A client, G1 P0101, postpartum 1 day, is assessed. The nurse notes that the client 's lochia rubra is moderate and her fundus is boggy 2 cm above the umbilicus and deviated to the right. Which of the following actions should the nurse take first?
- A. Notify the woman 's primary health care provider.
- B. Massage the woman 's fundus.
- C. Escort the woman to the bathroom to urinate.
- D. Check the quantity of lochia on the peripad.
Correct Answer: B
Rationale: A boggy fundus can indicate uterine atony, which can lead to postpartum hemorrhage. The first step is to massage the fundus to stimulate uterine contraction.
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What symptom can partners of persons with PPD experience?
- A. depression
- B. psychosis
- C. bipolar disorder
- D. mania
Correct Answer: A
Rationale: Partners of those with PPD can experience depression as they may feel overwhelmed and stressed by the challenges of caregiving.
Why does the nurse encourage ambulation in a patient who has experienced a cesarean birth?
- A. Ambulation helps to prevent DVT.
- B. Ambulation causes the person to lose weight in the hospital.
- C. Ambulation helps with breast-feeding.
- D. Ambulation decreases peristalsis.
Correct Answer: B
Rationale: The correct answer is B because ambulation after a cesarean birth helps the patient to lose weight. Walking promotes circulation, aids in healing, and can prevent complications such as blood clots and pneumonia. It also helps to restore strength and energy levels. Choices A, C, and D are incorrect because ambulation primarily benefits the patient's overall well-being and recovery, rather than directly preventing DVT, aiding breastfeeding, or decreasing peristalsis.
The nurse is aware the greatest source of bleeding during childbirth occurs following detachment of the placenta. Which physiological change takes place immediately after the expulsion of the placenta to decrease the amount of blood loss?
- A. Contractions of the uterine myometrium
- B. Factor VIII complex increases during gestation
- C. Platelet activity increases before labor and delivery
- D. Fibrin formation increases before the birth occurs
Correct Answer: A
Rationale: The correct answer is A: Contractions of the uterine myometrium. After the placenta is expelled, the uterine myometrium contracts, causing compression of blood vessels at the site of placental detachment, which helps to decrease blood loss. This contraction also helps to close off blood vessels and reduce the risk of postpartum hemorrhage.
Summary of other choices:
B: Factor VIII complex increases during gestation - Factor VIII is involved in blood clotting, but its increase during gestation is not directly related to decreasing blood loss after placental expulsion.
C: Platelet activity increases before labor and delivery - While platelet activity is important for blood clotting, the increase before labor and delivery does not specifically address the immediate decrease in blood loss after placental expulsion.
D: Fibrin formation increases before the birth occurs - Fibrin formation is part of the clotting process, but its increase before birth does not directly address the immediate decrease in blood loss post
A woman who is 18 hours postpartum says she is having 'hot flashes ' and 'sweats all the time. ' The appropriate nursing response is to:
- A. Report her signs and symptoms of hypovolemic shock.
- B. Tell her that her body is getting rid of unneeded fluid.
- C. Notify her nurse-midwife that she may have an infection.
- D. Limit her intake of caffeine-containing fluids.
Correct Answer: B
Rationale: Hot flashes and sweating are common during the postpartum period as the body gets rid of excess fluids. It is not an indicator of hypovolemic shock or infection.
Which is the initial treatment for the client with vWD who experiences a PPH?
- A. Cryoprecipitate
- B. Factor VIII and von Willebrand factor (vWf)
- C. Desmopressin
- D. Hemabate
Correct Answer: C
Rationale: The correct initial treatment for vWD client with PPH is desmopressin (Choice C) because it stimulates the release of von Willebrand factor and factor VIII from storage sites, helping to improve clotting. Cryoprecipitate (Choice A) contains multiple clotting factors and is usually reserved for severe bleeding. Factor VIII and vWf (Choice B) can be used for severe cases but are not typically the initial treatment. Hemabate (Choice D) is a medication used for postpartum hemorrhage due to uterine atony, not specifically for vWD-related bleeding.