A nurse is caring for a client who has postpartum endometritis and is receiving IV antibiotics.

Which of the following findings indicates that the treatment is effective? A) Decreased vaginal bleeding.

The correct answer is choice D. Both A and B.A boggy uterus is a uterus that is enlarged, soft, and tender due to the failure of the uterus to contract sufficiently after delivery.This condition is called uterine atony and it is the most common cause of postpartum hemorrhage.Postpartum hemorrhage is excessive bleeding after childbirth that can lead to shock and death if not treated promptly.

The nursing actions indicated for a boggy uterus are:

• Perform immediate fundal massage: This helps to stimulate uterine contractions and reduce bleeding.

• Ambulate to the bathroom or use bedpan to empty bladder: This helps to reduce bladder distension and allow the uterus to contract and descend into the pelvis.

Choice A is partially correct but not sufficient by itself.

Choice B is also partially correct but not sufficient by itself.Choice C is incorrect because administering oxytocin alone may not be effective in restoring uterine tone if there are other factors contributing to uterine atony, such as overdistension, prolonged labor, or infection.Oxytocin is a hormone that stimulates uterine contractions.

The correct answer is choice C) Administer oxytocin (Pitocin).Oxytocin is a hormone that stimulates uterine contractions and helps reduce postpartum bleeding by closing off the blood vessels that were attached to the placenta.

The nurse should administer oxytocin as ordered by the provider to help the client’s uterus contract and prevent hemorrhage.

Choice A) Document findings as normal is wrong because moderate bleeding with bright red blood and small clots is not normal for lochia flow 2 days after delivery.Lochia is the vaginal discharge that occurs after birth and consists of blood, tissue, mucus and bacteria.Lochia should be dark or bright red for the first 3 to 4 days, but the flow should be light and there should be no clots.Moderate bleeding with bright red blood and small clots indicates that the client may have retained placental fragments or uterine atony.

Choice B) Massage fundus until it becomes firm is wrong because the fundus is already firm, midline and at the level of the umbilicus, which indicates that the uterus is contracted properly.Massaging the fundus when it is already firm can cause more bleeding and pain.

Choice D) Increase IV fluid rate is wrong because increasing IV fluid rate will not stop the bleeding or address the underlying cause.Increasing IV fluid rate may also cause fluid overload or dilutional coagulopathy.The nurse should monitor the client’s vital signs, urine output and hematocrit levels to assess for signs of hypovolemia or anemia due to blood loss.