Which of the following is the most common cause of postpartum hemorrhage?

Uterine atony

Retained placenta

Lacerations

Hematomas

Answer and Explanation

The Correct Answer is A

Uterine atony is the most common cause of postpartum hemorrhage, accounting for up to 80% of cases. It occurs when the uterus does not contract enough to stop the bleeding from the placental site. Uterine atony can be caused by factors such as prolonged labor, multiple pregnancy, large baby, infection or use of certain medications.

The other statements are wrong because:

• B. Retained placenta is the second most common cause of postpartum hemorrhage, but it only accounts for about 10% of cases. It occurs when part or all of the placenta remains attached to the uterine wall and prevents the uterus from contracting properly.

• C. Lacerations are tears or cuts in the cervix, vagina or perineum that can cause bleeding after delivery. They are usually minor and can be repaired with stitches, but they can also be severe and require surgery. Lacerations are not very common causes of postpartum hemorrhage, and they usually occur along with other factors such as uterine atony or retained placenta.

• D. Hematomas are collections of blood under the skin or in the tissues that can result from trauma during delivery. They can cause pain, swelling and pressure in the affected area, but they are usually small and resolve on their own. Hematomas are rare causes of postpartum hemorrhage, and they usually occur along with other factors such as lacerations or coagulation disorders.

Normal ranges for blood loss after delivery are less than 500 mL for vaginal birth and less than 1000 mL for cesarean birth. Blood loss greater than these amounts can indicate postpartum hemorrhage and require immediate medical attention.

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Correct Answer is C

Explanation

Hemoglobin, which is an indicator of the number of RBCs and decreases during hypovolemia and hemorrhage.

Hemoglobin is a protein that carries oxygen in the blood and is measured in grams per deciliter (g/dL).

A normal range for hemoglobin is 12 to 16 g/dL for women.

A low hemoglobin level indicates anemia, which can be caused by blood loss or other factors.

A postpartum hemorrhage is a loss of more than 500 mL of blood after delivery, which can lead to hypovolemia (low blood volume) and shock.

Choice A is wrong because urine output 200 mL for the past 8 hours is within the normal range for a postpartum woman.

The kidneys may retain fluid during pregnancy and release it after delivery, resulting in increased urine output.

A normal urine output is 30 to 50 mL per hour.

Choice B is wrong because weight decrease of 2 pounds since delivery is expected for a postpartum woman.

The weight loss reflects the loss of fluid, blood, and placental tissue during delivery.

A normal weight loss after delivery is 10 to 12 pounds.

Choice D is wrong because hematocrit, which is the percent of RBCs in the total blood volume, and decreases during hypovolemia, may not reflect the true extent of blood loss in a postpartum hemorrhage.

Hematocrit is measured as a percentage and a normal range for hematocrit is 37 to 47% for women.

However, hematocrit may be falsely elevated due to hemoconcentration (increased concentration of blood cells) caused by fluid loss.

Hematocrit may take several days to reflect the actual blood loss.

A. Early B. Late C. Chronic D. Acute

Correct Answer is A

Explanation

Early postpartum hemorrhage occurs within the first 24 hours after delivery.The client has saturated two perineal pads in 15 minutes, which indicates severe bleeding and a possible complication of the third stage of labor.

Choice B is wrong because late postpartum hemorrhage occurs 24 hours to 12 weeks postpartum.This type of hemorrhage is usually caused by retained placental fragments or infection.

Choice C is wrong because chronic postpartum hemorrhage is not a recognized term.

Postpartum hemorrhage is an acute condition that requires immediate attention.

Choice D is wrong because acute postpartum hemorrhage is not a specific type of hemorrhage, but a general term for any excessive bleeding after childbirth.Postpartum hemorrhage can be classified into mild, moderate, or severe based on the amount of blood loss.

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Which of the following is the most common cause of postpartum hemorrhage?

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Naxlex Comprehensive Predictor Exams

Which of the following laboratory tests should the nurse report to the obstetrician when monitoring a client who is one day postpartum and has experienced significant postpartum hemorrhage?

Correct Answer is C

Explanation

A nurse is caring for a client who delivered vaginally 4 hours ago and has saturated two perineal pads in 15 minutes. The nurse identifies this as which of the following types of postpartum hemorrhage?

Correct Answer is A

Explanation

A nurse is performing fundal massage for a client who has uterine atony and postpartum hemorrhage. Which of the following actions should the nurse take when performing this procedure?

A nurse is providing discharge instructions to a client who had postpartum hemorrhage and received blood transfusions during her hospital stay. Which of the following information should the nurse include in the teaching? (Select all that apply)

A nurse is caring for a client who has postpartum hemorrhage and is receiving IV fluids and blood products. Which of the following interventions should the nurse include in the plan of care? (Select all that apply.)

A nurse is caring for a client who has just delivered her baby and is at risk for postpartum hemorrhage (PPH). Which intervention should be included in this client’s plan of care?

A nurse is caring for a client who has just delivered her baby and is at risk for PPH due to uterine atony.Which interventions should be included in this client’s plan of care? (Select all that apply)

A nurse is caring for a client who has just delivered a baby and is experiencing postpartum hemorrhage due to retained placental fragments. Which of the following interventions should the nurse anticipate? Select all that apply:

A nurse is assessing a client who had a cesarean birth and is experiencing postpartum hemorrhage due to uterine dehiscence. Which of the following manifestations should alert the nurse to this complication?

A nurse is providing discharge instructions to a client who had postpartum hemorrhage due to placenta accreta and underwent hysterectomy. Which of the following statements by the client indicates an understanding of the teaching?