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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

The client needs a second varicella vaccination at her postpartum visit to ensure full immunity. The initial dose provides partial immunity, and the second dose completes the vaccination series.

Choice B rationale

The client needs to use contraception for 1 month, not 3 months, before considering pregnancy after receiving the varicella vaccine. This is to prevent potential harm to a developing fetus.

Choice C rationale

The varicella vaccine is not given based on the baby’s blood type. It is administered to protect the client from varicella infection.

Choice D rationale

There is no need for testing to see if the client has developed immunity after receiving the varicella vaccine. The second dose is given to ensure full immunity.

Correct Answer is B

Explanation

Choice A rationale

Hemorrhage is not prevented by walking. Hemorrhage management involves monitoring and medical interventions, not ambulation.

Choice B rationale

Walking helps prevent blood clots by promoting circulation. Postoperative patients are encouraged to ambulate early to reduce the risk of deep vein thrombosis (DVT) and pulmonary embolism.

Choice C rationale

Breast engorgement is managed through breastfeeding or pumping, not walking. Ambulation does not directly affect breast engorgement.

Choice D rationale

Rupture of amniotic membranes is not relevant postpartum. This condition is related to labor and delivery, not postoperative care.

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