Registered Nurse Certified in Maternal Newborn Nursing (RNC-MNN) Practice Test

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Puerperal bradycardia during the postpartum period is least likely related to:

  1. decreased stroke volume

  2. decreased cardiac strain

  3. decreased blood volume

  4. contraction of the uterus

The correct answer is: decreased stroke volume

Puerperal bradycardia, which refers to a slow heart rate in the postpartum period, is a physiological response that can occur due to several factors as a woman's body adjusts following childbirth. The correct answer indicates that decreased stroke volume is least likely related to this condition. After delivery, women experience a rapid decline in blood volume due to blood loss during childbirth, but compensatory mechanisms are activated to manage changes in hemodynamics effectively. The heart rate may decrease as a response to decreased cardiac strain. This is due to the normalization of blood volume and improved cardiac efficiency once the stress of labor and delivery is over. During the postpartum period, the body works to readjust and recover from the significant changes it has undergone. The contraction of the uterus, for instance, promotes the return of blood flow to the systemic circulation and reduces blood loss, while simultaneously influencing heart rate through reflex mechanisms. In contrast, the concept of decreased stroke volume being a direct cause of bradycardia is not supported in this context; instead, the overall cardiovascular dynamics lead to a decrease in heart rate, independent of stroke volume. Therefore, decreased stroke volume is not a key contributor to the observed bradycardia during the postpartum period.