How much blood loss defines postpartum hemorrhage?

Correct Answer: B

Rationale: Postpartum hemorrhage is defined as excessive bleeding following childbirth, usually within the first 24 hours. It is a significant cause of maternal mortality and morbidity if not promptly recognized and managed. The correct answer is B: 500 mL, as this is the generally accepted threshold for defining postpartum hemorrhage. A: 250 mL is too low to be considered postpartum hemorrhage. While some blood loss is normal after childbirth, this amount is not typically concerning unless the woman is showing signs of distress or other symptoms. C: 750 mL is closer to the threshold for postpartum hemorrhage, but it is still higher than the generally accepted definition of 500 mL. At 750 mL, the woman would likely be experiencing significant symptoms and would require immediate medical attention. D: 1,000 mL is well above the threshold for postpartum hemorrhage and would indicate a severe and potentially life-threatening situation. At this level of blood loss, the woman would likely be in shock and would require immediate intervention to prevent further complications. In summary, the correct answer is B: 500 mL, as this is the generally accepted threshold for defining postpartum hemorrhage. Any amount of blood loss above this threshold should be taken seriously and prompt medical attention should be sought to ensure the safety and well-being of the mother.

Correct Answer: B

Rationale: Ethnicity and religion are important factors for the nurse to note from the prenatal record before proceeding with the physical assessment. Ethnicity can provide valuable information about potential genetic predispositions to certain health conditions or diseases that may impact the pregnancy. Additionally, cultural beliefs and practices related to pregnancy and childbirth can influence the care that the nurse provides to the patient. Weight gain is not necessarily crucial information to note before the physical assessment. While weight gain during pregnancy is important to monitor, it is typically a part of the physical assessment itself rather than a prerequisite for proceeding with the assessment. Age is also not essential information to note before the physical assessment. While maternal age can impact pregnancy outcomes, it is not a prerequisite for conducting a physical assessment. Gravidity and parity are important pieces of information to gather from the prenatal record, but they are not necessary before proceeding with the physical assessment. Gravidity refers to the number of times a woman has been pregnant, while parity refers to the number of times a woman has given birth to a viable offspring. This information is important for understanding the patient's obstetric history, but it is not required before conducting the physical assessment.

Correct Answer: C

Rationale: Leopold's maneuvers are a series of four steps used to assess the position of the fetus in the uterus. Step 1: In the first step, the nurse determines which part of the fetus is located in the upper abdomen. This helps to identify the fetal presentation. Step 2: The second step involves palpating both sides of the uterus to determine which side the fetus's back is on. This helps to determine the fetal position. Step 3: In the third step, the nurse determines the location of the presenting part in the pelvis. This helps to determine the fetal station and engagement. Step 4: The final step involves palpating the lower abdomen to determine the position of the fetal back and limbs. This helps to determine the fetal lie. In this scenario, based on Leopold's maneuvers, if the nurse determines that the fetus's back is on the right side of the mother's abdomen and the small parts are felt on the left side, this indicates a longitudinal lie. A vertical lie means that the fetus's long axis is parallel to the mother's long axis. This is the correct answer. Choice A is incorrect because a transverse fetal position means that the fetus is lying horizontally across the mother's abdomen, which would not be determined by Leopold's maneuvers. Choice B is incorrect because the fetal presentation refers to the part of the fetus that is entering the maternal pelvis first. This is usually determined during the vaginal examination, not by Leopold's maneuvers. Choice D is incorrect because fetal attitude refers to the relationship of the fetal body parts to one another. It is not determined by Leopold's maneuvers, which focus on the position of the fetus in the uterus.

Correct Answer: A

Rationale: In the second stage of labor, the cervix is fully dilated at 10 centimeters and the baby is pushed through the birth canal. Option A, bulging perineum, is a sign that indicates progression into the second stage of labor. This occurs as the baby's head descends and puts pressure on the perineum, causing it to bulge outward. This is a clear indication that the second stage of labor has begun. Option B, increased bloody show, is not necessarily a sign of progression into the second stage of labor. Bloody show is a common sign of labor but it can occur in the first stage as well. It is caused by the release of the mucus plug that seals the cervix during pregnancy. Option C, spontaneous rupture of membranes, is also not a definitive sign of progression into the second stage of labor. This can happen at any point during labor and does not necessarily indicate the beginning of the second stage. Option D, inability to breathe through contractions, is not a sign of progression into the second stage of labor. While contractions can become more intense and frequent in the second stage, breathing techniques can still be used to help manage the pain and discomfort. In summary, the bulging perineum is the most reliable sign that indicates progression into the second stage of labor. Other signs mentioned in the options can occur at various points during labor and are not specific to the second stage.

Correct Answer: A

Rationale: The correct answer is A. Descent is progressing well. This is because the primipara is in active labor, 7 cm dilated, and at +3 station. At this point, the fetus is descending through the birth canal, which indicates progress in labor. The +3 station means that the fetal head is 3 cm below the ischial spines in the pelvis, which is a good sign that descent is occurring as expected. Therefore, it is important for the nurse to report that descent is progressing well. Choice B, fetal head is not yet engaged, is incorrect. The fact that the fetus is at +3 station indicates that the fetal head is engaged and descending into the pelvis. This is a positive sign of progress in labor. Choice C, vaginal delivery is imminent, is incorrect. While the primipara is at 7 cm dilated and at +3 station, it is not guaranteed that delivery is imminent. Labor can still take some time to progress further before delivery occurs. Choice D, external rotation is complete, is incorrect. External rotation occurs during the second stage of labor, not during active labor. At this point, the focus is on descent and dilation, rather than rotation of the fetus.