A nurse is caring for a client who is at 37 weeks of gestation and is being tested for group B streptococcus B-hemolytic (GBS). The client is multigravida and multipara with no history of GBS. She asks the nurse why the test was not conducted earlier in her pregnancy. Which of the following is an appropriate response by the nurse?

Explanation

Choice A Reason:

Providing oxygen to the client via nonrebreather face mask is incorrect. Oxygen administration may be necessary if the client is hypoxic due to severe blood loss, but it is not the first action to address excessive vaginal bleeding.

Choice B Reason:

Emptying the client's bladder is incorrect. A full bladder can impede uterine contraction and contribute to postpartum hemorrhage. Emptying the bladder can help improve uterine tone and decrease bleeding. However, it is not the first action to take in the case of excessive vaginal bleeding.

Choice C Reason:

Administering oxytocin to the client is incorrect. Oxytocin is a uterotonic medication commonly used to promote uterine contraction and control postpartum bleeding. Administering oxytocin is an appropriate intervention for managing postpartum hemorrhage, but it may not be the first action to take.

Choice D Reason:

Massaging the client's fundus is correct. Massaging the client's fundus helps to stimulate uterine contractions, which can help control bleeding in the immediate postpartum period. Fundal massage is a standard intervention for managing postpartum hemorrhage and should be initiated promptly if excessive bleeding is noted.

Explanation

Choice A Reason:

Vaginal candidiasis is an infection that affects the vagina and does not directly contraindicate the use of a rectal suppository. However, if the suppository is intended for vaginal use, it may not be suitable in the presence of vaginal candidiasis due to the risk of exacerbating the infection.

Choice B Reason:

Afterpains refer to uterine contractions that occur after childbirth as the uterus returns to its normal size. Afterpains are not a contraindication to the use of a rectal suppository for constipation.

Choice C Reason:

Third-degree perineal laceration is correct. A suppository is a medication delivery system that is inserted into the rectum or vagina. In the case of constipation, rectal suppositories are often used to stimulate bowel movements. However, in the presence of a third-degree perineal laceration, the insertion of a rectal suppository could potentially worsen the injury or cause discomfort.

Choice D Reason:

Abdominal distention, or bloating, is a common symptom that may accompany constipation. It is not a contraindication to the use of a rectal suppository for constipation; in fact, relieving constipation may help alleviate abdominal distention.