A nurse is caring for a client who is 1 hr postpartum and has uterine atony. The client is exhibiting a large amount of vaginal bleeding. Which of the following actions should the nurse take?
Avoid performing sterile vaginal examinations.
Anticipate a prescription for misoprostol.
Obtain a specimen for a Kleihauer-Betke test.
Administer betamethasone IM.
The Correct Answer is B
Rationale:
A. Avoiding sterile vaginal examinations is not the appropriate action for managing uterine atony and postpartum hemorrhage. Vaginal examinations may be necessary to assess the degree of cervical dilation and to identify potential causes of bleeding.
B. Anticipating a prescription for misoprostol is appropriate for managing uterine atony and postpartum hemorrhage. Misoprostol is a prostaglandin analog that helps to promote uterine contractions and control bleeding.
C. Obtaining a specimen for a Kleihauer-Betke test is not the priority action in this situation. The Kleihauer-Betke test is used to estimate the amount of fetal-maternal hemorrhage in Rh-negative mothers.
D. Administering betamethasone IM is not indicated for the management of uterine atony and postpartum hemorrhage. Betamethasone is a corticosteroid used to promote fetal lung maturity when preterm birth is anticipated.
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Related Questions
Correct Answer is C
Explanation
Rationale:
A. "You should use an oil-based vaginal lubricant when inserting your diaphragm." Incorrect.
Oil-based lubricants can weaken latex diaphragms, increasing the risk of breakage. Water-based lubricants are recommended instead.
B. "You should keep the diaphragm in place for at least 4 hours after intercourse." Incorrect.
Diaphragms should be left in place for at least 6 hours after intercourse but not longer than 24 hours.
C. "You should have your provider refit you for a new diaphragm."
Correct answer. After childbirth, the size and shape of the cervix may change, affecting the fit of the diaphragm. Therefore, it's important to have the diaphragm refitted by a healthcare provider.
D. "You should store your diaphragm in sterile water after each use." Incorrect. Diaphragms should be cleaned and dried thoroughly after each use and stored in a cool, dry place, not in sterile water.
Correct Answer is D
Explanation
Rationale:
A. A temperature of 37.4°C (99.3°F) may be within the normal range, but it can also indicate a fever, which is common with endometritis.
B. A WBC count of 9,000/mm3 is within the normal range, but it may be elevated in response to infection such as endometritis.
C. Scant lochia is not typically associated with endometritis; instead, clients with endometritis may have increased or foul-smelling lochia.
D. Uterine tenderness is a common finding in clients with endometritis, as the infection causes inflammation and discomfort in the uterine lining.
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