During the immediate postpartum period,a client's fundus is firmly contracted,midline,and at the appropriate level,but she is exhibiting an excessive amount of bleeding.The nurse should suspect the cause of bleeding to be:

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Postpartum hemorrhage can occur rapidly and may not be recognized until the client is in shock.It can either be early,within the first 24 hours,or late,within the first 1 to 2 weeks after birth,but may occur up to 6 weeks after the birth.It can be caused by cervical or vaginal tears,prolonged labor,clotting disorders,manual removal of the placenta,or overdistention of the uterus.

During the Immediate Postpartum Period,a Client's Fundus Is Firmly Contracted,midline,and