A nurse is reviewing the medical record of a client who had a vaginal delivery 3 hr ago. Which of the following findings places the client at risk for postpartum haemorrhage?(Select all that apply.)
A.
Newborn weight 2.948 kg (6 lb 8 oz).
B.
History of uterine atony.
C.
Labor induction with oxytocin.
D.
History of human papillomavirus.
The Correct Answer and Explanation is:
The correct answers are B. History of uterine atony and C. Labor induction with oxytocin.
Explanation:
Postpartum hemorrhage (PPH) is a significant concern following vaginal delivery, defined as blood loss exceeding 500 mL within 24 hours post-delivery. Several factors increase the risk of PPH, and understanding these factors is crucial for effective nursing care.
B. History of uterine atony: Uterine atony, or the failure of the uterus to contract effectively after delivery, is one of the leading causes of PPH. If a client has a documented history of uterine atony, they are at an increased risk for recurrence after subsequent deliveries. The absence of adequate uterine tone leads to excessive blood loss due to insufficient compression of blood vessels within the uterus, making monitoring and early intervention essential.
C. Labor induction with oxytocin: While oxytocin is commonly used to stimulate labor and prevent uterine atony, its use can paradoxically contribute to an increased risk of PPH if not managed properly. In cases where oxytocin is used for labor induction, if the uterine contractions are overly strong or prolonged, it can lead to uterine exhaustion and atony after delivery. Therefore, clients who have received oxytocin should be closely monitored for signs of PPH.
A. Newborn weight 2.948 kg (6 lb 8 oz): This finding does not inherently increase the risk of PPH. While larger infants may increase the risk of certain complications, a newborn weight within this range is generally considered normal and does not significantly correlate with postpartum bleeding risks.
D. History of human papillomavirus: This condition is unrelated to PPH risk factors. HPV primarily affects cervical health and does not have a direct impact on the uterine tone or the mechanisms involved in postpartum bleeding.
In summary, nursing assessment and awareness of these risk factors are vital for timely intervention and prevention of complications associated with postpartum hemorrhage.