The nurse palpates a postpartum client's fundus two hours after birth and finds it located to the right of midline and somewhat soft. What does the nurse understand about this information?
The uterine placement is normal
The urinary bladder is distended
The uterus is filled with blood
There is an infection inside the uterus
The Correct Answer is B
A. The uterine placement is not normal if it's to the right of midline. The fundus should be at the midline immediately after birth.
B. The urinary bladder is distended. A full bladder can displace the uterus and cause it to be off- center.
C. The uterus being filled with blood is not the primary reason for the displacement described.
It's more likely due to a distended bladder.
D. Infection inside the uterus is not the primary reason for the displacement described. A distended bladder is a more common cause.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Artificial rupture of membranes involves breaking the amniotic sac to induce or augment labor but is not a method for cervical ripening.
B. Laminaria is a common mechanical method used to ripen the cervix before labor induction.
Laminaria tents are placed in the cervix to gradually dilate and soften it.
C. A catheter filled with sterile saline may be used for cervical ripening, but it is not the most common mechanical method.
D. Membrane stripping involves separating the amniotic membrane from the cervix, not a mechanical method for cervical ripening.
Correct Answer is C
Explanation
A. Placing fingers across the uterus is not a standard technique for assessing the uterine fundus postpartum. Palpation is typically performed on the abdomen.
B. Placing a gloved hand just above the symphysis pubis is more related to assessing descent and engagement of the fetal head during labor, not uterine fundal height.
C. Palpating the abdomen while feeling the uterine fundus allows the nurse to assess the fundal height, tone, and position.
D. Massaging the fundus vigorously to expel blood clots is not a recommended practice; gentle massage is performed to assess tone and firmness.
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