What is the highest priority nursing intervention when admitting a pregnant woman who has experienced a bleeding episode in late pregnancy?

The question that the nurse would prioritize the least during the assessment is "Do you plan to have a vaginal or cesarean delivery?" This is because the priority at this point is to determine the urgency of the situation and assess the patient's current condition. The patient's delivery plan can be addressed later after the initial assessment is completed and the patient's stability has been established.

The other questions are all important in determining the cause and severity of the bleeding and the appropriate course of action. The question about the number of weeks is important to determine the gestational age and potential causes of bleeding, as some causes are more common in certain stages of pregnancy. The question about pain can help to determine the possible causes of bleeding and the patient's comfort level. The question about the last ultrasound is important to determine the location of the placenta and whether there are any abnormalities or potential complications.

The most common cause of excessive blood loss after childbirth is the failure of the uterine muscle to contract firmly, which is also known as uterine atony. If the uterus does not contract effectively after delivery, it cannot properly close off the blood vessels that were connected to the placenta, leading to heavy bleeding. Uterine atony can occur due to various factors, such as prolonged labor, multiple births, or the use of certain medications during labor.
Other causes of excessive blood loss after childbirth include retained placental fragments, vaginal or vulvar hematomas, or unrepaired lacerations of the vagina or cervix, but these are less common than uterine atony.