(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 D

Explanation

The correct answer is choice D. I would stop feeding my baby until the pain goes away.This response indicates a need for further teaching because stopping breastfeeding can worsen the uterine cramping and also affect the milk supply and the baby’s nutrition.Uterine cramping or “afterpains” are normal after delivery and are caused by the uterus contracting and shrinking back to its normal size.Breastfeeding can trigger these contractions because it stimulates the release of oxytocin, a hormone that helps the uterus contract.

Choice A is wrong because ibuprofen is a safe and effective pain reliever for postpartum women and can be taken before feeding the baby.Choice B is wrong because massaging the abdomen gently during feeding can help ease the afterpains by stimulating blood flow and relaxing the muscles.Choice C is wrong because relaxation and breathing techniques can also help reduce the pain by lowering stress and tension levels.These are some of the self-help treatments that can be used along with medications to manage postpartum pain.

A. Lochia with clots. B. Fundus firmness C. Abdominal distension D. Breast tenderness. E. Temperature greater than 38°C for more than 48 hours.

Correct Answer is E

Explanation

The correct answer is choice E) Temperature greater than 38°C for more than 48 hours.This is because a fever higher than 38°C that lasts for more than two days can indicate a postpartum infection, which is a potentially serious complication that requires immediate medical attention.A postpartum infection can affect various parts of the body, such as the uterus, the breast, or the urinary tract.

Choice A) Lochia with clots is wrong because lochia is the normal vaginal discharge that occurs after childbirth and may contain some blood clots.However, if the lochia is foul-smelling, excessive, or bright red, it may be a sign of infection.

Choice B) Fundus firmness is wrong because a firm fundus (the top of the uterus) indicates that the uterus is contracting well and preventing excessive bleeding.A soft or boggy fundus can be a sign of infection or hemorrhage.

Choice C) Abdominal distension is wrong because some abdominal swelling is normal after delivery and may take several weeks to subside.However, if the abdomen is very tender, painful, or hard, it may be a sign of infection or other complications.

Choice D) Breast tenderness is wrong because some

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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?

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Naxlex Comprehensive Predictor Exams

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?

Correct Answer is D

Explanation

A nurse is assessing a postpartum client for signs of infection. Which of the following should the nurse report immediately? A) Lochia with clots.

Correct Answer is E

Explanation

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A nurse is caring for a client who delivered an infant vaginally 2 days ago and notes that there are no clots present in the lochia flow, but there is moderate bleeding with bright red blood and small clots present when massaging the fundus which is firm, midline, and at the level of the umbilicus.

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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?