A client at 37 weeks gestation is admitted with complaints of fever, pain and swelling in her groin, and contractions every 15 minutes.
The nurse, when assessing the client’s perineum, found erythematous lesions on the vulva that look like herpes. The nurse anticipates the patient’s treatment regimen to include which of the following?

Choice A rationale
Administering oxytocic medication is an intervention that may be necessary if the client’s bleeding does not stop or if the uterus does not contract adequately. However, the priority is to assess the situation, which includes palpating the uterine fundus.
Choice B rationale
Assisting the client on a bedpan to urinate can help if the bladder is full and preventing the uterus from contracting properly. However, the priority is to assess the uterus by palpating the uterine fundus.
Choice C rationale
Palpating the client’s uterine fundus is the priority nursing intervention. A boggy uterus (one that does not contract properly) is a common cause of postpartum hemorrhage. If the uterus is not firm upon palpation, massage it until it firms up.
Choice D rationale
Increasing the client’s fluid intake can help replace lost fluids, but it is not the priority intervention. The first step is to assess the cause of the bleeding, which includes palpating the uterine fundus.

Choice A rationale
Administering oxygen via a nasal cannula is not the appropriate response to a client experiencing tingling fingers during pattern-paced breathing. This symptom is not indicative of hypoxia.
Choice B rationale
Having the client tuck her chin to her chest can help alleviate the tingling sensation. This position can help reduce hyperventilation, which is often the cause of the tingling.
Choice C rationale
Assisting the client to breathe into a paper bag is not the appropriate response to a client experiencing tingling fingers during pattern-paced breathing. This action is typically used to treat hyperventilation, but it is not the first-line intervention.
Choice D rationale
Instructing the client to increase her respiratory rate to more than 42 breaths per minute is not the appropriate response to a client experiencing tingling fingers during pattern-paced breathing. This could exacerbate the problem by causing further hyperventilation.