NHM UP Staff Nurse-2021 Shift-2nd
Obstetrics & Gynaecology
Easy
If the placenta is not delivered within 30 minutes of delivery then it can be removed
Appeared in: NHM UP Staff Nurse-2021 Shift-2nd
Explanation
- A placenta not delivered within 30 minutes of childbirth is clinically defined as a retained placenta.
- This condition is a significant cause of postpartum hemorrhage (PPH) as the uterus cannot contract properly.
- The standard, first-line management for a retained placenta is manual removal under anesthesia.
- This procedure involves the provider inserting a hand into the uterus to manually separate the placenta from the uterine wall and extract it.
Why Other Options Were Wrong
- Option A: Controlled cord traction (CCT) is a prophylactic measure used during the active management of the third stage of labor to facilitate placental separation, not the treatment for a placenta that has already been retained for 30 minutes.
- Option C: Surgery is an invasive, last-resort option and not the standard initial procedure for a simple retained placenta.
- Option D: This is incorrect because a standard, effective procedure (manual removal) exists for managing a retained placenta.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Management of Retained Placenta as background academic context rather than a clinical decision trigger.
- Retained placenta is a leading cause of primary postpartum hemorrhage (PPH), a major cause of maternal mortality worldwide. Prompt recognition and management are critical nursing responsibilities.
- The nurse's role includes closely monitoring the mother for signs of placental separation, assessing for excessive bleeding, ensuring IV access is available, and preparing the mother and equipment for a potential manual removal.
- After the procedure, the nurse must continue to monitor uterine tone (fundal massage), vital signs, and blood loss to ensure the uterus remains contracted and to detect any further complications.
How to Approach the Question
- First, identify the key clinical information in the question: the placenta has not been delivered, and the timeframe is 'within 30 minutes of delivery'.
- Recall the definition of the stages of labor and their complications. Failure of the placenta to deliver within 30 minutes defines a 'retained placenta'.
- Consider the standard management protocol for a retained placenta. This is a direct recall of a clinical procedure.
- Evaluate the options: 'Controlled traction' is part of active management before 30 minutes. 'Surgery' is a last resort for severe complications. 'Manual method' is the standard procedure for removing a retained placenta.
- Select 'Manual method' as the correct intervention for the scenario described.
Concept Tested & Keywords
- Concept Tested: Management of Retained Placenta
- Stem keywords: placenta, not delivered, 30 minutes, removed
- Lead-in keywords: can be removed
- Clinical cues: Timeframe of 30 minutes after delivery is the key diagnostic criterion for retained placenta.
Question ID
QxrdIiBXdxNkPOloLffKwC
Reference Book
E6 Obstetrics Williams pp. 13-28, 12-27
E6 Midwifery Obstetrics and Gynecology Nursing Sandeep Kaur p. 1-3
Practise the full NHM UP Staff Nurse-2021 Shift-2nd
Attempt every question from this paper in a timed mock, then review the full solution for each one.
More Complications of the Third Stage of Labor Questions
- Post-partum women having bleeding within 24 hrs after delivery is called:
- Which of the following drug is preferrably administered immediately after delivery of baby?
- How is blood loss measured in Post-partum hemorrhage?
- Which of the following medication is used in PPH (Post-Partum Hemorrhage)?
- Duration of secondary PPH?
- The nurse in the postpartum unit is caring for a client who has just delivered a newborn infant following a pregnancy with placenta previa. The nurse…
- What nursing interventions should be performed during uterine Fundus Examination after post partum?
- Post-partum women having bleeding from 1st day after delivery is called as?
- The condition where the uterus turns inside out is called?
- Postpartum haemorrhage is the condition in which there is loss of more than ml vaginal blood?
More NHM UP Staff Nurse-2021 Shift-2nd Questions
- A man started walking West. He turned right, then right again and finally turned left. Towards which direction was he walking now?
- There are five houses P, Q, R, S and T. P is right of Q and T is left of R and right of P. Q is right of S. Which house is in the middle?
- If A means '+', B means '-', C means 'x', then find the value of following equation. 46 A 2 B 3 C 4=?
- Seema's younger brother Sohan is older than Seeta. Sweta in younger than Deepti but elder than Seema, who is the eldest?
- If 'MEAT' is written as 'TEAM', then 'BALE' is written as
- If an a certain code language 'SECTOR' is written as 'ESCTOR', then how will 'MOTHER' be written in that code?
- Arrange the following words according to English dictionary. 1. Hepatitis 2. Cholera 3. Peptidoglycan 4. Chitin
- Introducing Alka to guests, Rakesh said, "Her father is the only son of my father". How is Alka related to Rakesh?
- Arjuna Award is given for
- The first Indian to receive Noble Prize in Literature was