NR 327 Maternal Newborn Exam with Questions and Verified Answers

NR 327 Maternal Newborn Exam with Questions and Verified Answers A nurse is caring for a client who is 2 hours postpartum. The nurse notes the client's perineal pad has a large amount of lochia rubra with several clots. Which of the following actions should the nurse take first? Check for a full bladder. Massage the fundus. Measure vital signs. Administer carboprost IM. ANSWER Massage the fundus The primary cause of early postpartum bleeding is uterine atony manifested by a relaxed, boggy uterus. Thus, the greatest risk for the client is hemorrhage. The nurse should massage the client's fundus first. A nurse is caring for a client whose membranes have ruptured and is in active labor. The fetal monitor tracing reveals late decelerations. Which of the following actions should the nurse take first? Turn the client onto her left side. Palpate the client's uterus. Administer oxygen to the client. Increase the client's IV fluids. ANSWER Turn the client onto her left side Late decelerations indicate that the client is experiencing uteroplacental insufficiency. The client might be experiencing pressure on the inferior vena cava, which decreases the oxygen to the placenta and thus to the fetus. Turning the client onto her left side will relieve the pressure and facilitate better blood flow to the placenta, thereby increasing the fetal oxygen supply.