A 25 year-old woman gave birth to her second child 6 hours ago. She informs the nurse that she is bleeding more than with her previous birth experience. The initial nursing action is to:

Assess the location and firmness of the fundus.

Explain that this is normal for second-time moms.

Administer Pitocin as per standing order.

Change her pad and return in 1 hour and reassess.

Answer and Explanation

The Correct Answer is A

A. Correct. The priority is to assess the fundus for firmness and location. Uterine atony is a common cause of postpartum hemorrhage and requires immediate assessment and intervention.

B. Incorrect. Increased bleeding in a multiparous client should not be dismissed as normal without assessment.

C. Incorrect. Administering Pitocin may be appropriate but should follow an assessment of the fundus first.

D. Incorrect. Waiting an hour without assessing the fundus could delay necessary interventions for postpartum hemorrhage.

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Correct Answer is C

Explanation

A. This is expected immediately postpartum.

B. This is expected at 24 hours postpartum.

C. Immediately after birth, the fundus is at the level of the umbilicus. The uterus involutes (shrinks) approximately 1 cm (or 1 fingerbreadth) per day postpartum. 48 hours postpartum, the fundus should be 2 cm (or 2 fingerbreadths) below the umbilicus.

D. 3 cm below the umbilicus would be expected at 72 hours postpartum.

Correct Answer is {"dropdown-group-1":"A"}

Explanation

Massage the fundus: The client has heavy lochia rubra with clots, which indicates possible postpartum hemorrhage (PPH). A firm fundus does not rule out excessive bleeding, so fundal massage and further assessment are critical.

PPH is a life-threatening condition and must be addressed immediately.

Incorrect Answers & Rationale:

Encourage the client to ambulate: While ambulation is important postpartum, it is not the priority in the presence of heavy bleeding.

The client should remain in bed until bleeding is controlled.

Offer the client fluids: Fluids are beneficial but do not address the immediate concern of heavy bleeding. PPH requires active intervention, not just hydration.

Administer pain medication for postpartum discomfort: Pain relief is important, but postpartum hemorrhage is the priority. Uncontrolled bleeding is life-threatening and must be managed first.

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A 25 year-old woman gave birth to her second child 6 hours ago. She informs the nurse that she is bleeding more than with her previous birth experience. The initial nursing action is to:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

You are assessing a patient who delivered vaginally 48 hours ago. At this time, where would you expect to feel her fundus?

Correct Answer is C

Explanation

Exhibits The nursing priority is to dropdown

Correct Answer is {"dropdown-group-1":"A"}

Explanation

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