The nurse is assessing a patient who is a G5P5005 and delivered vaginally four hours ago.The patient's labor history includes a 16-hour oxytocin induction for a macrosomic infant.
Assessment findings include a firm uterus and a completely saturated peri pad with the presence of blood clots.
What does the nurse identify as the most likely cause for the increased bleeding?

Tissue.

Trauma.

Thrombin.

Tone.

Answer and Explanation

The Correct Answer is B

Choice A rationale

Retained tissue can cause postpartum hemorrhage, but with a firm uterus and no other signs of retained placenta, this is less likely the cause here.

Choice B rationale

Trauma is the most likely cause of increased bleeding in this scenario. The prolonged oxytocin induction and macrosomic infant suggest a higher risk of lacerations or uterine atony despite the firm uterus.

Choice C rationale

Thrombin disorders cause bleeding due to clotting issues. However, this patient shows signs of active bleeding and clotting, making this less likely.

Choice D rationale

Uterine atony, indicated by a soft, boggy uterus, is a common cause of postpartum hemorrhage, but in this case, the uterus is firm, so it's less likely to be the cause.

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Correct Answer is D

Explanation

Choice A rationale

Reduction of fever is not a primary effect of carboprost tromethamine. This medication is primarily used to induce uterine contractions to manage postpartum hemorrhage.

Choice B rationale

While maintaining stable blood pressure is important, it is not the specific indicator of carboprost tromethamine's effectiveness. This medication is used to control bleeding.

Choice C rationale

Increased comfort, although significant, is not the direct effect of carboprost tromethamine. The primary aim is to induce uterine contractions to manage hemorrhage.

Choice D rationale

Decreased lochia rubra indicates the reduction of postpartum bleeding, which is the primary purpose of administering carboprost tromethamine. This outcome shows the medication is effective.

A. Oxytocin. B. Methylergonovine. C. Betamethasone. D. Terbutaline.

Correct Answer is D

Explanation

Choice A rationale

Oxytocin is used to induce or augment labor, not typically used before an external version, which is a procedure to turn a breech baby to a head-down position.

Choice B rationale

Methylergonovine is used to prevent or control postpartum hemorrhage by inducing strong uterine contractions, not indicated before an external version.

Choice C rationale

Betamethasone is a corticosteroid used to accelerate fetal lung maturity in preterm labor, not required for an external version.

Choice D rationale

Terbutaline is a tocolytic agent used to relax the uterus, making it easier to manipulate the fetus during the external version procedure. .

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for the postpartum client.Which assessment finding should prompt the nurse to conclude that the administration of carboprost tromethamine (Hemabate) has been effective?

Correct Answer is D

Explanation

A client is scheduled for an external version.The nurse would expect to prepare which of the following medications to be administered prior to the procedure?

Correct Answer is D

Explanation

Which of the following physical findings would lead the nurse to suspect that a client who has pre-eclampsia with severe features has developed HELLP syndrome? Select all that apply.

The nurse is assisting the primary care provider (PCP) with a vacuum-assisted delivery because of a prolonged second stage of labor.The nurse will inform the PCP when which guideline of the procedure is met?

A gravid patient in labor suddenly has dyspnea, hypotension, frothy sputum, and loss of consciousness.The nurse knows these are signs and symptoms of which obstetrical emergency?

Which symptom would the nurse expect to observe in a postpartum client with a vaginal hematoma?

The nurse in a prenatal unit is providing care for a patient who experienced preterm premature rupture of the membranes (PPROM) at 32 weeks' gestation.Which assessment does the nurse consider unnecessary?

A client at 28 weeks' gestation with intact membranes is admitted with the following findings: contractions every 5 minutes lasting 60 seconds, 3 cm dilated, 80% effaced.Which of the following medications will the obstetrician likely order?