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A nurse is caring for a client who had a vaginal delivery 1 day ago. The nurse determines that the client's fundus is firm, located 2 fingerbreadths above the umbilicus, and deviated to the left. Which of the following actions should the nurse take first?

A.

Monitor perineal pads for clots.

B.

Assist the client to empty her bladder.

C.

Notify the provider.

D.

Administer a prescribed analgesic.

Answer and Explanation

The Correct Answer is B

Choice A rationale

 

"Monitor perineal pads for clots.”. This is incorrect because while monitoring for clots is important, it does not address the underlying issue causing the fundal deviation.

 

Choice B rationale

 

"Assist the client to empty her bladder.”. This is correct because a full bladder can cause the uterus to deviate and impede uterine involution. Emptying the bladder helps the uterus to contract properly and return to its normal position.

 

Choice C rationale

 

"Notify the provider.”. This is incorrect because the immediate action should be to address the potential cause of the deviation (a full bladder), which can be managed by the nurse.

 

Choice D rationale

 

"Administer a prescribed analgesic.”. This is incorrect because administering pain relief does not address the cause of the fundal deviation and does not alleviate the potential issue.

 


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Correct Answer is B

Explanation

Choice A rationale

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Choice B rationale

Moving the seat as far away as possible from the steering wheel reduces the risk of injury from airbag deployment and allows ample space for the growing abdomen, providing better safety for both mother and baby.

Choice C rationale

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Choice D rationale

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Correct Answer is A

Explanation

Choice A rationale

Deep-vein thrombosis (DVT) is a contraindication for diaphragm use due to the increased risk of thromboembolic events with estrogen-based contraceptives.

Choice B rationale

Tobacco use, although a risk factor for cardiovascular disease, is not a direct contraindication for diaphragm use, which is a non-hormonal contraceptive method.

Choice C rationale

Recurrent urinary tract infections are a contraindication for diaphragm use due to the risk of infection exacerbation from device insertion.

Choice D rationale

History of positive group B streptococcus B-hemolytic is not a contraindication for diaphragm use; it typically relates to pregnancy and neonatal infection risk.

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