A nurse is reviewing the medical record of a patient who had a vaginal delivery 3 hours ago. Which findings place the patient at risk for postpartum hemorrhage? (Select all that apply)
Vacuum-assisted delivery
Newborn weight 2.948 kg (6 lb 8 oz)
Labor induction with oxytocin
History of uterine atony
History of human papillomavirus
Correct Answer : A,C,D
Choice A rationale
Vacuum-assisted delivery can increase the risk of postpartum hemorrhage. This is because the use of vacuum can cause trauma to the birth canal and uterus, leading to increased bleeding.
Choice B rationale
A newborn weight of 2.948 kg (6 lb 8 oz) is within the normal range and does not increase the risk of postpartum hemorrhage.
Choice C rationale
Labor induction with oxytocin can increase the risk of postpartum hemorrhage. Oxytocin can cause the uterus to contract too strongly or too frequently, leading to uterine atony (a condition where the uterus fails to contract after delivery), which can result in heavy bleeding.
Choice D rationale
A history of uterine atony places the patient at risk for postpartum hemorrhage. Uterine atony is a condition in which the uterus fails to contract after the delivery of the baby and the placenta, leading to heavy bleeding.
Choice E rationale
A history of human papillomavirus (HPV) does not increase the risk of postpartum hemorrhage. HPV is a sexually transmitted infection that can cause genital warts and cervical cancer, but it does not affect the uterus’s ability to contract after delivery.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
The nurse should close the newborn’s eyes before applying eyepatches. This is because the intense light used in phototherapy can harm the newborn’s eyes. Therefore, protective eye patches are used to shield the newborn’s eyes from the light while allowing the rest of the body to be exposed to the light. This helps to convert the bilirubin in the skin into a form that can be easily eliminated from the body.
Choice B rationale
Turning the newborn every 4 hours is not specifically related to phototherapy. While turning is important for preventing pressure ulcers, it does not directly impact the effectiveness of phototherapy. The primary goal of phototherapy is to expose as much of the newborn’s skin as possible to the light, which helps to reduce the level of bilirubin.
Choice C rationale
Applying hydrating lotion to the newborn’s skin prior to treatment is not recommended. The use of lotions or creams can block the light and reduce the effectiveness of phototherapy. The skin should be clean and free of any barriers to light penetration.
Choice D rationale
Providing the newborn with 15 mL glucose water after each feeding is not directly related to phototherapy. While maintaining hydration is important for all newborns, it does not specifically enhance the effectiveness of phototherapy for jaundice.
Correct Answer is B
Explanation
Choice A rationale
Obtaining a specimen for a Kleihauer-Betke test is not the immediate action to take when a patient is experiencing a large amount of vaginal bleeding due to uterine atony.
Choice B rationale
Misoprostol is a medication that can be used to treat uterine atony. It helps to contract the uterus and reduce bleeding.
Choice C rationale
Administering betamethasone IM is not the appropriate action. Betamethasone is a steroid medication often used to mature the lungs of a fetus at risk of premature birth, not to treat uterine atony.
Choice D rationale
Avoiding sterile vaginal examinations is not the immediate action to take when a patient is experiencing a large amount of vaginal bleeding due to uterine atony.
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