When reviewing the causes of late postpartum hemorrhage, which of the following would the nurse identify as the most common cause?
Select one:

Retained placental fragments.

Cervical or vaginal lacerations.

Uterine inversion.

Uterine atony.

Answer and Explanation

The Correct Answer is D

Choice A Reason: Retained placental fragments. This is an incorrect answer that refers to a diﬀerent cause of late postpartum hemorrhage, which is less common than uterine atony. Retained placental fragments are pieces of placenta that remain atached to the uterine wall after delivery, which prevent uterine contraction and involution, and provide a source of bleeding and infection. Retained placental fragments can be caused by abnormal placentation (such as placenta accreta), manual removal of placenta, or incomplete separation of placenta.

Choice B Reason: Cervical or vaginal lacerations. This is an incorrect answer that refers to a diﬀerent cause of late postpartum hemorrhage, which is more likely to cause early postpartum hemorrhage than late postpartum hemorrhage. Cervical or vaginal lacerations are tears or cuts in the cervix or vagina that occur during delivery, which can cause bleeding from the damaged blood vessels. Cervical or vaginal lacerations can be caused by rapid or instrumental delivery, large or malpositioned fetus, or episiotomy.

Choice C Reason: Uterine inversion. This is an incorrect answer that refers to a diﬀerent cause of late postpartum hemorrhage, which is rare and life-threatening. Uterine inversion is a condition where the uterus turns inside out and protrudes through the cervix and vagina after delivery, which can cause massive bleeding and shock. Uterine inversion can be caused by excessive traction on the umbilical cord, fundal pressure, or uterine relaxation.

Choice D Reason: Uterine atony. This is because uterine atony is a condition where the uterus fails to contract and retract after delivery, which leads to bleeding from the placental site. Uterine atony is the most common cause of late postpartum hemorrhage, accounting for about 75% of cases. Late postpartum hemorrhage is excessive bleeding from the uterus or genital tract that occurs more than 24 hours but less than 12 weeks after delivery. Late postpartum hemorrhage can be caused by retained placental fragments, subinvolution of the uterus, infection, or coagulation disorders.

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Correct Answer is A

Explanation

Choice A Reason: Inspecting the placenta after delivery for intactness. This is because inspecting the placenta after delivery for intactness is a nursing intervention that can prevent late postpartum hemorrhage, which is excessive bleeding from the uterus or genital tract that occurs more than 24 hours but less than 12 weeks after delivery. Late postpartum hemorrhage can be caused by retained placental fragments, subinvolution of the uterus, infection, or coagulation disorders. Inspecting the placenta after delivery for intactness can help identify and remove any retained placental fragments that may interfere with uterine contraction and involution, which are essential for hemostasis.

Choice B Reason: Manually removing the placenta at delivery. This is an incorrect answer that indicates an inappropriate and risky intervention that can cause late postpartum hemorrhage. Manually removing the placenta at delivery is a procedure that involves inserting a hand into the uterus and detaching the placenta from the uterine wall. Manually removing the placenta at delivery is indicated only for a retained or adherent placenta that does not separate spontaneously or with gentle traction within 30 minutes after delivery. Manually removing the placenta at delivery can cause trauma, infection, or incomplete removal of the placenta, which can increase the risk of late postpartum hemorrhage.

Choice C Reason: Administering broad-spectrum antibiotics prophylactically. This is an incorrect answer that suggests an unnecessary and ineﬀective intervention that can prevent late postpartum hemorrhage. Administering broad- spectrum antibiotics prophylactically is a pharmacological intervention that involves giving antibiotics to prevent or treat infection. Administering broad-spectrum antibiotics prophylactically is indicated for women with risk factors or signs of infection during or after delivery, such as prolonged rupture of membranes, chorioamnionitis, fever, or foul- smelling lochia. Administering broad-spectrum antibiotics prophylactically may reduce the risk of infection-related late postpartum hemorrhage, but it does not address other causes of late postpartum hemorrhage such as retained placental fragments or subinvolution of the uterus.

Choice D Reason: Applying traction on the umbilical cord to speed up separation of the placenta. This is an incorrect answer that refers to a diﬀerent intervention that can prevent early postpartum hemorrhage, not late postpartum hemorrhage. Applying traction on the umbilical cord to speed up separation of the placenta is a technique that involves pulling on the umbilical cord while applying counter pressure on the uterus to facilitate placental expulsion. Applying traction on the umbilical cord to speed up separation of the placenta is indicated for active management of the third stage of labor, which can prevent early postpartum hemorrhage, which is excessive bleeding from the uterus or genital tract that occurs within 24 hours after delivery. Early postpartum hemorrhage can be caused by uterine atony, retained placenta, lacerations, or coagulation disorders.

A. "If I go too long overdue, the amniotic ﬂuid volume can become too low for my baby to be safe." B. "My baby took longer to grow, and now she's ready to be born." C. "I don't really need this induction, my baby will come whenever he wants to." D. "Since I am so tired of being pregnant, I am being induced."

Correct Answer is A

Explanation

Choice A Reason: "If I go too long overdue, the amniotic ﬂuid volume can become too low for my baby to be safe." This is a correct answer that indicates that the client understands one of the Reasons for induction of labor at 42 weeks' pregnancy.

Choice B Reason: "My baby took longer to grow, and now she's ready to be born." This is an incorrect answer that shows a misconception about fetal growth and development. Fetal growth does not depend on gestational age alone, but also on genetic, maternal, placental, and environmental factors. A post-term fetus does not necessarily grow faster or larger than a term fetus. In fact, some post-term fetuses may experience intrauterine growth restriction (IUGR), which means slower than expected growth for gestational age.

Choice C Reason: "I don't really need this induction, my baby will come whenever he wants to." This is an incorrect answer that reveals a lack of awareness or acceptance of the need for induction of labor at 42 weeks' pregnancy. Induction of labor is recommended for post-term pregnancies to prevent potential complications such as fetal distress, stillbirth, or maternal hemorrhage.

Choice D Reason: "Since I am so tired of being pregnant, I am being induced." This is an incorrect answer that implies that induction of labor is based on maternal preference or convenience rather than medical indication. Induction of labor should not be done without a valid Reason or informed consent, as it carries some risks such as failed induction, prolonged labor, infection, uterine rupture, or cesarean delivery.

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When reviewing the causes of late postpartum hemorrhage, which of the following would the nurse identify as the most common cause? Select one:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which of the following would be essential to implement to prevent late postpartum hemorrhage? Select one:

Correct Answer is A

Explanation

The client at 42 weeks' pregnancy is admited for induction of her labor. Which statement indicates that she understands the Reasons for the induction? Select one:

Correct Answer is A

Explanation

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When reviewing the causes of late postpartum hemorrhage, which of the following would the nurse identify as the most common cause?
Select one: