A nurse is caring for a client who delivered vaginally 4 hours ago and has a boggy uterus that is displaced to the right of midline.
Which of the following actions should the nurse take first?
Apply ice packs to the perineum
Assist the client to empty her bladder
Increase the rate of IV fluids
Administer carboprost as prescribed
The Correct Answer is B
This is because a boggy uterus that is displaced to the right of midline indicates that the bladder is full and pushing the uterus out of place. A full bladder can prevent the uterus from contracting effectively after delivery, leading to excessive bleeding and postpartum hemorrhage (PPH) .
Emptying the bladder can help the uterus return to its normal position and tone.
Choice A is wrong because applying ice packs to the perineum may help reduce swelling and pain, but it will not address the underlying cause of the boggy uterus.
Choice C is wrong because increasing the rate of IV fluids may worsen the bleeding by diluting the blood and reducing its clotting ability.
Choice D is wrong because administering carboprost, a medication that stimulates uterine contractions, may be indicated if other measures fail to restore uterine tone, but it is not the first action to take. Carboprost also has side effects such as fever, nausea, vomiting, and diarrhea .
Normal ranges for uterine size and position after delivery are:
• Immediately after delivery: at or slightly below the level of the umbilicus (navel)
• 6 hours after delivery: 1 fingerbreadth above the umbilicus
• 12 hours
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Early postpartum hemorrhage occurs within the first 24 hours after delivery.The client has saturated two perineal pads in 15 minutes, which indicates severe bleeding and a possible complication of the third stage of labor.
Choice B is wrong because late postpartum hemorrhage occurs 24 hours to 12 weeks postpartum.This type of hemorrhage is usually caused by retained placental fragments or infection.
Choice C is wrong because chronic postpartum hemorrhage is not a recognized term.
Postpartum hemorrhage is an acute condition that requires immediate attention.
Choice D is wrong because acute postpartum hemorrhage is not a specific type of hemorrhage, but a general term for any excessive bleeding after childbirth.Postpartum hemorrhage can be classified into mild, moderate, or severe based on the amount of blood loss.
Correct Answer is ["A","B","C","D"]
Explanation
• Choice A: Administering oxytocin.Oxytocin is a uterotonic agent that stimulates uterine contractions and reduces bleeding from the placental site.It is the most effective intervention for preventing and treating postpartum hemorrhage.
• Choice B: Administering methylergonovine maleate.Methylergonovine maleate is another uterotonic agent that causes sustained uterine contraction and vasoconstriction.It can be used as an alternative or adjunct to oxytocin for postpartum hemorrhage.
• Choice C: Administering carboprost tromethamine.Carboprost tromethamine is a prostaglandin analog that induces strong and prolonged uterine contractions and decreases blood loss.
It can be used as a second-line treatment
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.