NCLEX - Postpartum Care Q&As A+ graded.

A 25 year-old woman gave birth to her second child 6 hours ago. She informs the nurse that she is bleeding more than with her previous birth experience. The initial nursing action is to: a. Explain that this is normal for second-time moms. b. Assess the location and firmness of the fundus. c. Change her pad and return in 1 hour and reassess. d. Give her 10 units of oxytocin as per standing order. correct answers ANS: b a. The nurse should not inform the patient that this is normal until she has assessed for the degree and potential cause of bleeding. b. It is important to first assess for uterine atony or displaced uterus from full bladder. c. If the uterus is firm and midline, then the nurse should change the pad and return within 30 minutes to assess the amount of lochia. d. The nurse would give oxytocin if the uterus is boggy and does not respond to uterine massage. Which of these medications is commonly used to control postpartum bleeding related to uterine atony? a. Magnesium sulfate b. Phytonadione c. Oxytocin d. Warfarin correct answers ANS: c a. Magnesium sulfate is commonly used for PIH and preterm labor. It is a smooth muscle relaxant and can cause the uterus to relax. b. Phytonadione (vitamin K) is important for clotting but will not cause the uterus to contract. c. Oxytocin is commonly used to control postpartum bleeding related to uterine atony. d. Warfarin is an anticoagulant and will increase the risk of hemorrhage. During a postpartum assessment, the nurse notes that the uterus is midline and boggy. The immediate nursing action is: a. To notify the patients midwife or physician b. Massage the fundus until firm and reevaluate within 30 minutes c. Give Syntocinon as per orders d. Assist the patient to the bathroom and ask her to void correct answers ANS: b a. If the uterus does not respond to massage, then the nurse would give Syntocinon and notify the primary health provider. b. The first nursing action for a boggy uterus is to massage the fundus.