A nurse is providing discharge teaching to a client who had a vaginal delivery with a midline episiotomy.

Which of the following instructions should the nurse include in the teaching? (Select all that apply.)

Use a sitz bath three times per day and after each bowel movement

Wipe from back to front after voiding or having a bowel movement

Apply ice packs to the perineum for the first 24 hours

Perform Kegel exercises several times per day

Report any increase in redness, swelling, or discharge from the episiotomy site.

Answer and Explanation

Correct Answer : A,C,D,E

The correct answer is choice A, C, D and E. These are the instructions that the nurse should include in the teaching for a client who had a vaginal delivery with a midline episiotomy.

• Choice A is correct because using a sitz bath three times per day and after each bowel movement can help reduce pain, swelling and infection of the perineum.

• Choice C is correct because applying ice packs to the perineum for the first 24 hours can help reduce inflammation and bleeding.

• Choice D is correct because performing Kegel exercises several times per day can help strengthen the pelvic floor muscles and improve urinary continence.

• Choice E is correct because reporting any increase in redness, swelling or discharge from the episiotomy site can help detect signs of infection or wound breakdown.

• Choice B is wrong because wiping from back to front after voiding or having a bowel movement can increase the risk of infection by introducing bacteria from the anal area to the vaginal area. The correct way to wipe is from front to back.

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Correct Answer is D

Explanation

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.

A. Assess vital signs B. Palpate fundus C. dminister oxytocin as prescribed. D. Check perineal pad.

Correct Answer is B

Explanation

The correct answer is choice B. Palpate fundus.The nurse should first assess the tone of the uterus by palpating the fundus, as uterine atony is the most common cause of postpartum hemorrhage.

If the uterus is boggy or soft, the nurse should massage it gently until it becomes firm and contracts.

This will help control the bleeding from the placental site.

Choice A is wrong because assessing vital signs is not the first priority in this situation.Vital signs may not reflect the severity of blood loss until late in the process of hemorrhage.

The nurse should monitor vital signs after ensuring that the uterus is contracted.

Choice C is wrong because administering oxytocin as prescribed is not the first action the nurse should take.

Oxytocin is a medication that stimulates uterine contractions and reduces bleeding, but it should be given

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A nurse is providing discharge teaching to a client who had a vaginal delivery with a midline episiotomy. Which of the following instructions should the nurse include in the teaching? (Select all that apply.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

(from search results) A nurse discovers a postpartum client with a boggy uterus, displaced above the right of the umbilicus. What nursing action is indicated?

Correct Answer is D

Explanation

A nurse is caring for a postpartum client who reports heavy vaginal bleeding and passing large clots since delivery 2 days ago. Which of the following actions should the nurse take first?

Correct Answer is B

Explanation

Question 48. A client who has undergone a cesarean section is experiencing abdominal pain and tenderness. Which of the following should the nurse assess for?

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A nurse is assessing a postpartum client who delivered vaginally 2 days ago and notes that her fundus is boggy and displaced to the right side of her abdomen. Which of the following actions should the nurse take first?

(Select all that apply) A nurse is monitoring a postpartum woman who is taking codeine for severe pain after birth. The nurse knows that codeine can pass through breastmilk and cause adverse effects in the baby. Which signs and symptoms should the nurse watch for in the baby?

A nurse is providing discharge teaching to a client who had a vaginal delivery with a midline episiotomy. Which of the following instructions should the nurse include in the teaching? (Select all that apply.)

A nurse is caring for a client who has postpartum endometritis and is receiving IV antibiotics. Which of the following findings indicates that the client is experiencing an adverse effect of the medication?

A nurse is providing discharge teaching to a client who had a vaginal delivery with a midline episiotomy.

Which of the following instructions should the nurse include in the teaching? (Select all that apply.)