A nurse massages the uterus of a postpartum woman after making a hypothesis of uterine atony.
Which of the following outcomes would indicate that the client's condition had improved?
Decreased pain level.
Stable blood pressure.
Fundus firm at or below the umbilicus.
Reduced lochial flow.
The Correct Answer is C
Choice A rationale
Decreased pain level can be an effect of addressing the cause of pain, but it doesn't indicate improved uterine tone or resolution of atony.
Choice B rationale
Stable blood pressure is important, but it is not the direct outcome of improved uterine tone or the resolution of uterine atony.
Choice C rationale
A firm fundus at or below the umbilicus indicates successful contraction of the uterus, resolving uterine atony and reducing bleeding.
Choice D rationale
Reduced lochial flow can indicate decreased bleeding, but it does not directly indicate improved uterine tone or resolution of uterine atony.
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Correct Answer is B
Explanation
Choice A rationale
Oral rehydration therapy is not used in place of feedings for infants undergoing phototherapy for elevated bilirubin levels. It's crucial to maintain proper nutrition and hydration through regular feedings.
Choice B rationale
Rotating the baby helps ensure even exposure to the bili lights, which aids in breaking down bilirubin effectively across the baby's body.
Choice C rationale
Applying restraints is inappropriate and unnecessary. It could cause distress and is not a standard practice for phototherapy.
Choice D rationale
Administering intravenous fluids is not typically needed unless there's a risk of dehydration or other medical indications as per the doctor's orders.
Correct Answer is B
Explanation
Choice A rationale
Retained tissue can cause postpartum hemorrhage, but with a firm uterus and no other signs of retained placenta, this is less likely the cause here.
Choice B rationale
Trauma is the most likely cause of increased bleeding in this scenario. The prolonged oxytocin induction and macrosomic infant suggest a higher risk of lacerations or uterine atony
despite the firm uterus.
Choice C rationale
Thrombin disorders cause bleeding due to clotting issues. However, this patient shows signs of active bleeding and clotting, making this less likely.
Choice D rationale
Uterine atony, indicated by a soft, boggy uterus, is a common cause of postpartum hemorrhage, but in this case, the uterus is firm, so it's less likely to be the cause.