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?

Rationale:

A. Inserting a urinary catheter is an invasive procedure and should not be the first action taken to address bladder distention following a vaginal birth. It should only be considered if the client is unable to void voluntarily.

B. Assisting the client to the bathroom is the initial intervention to attempt to relieve bladder distention. Encouraging the client to void in a comfortable and familiar environment may stimulate urination and help alleviate the distention.

C. Offering the client a sitz bath may provide comfort and promote perineal healing but is not the first intervention for bladder distention.

D. Pouring warm water over the client's perineum may also provide comfort but does not directly address bladder distention.

Rationale:

A. Massaging the client's fundus is not indicated for hypotension following epidural anesthesia.

Fundal massage is typically performed to prevent or manage uterine atony and postpartum hemorrhage.

B. Turning the client to a side-lying position is a recommended intervention for hypotension following epidural anesthesia. This position helps improve venous return to the heart and can help alleviate hypotension by reducing aortocaval compression.

C. Applying oxygen via nasal cannula may be indicated if the client is experiencing respiratory distress, but it is not the primary intervention for hypotension.

D. Assisting the client to empty their bladder may be appropriate to relieve urinary retention but is not the priority intervention for hypotension.