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HESI RN EXIT CASE STUDY - POSTPARTUM 1. 1. Prior to discontinuing the IV oxytocin, which assessment is most impor- tant for the nurse to obtain ANS: Uterine firmness. 2. 2. The postpartum client has minimal sensation in her lower extremities, due to the effects of the epidural anesthesia. What is the priority nursing concern for this client ANS: Fall risk. 3. 3. What is the priority nursing action to address the client's needs related to her repaired 4th degree perineal laceration ANS: Apply perineal ice packs consis- tently for the first 24 hours. 4. 4. The nurse performs the first assessment upon the client's arrival to the postpartum unit. Where would the nurse expect to palpate the fundus ANS: 1 cm above the umbilicus. 5. Fifteen minutes after the initial assessment, the nurse finds the client disori- ented and lying on her back in a pool of vaginal blood, with the sheets beneath her saturated with blood. 5. Which action is most important for the nurse to implement immediately ANS: - Massage the fundus. 6. 6. What is the best method for the nurse to use to obtain immediate assis - tance ANS: Activate the priority call light from the bedside. 7. 7. The nurse has requested assistance and personnel are on their way. While waiting for help to arrive, what is the next priority action ANS: Assess for bladder distention. 8. 8. The charge nurse, two staff nurses, and an unlicensed assistive personnel (UAP) rush in to assist the nurse with the client. Which task is best delegated to the UAP during this crisis ANS: Obtain the vital signs and O2 saturation. 9. 9. The HCP is notified that the client is hemorrhaging and has an estimated blood loss of 1,200 mL since delivery. Her blood pressure is 70/40 mmHg, pulse 120 beats/min, respirations 28 breaths/min, and O2 saturation 73%. The HCP's prescription includes stat oxytocin 10 units in each liter of normal saline to infuse at 40 milliunits (mU)/minute. How many mL of oxytocin should the
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