(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?

Perform immediate fundal massage

Ambulate to the bathroom or use bedpan to empty bladder

Administer oxytocin as prescribed

D. Both A and B.

Answer and Explanation

The Correct Answer is D

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.

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Correct Answer is ["A","B","C","D"]

Explanation

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.

A. Administer oxytocin as prescribed B. Assist with ambulation. C. Encourage frequent voiding D. Massage her fundus

Correct Answer is D

Explanation

The correct answer is choice D. Massage her fundus.

This is because a boggy and displaced fundus indicates uterine atony, which is the failure of the uterus to contract sufficiently after delivery.

This can lead to excessive bleeding and postpartum hemorrhage.Massaging the fundus can help stimulate uterine contractions and reduce blood loss.

Choice A is wrong because administering oxytocin is not the first action the nurse should take.Oxytocin is a medication that can also help the uterus contract, but it should be given after massaging the fundus and assessing the bleeding.

Choice B is wrong because assisting with ambulation is not appropriate for a client with a boggy and displaced fundus.Ambulation can increase bleeding and cause orthostatic hypotension due to blood loss.

Choice C is wrong because encouraging frequent voiding is not the first action the nurse should take.

A full bladder can displace the uterus and prevent effective contractions, so voiding can help the uterus return to its normal position.However, this should be done after massaging the fundus and assessing the bleeding.

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(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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a postpartum client who has an episiotomy wound infection. Which of the following should the nurse do? (Select all that apply.) A) Administer antibiotics as prescribed.

Correct Answer is ["A","B","C","D"]

Explanation

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?

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?

A nurse is evaluating a postpartum woman’s knowledge about pain management after birth. The nurse asks the woman what she would do if she has uterine cramping while breastfeeding her baby. Which response by the woman indicates a need for further teaching?

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?

A nurse is caring for a postpartum client who delivered vaginally yesterday and has been experiencing heavy vaginal bleeding since delivery. Which of the following actions should the nurse take first?

A nurse is preparing a discharge plan for a postpartum woman who had a vaginal delivery with a second-degree perineal tear. The nurse includes instructions on how to care for the perineum at home. Which statement by the woman indicates that she understands the instructions?

A nurse is assessing a client who delivered an infant vaginally 2 days ago and notes that the fundus is firm, midline, and at the level of the umbilicus, lochia rubra is moderate, and there are no clots present in the lochia flow. Which of the following actions should the nurse take?

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?

(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?

(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?