The practical nurse (PN) determines that a client who is one day postpartum has a moderate amount of lochia rubra and the uterus is firm, dextroverted, and three fingerbreadths above the umbilicus. Which should be the PN's initial action?
Provide a stool softener for constipation.
Assess the bladder for distension.
Check the hemoglobin to determine uterine hemorrhage.
Massage the uterus to decrease atony.
The Correct Answer is B
Correct Answer: B.
A. Providing a stool softener for constipation might be necessary postpartum but isn't the initial action indicated by the client's current status.
B. Assessing the bladder for distension is crucial because a distended bladder can displace the uterus and impede its ability to contract properly, leading to uterine atony and increased bleeding.
C. Checking the hemoglobin to determine uterine hemorrhage is important but might not be the initial step needed based on the client's condition.
D. Massaging the uterus to decrease atony is a potential intervention, but assessing for bladder distension takes priority in this scenario to prevent uterine displacement.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Oriented x 3. - The client must recall the time, day, date, location, and reason for being there to be considered oriented x 3. As the client can only remember his name and location, it does not fulfill the criteria for oriented x 3.
B. Oriented x 1. - This is inaccurate as the patient is oriented in two aspects: person and place.
C. Oriented x 2. - The client recalls their name and place, hence is oriented in two aspects. This is therefore accurate.
D. Oriented x 4. - This would require the client to recall all four aspects of orientation (time, day, date, location, and reason for being there), which the client did not demonstrate in this scenario.
Correct Answer is ["A","B","C","D"]
Explanation
Taking prophylactic prescriptions for diarrhea can prevent or minimize gastrointestinal issues post-disaster.
Drinking boiled water or bottled oral rehydration solutions reduces the risk of waterborne diseases.
Washing fruits and vegetables in running tap water removes contaminants.
Cleaning hands with soap, clean water, or antibacterial solutions prevents the spread of infections.
Identifying sexual contacts isn't directly related to immediate post-disaster health concerns.
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