Which patient would be at the highest risk for postpartum hemorrhage?
One who births in the lithotomy position.
One who receives uterine massage postpartum.
One whose third stage lasts less than 10 minutes.
One who gives birth to an infant weighing 9 pounds (4310 grams).
The Correct Answer is D
Choice A rationale
While lithotomy positioning can increase pressure on perineal tissues, it does not directly correlate with an elevated risk of postpartum hemorrhage. Other factors have stronger evidence for causing hemorrhage.
Choice B rationale
Uterine massage is a preventative measure against postpartum hemorrhage. It stimulates uterine contractions, promoting tone, and reducing atony, which is a primary cause of excessive postpartum bleeding.
Choice C rationale
A third stage lasting less than 10 minutes is within normal limits, reducing the likelihood of placental retention and subsequent bleeding. Prolonged stages, rather than shortened ones, increase risk.
Choice D rationale
Macrosomia, defined as infant birth weight over 4000 grams, increases uterine atony risk due to overdistension, impairing effective contractions post-delivery. Overdistension complicates placental separation, raising postpartum hemorrhage risk.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
Projectile vomiting is not a typical symptom of diaphragmatic hernia. This condition primarily affects respiratory function due to lung compression by abdominal organs in the chest cavity.
Choice B rationale
High-pitched crying is not a hallmark symptom of diaphragmatic hernia. The condition primarily presents with respiratory distress due to lung underdevelopment and organ displacement.
Choice C rationale
Respiratory distress occurs due to lung compression and underdevelopment caused by abdominal organs herniating into the chest cavity. This is a primary symptom observed in diaphragmatic hernia cases.
Choice D rationale
Fecal incontinence is unrelated to diaphragmatic hernia. The condition primarily impacts respiratory function due to the displacement of abdominal organs into the thoracic cavity.
Correct Answer is D
Explanation
Choice A rationale
A soft fundus indicates uterine atony, an abnormal finding requiring immediate intervention. This teaching would lead to improper patient monitoring of complications such as hemorrhage.
Choice B rationale
Clots as large as a golf ball are not considered normal and may signal uterine atony or retained placental fragments, which necessitate medical intervention for hemorrhage risk.
Choice C rationale
Decreased brownish-red lochia may reflect normal postpartum changes as it progresses to serosa and alba but is not typically an indicator of complications.
Choice D rationale
Increased lochia or a return to bright red bleeding signals potential complications like subinvolution or late postpartum hemorrhage, which demand prompt medical attention.
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