, contractions are usually felt as a tightening or cramping in the lower abdomen or back.
Choice C rationale
Brownish vaginal discharge can occur during pregnancy and is not necessarily a sign of labor. If the discharge is heavy, or accompanied by other symptoms such as pain or cramping, it should be evaluated by a healthcare provider.
Choice D rationale
The presence of amniotic fluid in the vaginal vault, also known as “water breaking,” can be a sign that labor is imminent. However, it does not confirm that labor has begun, as it can occur before the onset of contractions and cervical dilation.
Correct Answer is B
Explanation
Choice A rationale
While reduced fetal oxygen supply can occur with hypertonic contractions and inadequate uterine relaxation, it’s not the primary adverse effect. The main concern is the impact on the progress of labor.
Choice B rationale
This is the correct answer. Inadequate uterine relaxation between hypertonic contractions can delay cervical dilation, slowing the progress of labor.
Choice C rationale
Prolonged labor is not typically associated with hypertonic contractions and inadequate uterine relaxation. In fact, these conditions can lead to a more rapid labor.
Choice D rationale
Increased maternal stress can occur with any labor complication, but it’s not the primary adverse effect of hypertonic contractions and inadequate uterine relaxation.
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