Maternity Nursing: Intrapartum Q 53
A nurse assists in the vaginal delivery of a newborn infant. After the delivery, the nurse observes the umbilical cord lengthen and a spurt of blood from the vagina. The nurse documents these observations as signs of:
A. Hematoma
B. Placenta previa
C. Uterine atony
D. Placental separation
Correct Answer: D. Placental separation
As the placenta separates, it settles downward into the lower uterine segment. The umbilical cord lengthens, and a sudden trickle or spurt of blood appears. Delivery of the placenta usually happens within 5-10 minutes after delivery of the fetus, but it is considered normal up to 30 minutes after delivery of the fetus.
Option A: A hematoma is a bad bruise. It happens when an injury causes blood to collect and pool under the skin. The pooling blood gives the skin a spongy, rubbery, lumpy feel. A hematoma usually is not a cause for concern. It is not the same thing as a blood clot in a vein, and it does not cause blood clots.
Option B: Placenta previa occurs when a baby’s placenta partially or totally covers the mother’s cervix — the outlet for the uterus. Placenta previa can cause severe bleeding during pregnancy and delivery. If the woman has placenta previa, she might bleed throughout her pregnancy and during her delivery.
Option C: Atony of the uterus, also called uterine atony, is a serious condition that can occur after childbirth. It occurs when the uterus fails to contract after the delivery of the baby, and it can lead to a potentially life-threatening condition known as postpartum hemorrhage.