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A nurse is collecting data from a postpartum client and finds a large amount of lochia rubra with several clots on the client’s perineal pad.Which of the following actions should the nurse take first?

A.

Measure the client’s vital signs.

B.

Request the provider perform a vaginal examination.

C.

Check the client’s fundus.

D.

Feel for a full bladder.

Answer and Explanation

The Correct Answer is C

Choice C rationale

 

Checking the fundus helps determine if the uterus is contracting properly, which is essential in managing postpartum bleeding.

 

Choice A rationale

 

Measuring vital signs is important but not the first action to control bleeding.

 

Choice B rationale

 

Requesting a vaginal examination is necessary but not the immediate action to control bleeding.

 

Choice D rationale

 

Feeling for a full bladder is important but not the first action to control bleeding.


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Correct Answer is A

Explanation

Choice A rationale

At 1 cm above the umbilicus is the expected position of the uterine fundus 12 hours postpartum. After delivery, the fundus is typically at the level of the umbilicus and then descends approximately 1 cm per day. At 12 hours postpartum, it is normal for the fundus to be slightly above the umbilicus.

Choice B rationale

One fingerbreadth above the symphysis pubis is not the expected position of the fundus 12 hours postpartum. This position is more typical several days postpartum as the uterus continues to involute and return to its pre-pregnancy size.

Choice C rationale

To the right of the umbilicus is not a normal finding and may indicate a full bladder, which can displace the uterus. The nurse should assist the client to void and then reassess the fundal position.

Choice D rationale

Three fingerbreadths above the umbilicus is not expected 12 hours postpartum. This position may indicate uterine atony or subinvolution, which requires further assessment and intervention.

Correct Answer is C

Explanation

Choice C rationale

Postpartum blues are characterized by tearfulness, insomnia, lack of appetite, and a feeling of letdown. These symptoms are common and usually resolve within a few weeks without medical intervention.

Choice A rationale

The letting-go phase occurs when the woman has assumed responsibility for caring for herself and her infant. It is not associated with the symptoms described.

Choice B rationale

Postpartum fatigue can cause tiredness and lack of energy but does not typically include tearfulness and a feeling of letdown.

Choice D rationale

Postpartum psychosis is a severe mental health condition that includes symptoms such as hallucinations, delusions, and severe mood swings. It is not characterized by the milder symptoms described. .

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