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A nurse is caring for a client who had a vaginal delivery 2 hours ago. Which of the following actions should the nurse anticipate in the care of this client? (Select all that apply.)

A.

Administer methylergonovine maleate if the uterus is boggy

B.

Massage a firm fundus.

C.

Document fundal height.

D.

Observe the lochia during palpation of the fundus

E.

Determine whether the fundus is midline.

Question Solution

Correct Answer : A,C,D,E

Rationale: 

 

A. Administering methylergonovine maleate is indicated if the uterus is boggy (atonic), as it helps to contract the uterus and reduce the risk of postpartum hemorrhage. 

 

B. Massaging a firm fundus is not appropriate; instead, the nurse should massage a boggy (soft) fundus to promote uterine contraction. 

 

C. Documenting fundal height is a necessary action to assess uterine involution and ensure it is progressing as expected after delivery. 

 

D. Observing the lochia during palpation of the fundus is important to assess for any abnormal findings, such as heavy bleeding, which could indicate complications. 

E. Determining whether the fundus is midline is crucial; a displaced fundus may indicate bladder distention, which can affect uterine contraction.


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Correct Answer is B

Explanation

Rationale:

A. Cytomegalovirus (CMV) is not nationally notifiable, though it can have significant effects, especially in pregnant women.

B. Foodborne botulism is a nationally notifiable condition due to its potential for widespread outbreaks and severe health consequences.

C. Erythema infectiosum, or fifth disease, is not a nationally notifiable disease, although it is recognized in clinical settings.

D. Herpes simplex virus type 1 (HSV-1) is common and not considered a nationally notifiable infectious disease.

Correct Answer is C

Explanation

Rationale:

A. Concerns about participation in team sports are important, but they do not directly warrant a request for a high-frequency chest compression vest.

B. Discomfort with nebulizer treatments suggests the need for alternate therapies but does not specifically indicate a need for the vest.

C. A statement regarding a small amount of mucus after percussion therapy suggests that traditional methods of airway clearance may not be effective enough, indicating a need for a high-frequency chest compression vest to help mobilize mucus.

D. A fever may indicate an infection or exacerbation but does not directly relate to the need for a high-frequency chest compression vest.

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