NU143CL Unit 8 Case Study Analysis Example

Course	NU143CL Maternal Infant Nursing Clinical
Unit	Unit 8
Paper type	Case study analysis
Length	About 850 words, 6 pages double-spaced
Format	APA 7 student paper
School	Purdue University Global
Program	BSN (prelicensure)
Updated	October 2026

Free sample paper for NU143CL Unit 8

A Boggy Uterus Forty-Five Minutes After a Large Baby: A Case Study Analysis of Postpartum Hemorrhage From Uterine Atony in a Composite Mother After a Twenty-Two-Hour Induction, Reading the Risk That Was Visible Beforehand

[Student Name]

Purdue University Global

NU143CL: Maternal Infant Nursing Clinical

Unit 8 Case Study Analysis

[Instructor Name]

[Date]

The patient is composite; values are bracketed where illustrative, and medication and procedure decisions belong to the provider and the hemorrhage protocol.

What this part is doingThe analysis starts with the risks visible before the bleed, because recognizing them early is the nursing skill this case teaches.

The Case

[Ms. E.], composite, 30, gravida 2, para 2, was induced at 41 weeks with oxytocin for twenty-two hours, pushed for two and a half hours and gave birth vaginally to a boy weighing [4,300] g. The placenta delivered intact. Estimated blood loss at birth was [400] mL, and her fundus was firm at the umbilicus. At forty-five minutes, during a routine fundal check, the uterus was soft and two fingerbreadths above the umbilicus, and she passed a [6] cm clot followed by steady bright red bleeding. Within minutes her pulse climbed to [112], and her blood pressure read [104/62].

The Risk That Was Visible

Several factors raised her risk before any bleeding began: a large baby, which overstretches the uterine muscle; a long induction with prolonged oxytocin exposure, after which the muscle's receptors respond less well; a long second stage; and multiparity. None guaranteed a hemorrhage, but together they placed her in a higher-risk group. Risk assessment on admission and before birth allows teams to prepare, for example by confirming blood type and screen and having medications at hand (American College of Obstetricians and Gynecologists, 2017).

The bleed happened at forty-five minutes, but the risk had been accumulating for twenty-two hours, and every factor was already in the chart.

Why the Uterus Lost Tone

After the placenta separates, bleeding from its site is controlled mainly by the contraction of the uterine muscle, which clamps the blood vessels. The four common causes of postpartum hemorrhage are often summarized as tone, trauma, tissue and thrombin. Tone, meaning uterine atony, is by far the most common. An overstretched, fatigued muscle exposed to long oxytocin infusion is less able to stay contracted (Perry et al., 2022). Her soft uterus and clots fit atony, while an intact placenta and no visible tears made tissue and trauma less likely, though both were checked.

What this part is doingThe four causes are used to explain why atony was most likely and how the others were ruled out.

The Nursing Response, Step by Step

1. Massaged the fundus firmly with one hand while supporting the lower uterus with the other, and expressed clots.

2. Called for help and activated the hemorrhage protocol.

3. Increased the oxytocin infusion as ordered and prepared second-line uterotonic medications per protocol, checking each drug's contraindications, such as high blood pressure for some agents (Burchum & Rosenthal, 2022).

4. Started a second large-bore IV and sent blood for type and crossmatch.

5. Emptied her bladder with a catheter, since a full bladder can prevent the uterus from contracting.

6. Weighed pads and linens to measure blood loss rather than estimating.

7. Monitored vital signs every five minutes and watched for signs of shock.

8. Kept her and her partner informed in short, calm sentences.

After the second medication, the uterus became firm. Total measured blood loss was [1,250] mL. Her heart rate settled at [96]. The team debriefed briefly afterward, noting that the protocol cart arrived within two minutes and that weighing pads gave a measured loss far higher than the first visual estimate.

What this part is doingBlood loss is weighed, not estimated, which the debrief shows mattered.

Afterward

She received IV fluids and was monitored closely for twenty-four hours, with fundal checks every hour at first; her hemoglobin fell from [12.1] to [8.9] g/dL, and she began oral iron. Breastfeeding was supported once she was stable, since nipple stimulation also releases oxytocin.

Supporting the Family During the Bleed

Her partner was holding the baby when the bleeding began and watched the room fill with staff. One nurse was assigned to stay with him, explain what was happening in plain terms and keep the baby skin-to-skin on his chest so the newborn stayed warm. When Ms. E. asked whether she was dying, the nurse at her side answered honestly that she was bleeding more than expected, that the team knew how to stop it and that the medicine was working. Afterward, the nurse returned to talk through what had happened, because women who experience hemorrhage often remember the fear more than the details and may have questions days later. Offering that conversation before discharge is part of the care, not an extra.

Teaching Before Discharge

She learned to recognize signs of anemia, such as dizziness on standing and unusual tiredness, and to take her iron with vitamin C away from calcium-rich foods. She was told to report heavier bleeding or large clots at home, and to rise slowly at first, especially at night when feeding.

What Could Be Prepared Next Time

A documented hemorrhage risk score on admission and again before birth, blood type and screen already available, uterotonics at the bedside before birth, and quantitative blood loss measurement from the start. These steps do not prevent atony, but they shorten the time from recognition to treatment.

References

American College of Obstetricians and Gynecologists. (2017). Postpartum hemorrhage (Practice Bulletin No. 183). Obstetrics & Gynecology, 130(4), e168-e186. https://doi.org/10.1097/AOG.0000000000002351

Burchum, J. R., & Rosenthal, L. D. (2022). Lehne's pharmacology for nursing care (11th ed.). Elsevier.

Perry, S. E., Hockenberry, M. J., Cashion, K., Alden, K. R., Olshansky, E., & Lowdermilk, D. L. (2022). Maternal child nursing care (7th ed.). Elsevier.

What the NU143CL Unit 8 assignment asks for

Unit 8 often returns to bleeding after birth, asking for an analysis of a hemorrhage case. Prompts commonly want the risk factors present, the cause explained, the nursing response in sequence, the outcome and what could be improved. Instructors look for recognition that risk accumulates before the bleed, a correct explanation of atony as the most common cause, and a response that follows a hemorrhage protocol in a sensible order, including emptying the bladder and measuring blood loss. Attention to the family during an emergency and to teaching about anemia afterward shows care beyond the technical response. Recommendations should focus on preparation, such as risk assessment and supplies at the bedside. Values are bracketed where illustrative.

Inside the NU143CL Unit 8 example

The analysis opens with the case, from the long induction and large baby to the soft uterus, clot and rising pulse at forty-five minutes. A section reads the visible risk factors, with the highlighted line on twenty-two hours of accumulating risk, citing the national practice bulletin. The four causes explain why atony was most likely, with a margin note. Eight numbered steps describe the response, from massage to weighing pads, followed by a short debrief. Sections cover her recovery, support for her partner and her during the bleed, teaching on anemia and bleeding at home, and preparations for next time. Each step names who did it.

Where the points sit in the NU143CL Unit 8 rubric

Hemorrhage case analyses in NU 143CL are scored on risk recognition, explanation of cause, quality and order of the response, and recommendations. Risk recognition earns credit when the factors present before the bleed are named and connected to atony. Explanation points go to the role of uterine contraction in controlling bleeding and to ruling out other causes. The response carries significant weight: graders look for massage, calling for help, uterotonics per protocol, IV access, bladder emptying and measured blood loss in a sensible order, supported by sources in APA 7. Recommendations rewarding preparation, and attention to the family, round out the expectations. A debrief that names what worked is part of a strong analysis.

Common NU143CL Unit 8 mistakes, and how to avoid them

Hemorrhage analyses often start at the moment of bleeding and miss the risk factors that were in the chart for hours. Another frequent gap is leaving out bladder emptying, which can stop a uterus from contracting. Some papers estimate blood loss visually, which underestimates it. Many forget the partner holding the baby across the room. Read the chart for risk before birth, explain atony and how the other causes were excluded, list the response in order, weigh pads and linens, assign someone to support the family, teach anemia signs before discharge and recommend preparations that shorten the time from recognition to treatment. Assign one person to the family.

Get an NU143CL Unit 8 example written to your instructions

A postpartum infection, severe hypertension, a newborn with low blood sugar or one needing phototherapy: Unit 8 cases range that widely. Pass along the case exactly as assigned, its questions and the rubric, and each question gets its own answer, values bracketed. The first custom sample is free of charge; 24-48h. The paper above is an original model document written by our desk, not a submitted student paper and not an official Purdue University Global document.

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NU143CL Unit 8 questions, answered

Where can I find a free NU143CL Unit 8 sample paper?

You can read the complete NU143CL Unit 8 case study analysis of postpartum hemorrhage here, with visible risks, the cause, an eight-step response, family support, teaching and preparations, citing three sources. We can analyze a hemorrhage case from your rotation with you.

What is the most common cause of postpartum hemorrhage?

Uterine atony, meaning the uterus does not contract firmly enough to clamp the blood vessels at the placental site. It is far more common than trauma, retained tissue or clotting problems.

What risk factors for atony did the patient have in NU143CL Unit 8?

A large baby that overstretched the uterus, a twenty-two-hour oxytocin induction, a long second stage and a previous birth, which together placed her in a higher-risk group.

Why empty the bladder during a postpartum hemorrhage?

A full bladder can prevent the uterus from contracting and push it out of position, so emptying it helps the uterus firm up alongside massage and medication.

Is weighing pads better than eyeballing blood loss?

Visual estimates often underestimate loss. Weighing pads and linens gives a measured total, which in the sample was far higher than the first estimate.