A nurse is caring for a client who received meperidine (Demerol) IV for pain relief during labor 2 hours ago and is now ready to deliver vaginally.

Which of the following medications should the nurse have available to reverse respiratory depression in the newborn?

The correct answer is B. Palpate fundus.

The nurse should first assess the fundus to determine if it is firm and at the expected level of involution.

A boggy or displaced fundus can indicate uterine atony, which is the most common cause of postpartum hemorrhage.

By massaging the fundus, the nurse can stimulate uterine contractions and reduce bleeding.

A. Assess vital signs.

This statement is wrong because assessing vital signs is not the first action the nurse should take.

Vital signs can indicate the severity of blood loss and shock, but they do not address the cause of bleeding.

C. Administer oxytocin as prescribed.

This statement is wrong because administering oxytocin is not the first action the nurse should take.

Oxytocin is a medication that can enhance uterine contractions and reduce bleeding, but it should be given after assessing and massaging the fundus.

D. Check perineal pad.

This statement is wrong because checking perineal pad is not the first action the nurse should take.

Checking perineal pad can help estimate the amount of blood loss, but it does not address the cause of bleeding.

The correct answer is choice A, B, C and D. Antibiotics, wound monitoring, wound care and wound culture are all appropriate interventions for a postpartum client who has an episiotomy wound infection.According to Mayo Clinic, an episiotomy wound infection can cause pain, fever, pus and wound breakdown.According to SpringerLink, an episiotomy wound infection is usually caused by a polymicrobial infection of Gram-negative and Gram-positive bacteria.

Therefore, administering antibiotics as prescribed can help treat the infection and prevent complications.

Monitoring wound healing can help detect any signs of worsening infection or dehiscence.

Teaching wound care can help the client prevent further contamination and promote healing.

Culturing the wound if indicated can help identify the causative organisms and guide antibiotic therapy.

Choice E is wrong because applying heat to the wound can increase inflammation and pain.According to NCBI, there is no evidence that heat therapy is beneficial for episiotomy wounds.

Instead, cold therapy may be more effective in reducing swelling and discomfort.