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

Answer and Explanation

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

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Correct Answer is ["B","D","E"]

Explanation

The correct answer is choice B, D and E. These are the factors that put this client at risk for developing postpartum hemorrhage:

• Uterine overdistention: This occurs when the uterus is stretched too much by a large baby, multiple babies, or excess amniotic fluid.This can impair the normal contraction of the uterus after delivery and lead to bleeding.

• Oxytocin use: This is a hormone that stimulates uterine contractions during labor.However, prolonged or excessive use of oxytocin can cause uterine atony, which is the failure of the uterus to contract and compress the blood vessels after delivery.

• Chorioamnionitis: This is an infection of the membranes and amniotic fluid that surround the baby.It can cause inflammation and damage to the uterine lining, which can interfere with blood clotting and increase the risk of bleeding.

Choice A and C are wrong because:

• Grand multiparity: This means having given birth five or more times.It is not a risk factor for postpartum hemorrhage by itself, but it may be associated with other risk factors such as uterine overdistention, oxytocin use, or placental abnormalities.

• Precipitous labor: This means having a very fast labor, lasting less than three hours.It is not a risk factor for postpartum hemorrhage by itself, but it may be associated with other risk factors such as trauma to the birth canal, retained placenta, or coagulation disorders.

A. Early B. Late C. Chronic D. Acute

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.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who experienced a postpartum hemorrhage after delivering a large baby following oxytocin induction of labor. Which of the following factors put this client at risk for developing postpartum hemorrhage? (Select all that apply)

Correct Answer is ["B","D","E"]

Explanation

A nurse is caring for a client who delivered vaginally 4 hours ago and has saturated two perineal pads in 15 minutes. The nurse identifies this as which of the following types of postpartum hemorrhage?

Correct Answer is A

Explanation

A nurse is caring for a client who has just delivered her baby and is at risk for postpartum hemorrhage (PPH). Which intervention should be included in this client’s plan of care?

A nurse is performing fundal massage for a client who has uterine atony and postpartum hemorrhage. Which of the following actions should the nurse take when performing this procedure?

Which of the following laboratory tests should the nurse report to the obstetrician when monitoring a client who is one day postpartum and has experienced significant postpartum hemorrhage?

A nurse is assessing a client who had a cesarean birth and is experiencing postpartum hemorrhage due to uterine dehiscence. Which of the following manifestations should alert the nurse to this complication?

A nurse is preparing to administer methylergonovine to a client who has a postpartum hemorrhage due to uterine atony. Which of the following assessments should the nurse perform prior to administration?

A nurse is caring for a client who has postpartum hemorrhage and is receiving IV fluids and blood products. Which of the following interventions should the nurse include in the plan of care? (Select all that apply.)

A nurse is evaluating the effectiveness of interventions for a client who has postpartum hemorrhage due to retained placental fragments. Which of the following outcomes indicates that the interventions are successful?

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?

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?