A patient delivered her fourth child after protracted and difficult labor during which oxytocin was used to augment contractions.
The next day, her vaginal bleeding continues to be moderately heavy with numerous large clots. Palpating the fundus, the nurse find that it is in the midline but boggy and above the level of the umbilicus. Fundal massage is indicated. What should the nurse do first?
A) Ensure that her bladder is empty
B) Place one hand over the symphysis pubis
C) Seek an order to obtain and administer an oxytocic
D) Insert uterine packing to control the hemorrhage
Question 2
Within 24 hours of delivery, the postpartum patient complains of pain in the pelvic region.
Comfort measures and medication fail to eliminate the pain. Her pulse is rapid, and blood pressure, hematocrit, and hemoglobin are low. The fundus is firm and lochia is dark red and flowing in only moderate amounts without pooling. What should the nurse suspect is occurring with the patient?
A) Retained placental fragments
B) Deep vein thrombosis (DVT)
C) Lacerations in the uterus
D) Deep pelvic hematoma
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