Choice A rationale

While blunt force trauma can cause placental abruption, it is not the most common risk factor. Trauma can lead to abruptio placentae, but this is more likely in cases of severe injury.

Choice B rationale

Cigarette smoking is a risk factor for many pregnancy complications, including placental abruption. However, it is not the most common risk factor.

Choice C rationale

Cocaine use can cause abrupt vasoconstriction and is a risk factor for placental abruption. However, it is not the most common risk factor.

Choice D rationale

Hypertension is the most common risk factor for placental abruption. Chronic hypertension, gestational hypertension, and preeclampsia can all contribute to the risk of developing this condition.

Choice A rationale:
Perineal pad clots are not the greatest risk for this patient. While it’s important to monitor the amount and type of lochia, the nurse’s notes indicate that the patient has a moderate amount of lochia rubra, which is normal within the first few days postpartum. Large clots could indicate a problem such as a retained placental fragment, but this is not mentioned in
the scenario.
Choice B rationale:
Pelvic pain is a common complaint after childbirth due to uterine contractions, especially during breastfeeding, and usually resolves within a few days. The patient’s pain is rated as 4 on a scale of 0 to 10, which is considered moderate. While it’s important to manage the patient’s pain, it’s not the greatest risk in this scenario.
Choice C rationale:
A boggy uterus poses the greatest risk for this patient. A boggy or soft uterus indicates uterine atony, which is a lack of normal muscle tone that can lead to excessive bleeding. This is a serious condition that can lead to postpartum hemorrhage if not treated promptly. The nurse’s notes indicate that the patient’s fundus is boggy and located above the umbilicus, which is a concern. The fundus should be firm and gradually descend into the pelvis within the first few days postpartum.
Choice D rationale:
Breast engorgement is a common discomfort that occurs when the breasts are overly full with milk. It typically occurs within the first week postpartum as the milk supply increases. The nurse’s notes indicate that the patient’s breasts are soft, warm, and tender to touch, which is normal. While it’s important to manage the patient’s comfort, breast
engorgement is not the greatest risk in this scenario.