Nurses need to understand the basic definitions and incidence data regarding PPH. Which statement regarding this condition is most accurate?

Correct Answer: B

Rationale: The correct answer is B because it accurately defines the criteria for postpartum hemorrhage (PPH). PPH is traditionally defined as losing more than 1000 ml of blood after vaginal birth and 2500 ml after cesarean birth. This definition helps healthcare providers recognize and manage PPH effectively. Now, let's analyze why the other choices are incorrect: A: This statement is incorrect because PPH may not always be easy to recognize early based solely on visible bleeding. Other signs and symptoms, such as tachycardia and hypotension, also play a crucial role in identifying PPH. C: This statement is incorrect because underestimating, rather than overestimating, the amount of blood loss in PPH can lead to delayed intervention and potentially worsen the patient's condition. D: This statement is incorrect because PPH is not classified based on timing (early or late PPH), but rather on the amount of blood loss as defined in choice B.

Correct Answer: C

Rationale: The correct initial treatment for vWD client with PPH is desmopressin (Choice C) because it stimulates the release of von Willebrand factor and factor VIII from storage sites, helping to improve clotting. Cryoprecipitate (Choice A) contains multiple clotting factors and is usually reserved for severe bleeding. Factor VIII and vWf (Choice B) can be used for severe cases but are not typically the initial treatment. Hemabate (Choice D) is a medication used for postpartum hemorrhage due to uterine atony, not specifically for vWD-related bleeding.

Correct Answer: A

Rationale: The correct answer is A: Hysterectomy. Hysterectomy is the appropriate surgical procedure for late postpartum hemorrhage (PPH) when nonsurgical treatments fail. It involves the removal of the uterus, which can effectively stop the bleeding. Other choices like Laparoscopy (B) and Laparotomy (C) are surgical techniques used to access the abdomen but do not address the underlying cause of PPH. Dilation and curettage (D&C) (D) is a procedure to remove tissue from the uterus and would not be effective in treating late PPH.

Correct Answer: A

Rationale: The correct answer is A because operative and precipitate births increase the risk of obstetric lacerations due to the rapid delivery or use of instruments. Operative births involve interventions like forceps or vacuum extraction, which can cause trauma. Precipitate births, characterized by rapid labor and delivery, may lead to tearing of the lower genital tract. Choices B, C, and D are incorrect as they do not directly influence the causes and incidence of obstetric lacerations. Adherent retained placenta, abnormal fetal presentation, and congenital abnormalities of maternal soft tissue are not primary factors contributing to lacerations during childbirth.

Correct Answer: A

Rationale: The correct answer is A: Contractions of the uterine myometrium. After the placenta is expelled, the uterine myometrium contracts, causing compression of blood vessels at the site of placental detachment, which helps to decrease blood loss. This contraction also helps to close off blood vessels and reduce the risk of postpartum hemorrhage. Summary of other choices: B: Factor VIII complex increases during gestation - Factor VIII is involved in blood clotting, but its increase during gestation is not directly related to decreasing blood loss after placental expulsion. C: Platelet activity increases before labor and delivery - While platelet activity is important for blood clotting, the increase before labor and delivery does not specifically address the immediate decrease in blood loss after placental expulsion. D: Fibrin formation increases before the birth occurs - Fibrin formation is part of the clotting process, but its increase before birth does not directly address the immediate decrease in blood loss post