Author Question: A multiparous client is admitted to the postpartum unit after a rapid labor and birth of a 4000-g ... (Read 28 times)

jenna1 · **on:** Jun 28, 2018

A multiparous client is admitted to the postpartum unit after a rapid labor and birth of a 4000-g infant. Her fundus is boggy, lochia is heavy, and vital signs are unchanged.

The nurse has the client void and massages her fundus, but the fundus remains difficult to find and the rubra lochia remains heavy. Which action should the nurse take next?

a. Recheck vital signs.
b. Insert a Foley catheter.
c. Notify the health care provider.
d. Continue to massage the fundus.

Question 2

Early postpartum hemorrhage is defined as a blood loss greater than:

a. 500 mL within 24 hours after a vaginal birth.
b. 750 mL within 24 hours after a vaginal birth.
c. 1000 mL within 48 hours after a cesarean birth.
d. 1500 mL within 48 hours after a cesarean birth.

nicoleclaire22 · **Reply #1 on:** Jun 28, 2018

Answer to Question 1

ANS: C
Treatment of excessive bleeding requires the collaboration of the health care provider and the nurses. Do not leave the client alone. The nurse should call the clinician while a second nurse rechecks the vital signs. The client has voided successfully, so a Foley catheter is not needed at this time. The uterine muscle can be overstimulated by massage, leading to uterine atony and rebound hemorrhage.

Answer to Question 2

ANS: B
The average amount of bleeding after a vaginal birth is 500 mL. Early postpartum hemorrhage occurs in the first 24 hours, not 48 hours. Blood loss after a cesarean averages 1000 mL. Late postpartum hemorrhage is 48 hours and later.