Question

A nurse is reviewing the medical record of a client who experienced a vaginal birth 2 hr ago. The nurse should identify that which of the following findings places the client at risk for a postpartum hemorrhage?

A. Two-vessel umbilical cord
Rationale: The presence of a two-vessel umbilical cord does not increase a client's risk for a postpartum hemorrhage.
B. Precipitous birth
Rationale: A client who has a precipitous birth is at an increased risk for postpartum hemorrhage.
C. Small for gestational age newborn
Rationale- A client who has a newborn that is small for gestational age is not at an increased risk for the postpartum hemorrhage. A client who gives birth to a large newborn is at an increased risk.
D. Gestational hypertension
Rationale: Gestational hypertension does not increase a client's risk for a postpartum hemorrhage

Answer 1

In summary, a precipitous birth is the finding that places a client at a higher risk for postpartum hemorrhage because it can lead to uterine atony and insufficient uterine contractions after delivery.

Step-by-step explanation:

A nurse reviewing the medical record of a client who experienced a vaginal birth 2 hours ago should identify that a precipitous birth places the client at an increased risk for postpartum hemorrhage. A precipitous birth, defined as labor that lasts fewer than 3 hours from the onset of contractions to delivery, can result in insufficient time for the uterine contractions to compress the vessels at the site where the placenta was attached, leading to excessive bleeding.

Uterine atony, or failure of the uterus to contract properly after delivery, is a common cause of postpartum hemorrhage and is more likely when the labor and delivery are very rapid. This increased risk overshadows other factors mentioned, such as a two-vessel umbilical cord, having a newborn that is small for gestational age, or gestational hypertension, which are not direct risk factors for postpartum hemorrhage.