What is characteristic of an early (primary) PPH?

Correct Answer: C

Rationale: The correct answer is C because early (primary) postpartum hemorrhage (PPH) often occurs due to uterine atony, which is the inability of the uterus to contract effectively after childbirth. This leads to excessive bleeding within 24 hours of delivery. Choice A is incorrect because early PPH occurs within 24 hours postpartum, not after 12 weeks. Choice B is incorrect because early PPH is indeed an emergency due to the risk of rapid blood loss. Choice D is incorrect as early PPH is typically diagnosed before or shortly after discharge, not after.

Correct Answer: C

Rationale: The correct answer is C: von Willebrand disorder. This is a risk factor for postpartum hemorrhage (PPH) as it can lead to abnormal bleeding during and after childbirth. von Willebrand disorder is a hereditary bleeding disorder that affects the blood's ability to clot properly. This can increase the likelihood of excessive bleeding during delivery, putting the mother at risk for PPH. Choice A: primipara is incorrect, as being a first-time mother (primipara) is not a direct risk factor for PPH. Choice B: rubella nonimmune is incorrect, as rubella immunity status is not directly related to the risk of PPH. Choice D: history of appendectomy is incorrect, as a previous appendectomy is not a known risk factor for PPH. In summary, the presence of von Willebrand disorder in the prenatal record is a significant risk factor for PPH due to its impact on blood clotting ability during childbirth.

Correct Answer: D

Rationale: The correct answer is D: Start an IV bolus. In postpartum hemorrhage (PPH), the priority is to restore circulating volume quickly to prevent shock. Starting an IV bolus with fluids or blood products helps improve perfusion and oxygenation. Choice A is incorrect as warming the person does not address the underlying issue of hypovolemia. Choice B is incorrect as monitoring oxygen saturation is not the immediate priority. Choice C is incorrect as sitting the person up could potentially worsen their condition by reducing venous return.

Correct Answer: B

Rationale: The correct answer is B: risk for fluid overload. A person with a coagulation disorder is at risk for excessive bleeding, which may lead to fluid overload due to blood loss and subsequent fluid replacement. This nursing diagnosis addresses the potential complications related to fluid imbalance in this population. Incorrect choices: A: risk for bleeding - While bleeding is a concern for someone with a coagulation disorder, this choice does not address the potential fluid overload that may result from excessive bleeding. C: risk for breast-feeding failure - This choice is not relevant to the immediate health concerns of a person with a coagulation disorder. D: risk for hypertension - Hypertension is not directly related to a coagulation disorder, therefore this choice is not appropriate as a nursing diagnosis in this context.

Correct Answer: B

Rationale: The correct answer is B: shiny, hard breast. Engorgement is characterized by a significant increase in blood and lymph fluid in the breast tissue, causing the breasts to become swollen, shiny, and hard. This occurs when milk production exceeds removal, leading to congestion and inflammation. Protuberant nipples (A) may be a result of engorgement but are not a defining symptom. Insufficient milk production (C) is not a symptom of engorgement but rather a separate issue related to milk supply. Soft, lumpy breast (D) is more indicative of a blocked duct or mastitis, not engorgement.