Two hours after delivery, a patient's fundus is boggy and has ...

[storky111]

Two hours after delivery, a patient's fundus is boggy and has risen to above the umbilicus. The first action the nurse would take is to:
 
  1. Massage the fundus until firm.
  2. Express retained clots.
  3. Increase the intravenous solution.
  4. Call the physician.

Question 2

The nurse is interviewing an adolescent client. The client reports a weight loss of 50 pounds over the last 4 months, and reports running at least 5 miles per day. The client asserts that her menarche was 5 years ago.
 
  Her menses are usually every 28 days, but her last menstrual period was 4 months ago. The client denies any sexual activity. Which is the best statement for the nurse to make? 1. Your lack of menses might be related to your rapid weight loss.
  2. It is common and normal for runners to stop having any menses.
  3. Increase your intake of iron-rich foods to reestablish menses.
  4. Adolescents rarely have regular menses, even if they used to be regular.

[paavo]

Answer to Question 1

1
Rationale 1: Massage of the uterus has to occur before the expression of retained clots.
Rationale 2: Expressing retained clots is not the nurse's first action.
Rationale 3: Increasing the intravenous solution is not a priority in this case.
Rationale 4: The physician does not need to be notified unless either the uterus does not respond to massage or the bleeding does not decrease.

Answer to Question 2

1
Explanation: 1. Secondary amenorrhea can be caused by rapid weight loss, including the development of the eating disorders anorexia and bulimia. Runners with low body fat might have irregular menses, but amenorrhea is not a normal condition.