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The patient has experienced a postpartum hemorrhage at 6 hours postpartum. After controlling the hemorrhage, the patient's partner asks what would cause a hemorrhage. How should the nurse respond?
 
  1. Sometimes the uterus relaxes and excessive bleeding occurs.
  2. The blood collected in the vagina and poured out when your partner stood up.
  3. Bottle-feeding prevents the uterus from getting enough stimulation to contract.
  4. The placenta had embedded in the uterine tissue abnormally.

1
Rationale 1: Uterine atony, in which the uterus relaxes, is the most common cause of early postpartum hemorrhage (within the first 24 hours after delivery).
Rationale 2: Although blood can pool in the vagina and thus pour out when the patient stands, this does not constitute a hemorrhage.
Rationale 3: Although breastfeeding stimulates the release of oxytocin, which causes the uterus to contract, bottle-feeding does not cause hemorrhage.
Rationale 4: Had the placenta embedded abnormally (as in placenta accreta), the hemorrhage would have occurred immediately after the placenta delivered.