A nurse is caring for a client who experienced a postpartum hemorrhage after delivering a large baby following oxytocin induction of labor.

Which of the following factors put this client at risk for developing postpartum hemorrhage? (Select all that apply)

The correct answer is choice B, D and E. These are the factors that put this client at risk for developing postpartum hemorrhage:

• Uterine overdistention: This occurs when the uterus is stretched too much by a large baby, multiple babies, or excess amniotic fluid.This can impair the normal contraction of the uterus after delivery and lead to bleeding.

• Oxytocin use: This is a hormone that stimulates uterine contractions during labor.However, prolonged or excessive use of oxytocin can cause uterine atony, which is the failure of the uterus to contract and compress the blood vessels after delivery.

• Chorioamnionitis: This is an infection of the membranes and amniotic fluid that surround the baby.It can cause inflammation and damage to the uterine lining, which can interfere with blood clotting and increase the risk of bleeding.

Choice A and C are wrong because:

• Grand multiparity: This means having given birth five or more times.It is not a risk factor for postpartum hemorrhage by itself, but it may be associated with other risk factors such as uterine overdistention, oxytocin use, or placental abnormalities.

• Precipitous labor: This means having a very fast labor, lasting less than three hours.It is not a risk factor for postpartum hemorrhage by itself, but it may be associated with other risk factors such as trauma to the birth canal, retained placenta, or coagulation disorders.

Early postpartum hemorrhage occurs within the first 24 hours after delivery.The client has saturated two perineal pads in 15 minutes, which indicates severe bleeding and a possible complication of the third stage of labor.

Choice B is wrong because late postpartum hemorrhage occurs 24 hours to 12 weeks postpartum.This type of hemorrhage is usually caused by retained placental fragments or infection.

Choice C is wrong because chronic postpartum hemorrhage is not a recognized term.

Postpartum hemorrhage is an acute condition that requires immediate attention.

Choice D is wrong because acute postpartum hemorrhage is not a specific type of hemorrhage, but a general term for any excessive bleeding after childbirth.Postpartum hemorrhage can be classified into mild, moderate, or severe based on the amount of blood loss.