A nurse is caring for a postpartum person who is experiencing excessive bleeding. What is the first step in managing postpartum hemorrhage?

Correct Answer: A

Rationale: The correct answer is A: administer uterotonics. Uterotonics help to contract the uterus, which can help stop the bleeding in postpartum hemorrhage. This is the initial step in managing postpartum hemorrhage to address the primary cause of excessive bleeding. Administering IV fluids (B) can support circulation but does not address the underlying issue. Performing manual removal of the placenta (C) is invasive and not the first-line treatment for postpartum hemorrhage. Monitoring vital signs (D) is important but should not delay the immediate intervention of administering uterotonics.

Correct Answer: A

Rationale: The correct answer is A: Late decelerations. Late decelerations indicate uteroplacental insufficiency, which can lead to fetal hypoxia and distress. This is the most concerning finding as it indicates a problem with oxygen delivery to the fetus. Bradycardia (B) and Tachycardia (C) can also be concerning, but late decelerations are more specific to fetal distress. Variable decelerations (D) are caused by cord compression and are concerning but not as indicative of fetal distress as late decelerations.

Correct Answer: A

Rationale: The correct answer is A: assist with the delivery of the placenta. During the third stage of labor, the placenta needs to be delivered. This is done by gently applying traction to the umbilical cord while supporting the uterus to facilitate the expulsion of the placenta. This step is crucial to prevent postpartum hemorrhage. Choice B (prepare for a vaginal birth) is incorrect because the person is already in the third stage of labor, which means the baby has been delivered and they are now focusing on delivering the placenta. Choice C (administer oxytocin) is incorrect because while oxytocin may be used to help control bleeding after the placenta is delivered, it is not the most appropriate intervention during the third stage of labor. Choice D (apply gentle pressure to the uterus) is incorrect because direct pressure to the uterus is not the primary intervention during the third stage of labor; assisting with the delivery of the placenta takes precedence.

Correct Answer: B

Rationale: The correct answer is B: administer uterotonic medications. Administering uterotonic medications helps prevent postpartum hemorrhage by promoting uterine contractions, which helps to control bleeding. The step-by-step rationale for this answer is as follows: 1. Uterotonic medications, such as oxytocin or misoprostol, are recommended as a prophylactic measure to prevent postpartum hemorrhage. 2. These medications help the uterus to contract, which compresses blood vessels and reduces the risk of excessive bleeding. 3. Administering uterotonic medications is a proactive approach to managing postpartum hemorrhage in high-risk individuals. Summary: Monitoring vital signs (choice A) is important but does not directly prevent hemorrhage. Assessing uterine tone (choice C) is helpful but may not be sufficient in preventing hemorrhage. Performing fundal massage (choice D) can help manage hemorrhage but is not as effective as administering ut

Correct Answer: D

Rationale: The correct answer is D: administer an epidural. Uterine hyperstimulation during labor can lead to fetal distress and complications. Administering an epidural can help manage pain and relax the uterus, reducing the risk of hyperstimulation. Stopping the oxytocin infusion (choice A) is also important, but managing the uterine contractions with an epidural takes priority. Increasing the oxytocin infusion (choice B) would exacerbate the hyperstimulation. Administering IV fluids (choice C) may be helpful, but it does not directly address the uterine hyperstimulation.