A nurse is assessing a client who is 8 hour postpartum. Where should the nurse expect to find the fundus?

at the umbilicus

At a non-palpable depth

just above the symphysis pubis

just below the umbilicus

Answer and Explanation

The Correct Answer is D

A) At the umbilicus:
After delivery, the fundus is typically located at or just below the umbilicus in the immediate postpartum period, but it will gradually descend over the next few days. By 8 hours postpartum, the fundus is often slightly below the umbilicus, not directly at the umbilicus. The fundus will continue to shrink in size and move downward toward the pelvic region as the uterus contracts and involutes.

B) At a non-palpable depth:
A fundus that is non-palpable is generally expected later in the postpartum period, typically by 10-14 days after delivery, as the uterus contracts and returns to its pre-pregnancy size. At 8 hours postpartum, the fundus is still palpable, generally just below the umbilicus, and should be evaluated for firmness and position.

C) Just above the symphysis pubis:
The fundus is usually higher than the symphysis pubis at 8 hours postpartum, as it is still in the process of descending from the higher position it occupied during pregnancy. It would be expected to be just below the umbilicus or about 1 to 2 finger widths below it. By the second or third day postpartum, the fundus begins to move lower toward the symphysis pubis as it continues to involute.

D) Just below the umbilicus:
Eight hours after delivery, the nurse should expect to palpate the fundus just below the umbilicus. This is a typical finding as the uterus begins to contract and shrink after the delivery of the placenta. The fundus will descend about 1-2 cm per day postpartum, so by 8 hours, it is usually just slightly below the level of the umbilicus.

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Correct Answer is ["108"]

Explanation

Given:

Total volume to infuse: 325 mL

Infusion time: 3 hours

To find:

Infusion rate (mL/hr)

Step 1: Calculate the infusion rate

Infusion rate (mL/hr) = Total volume / Infusion time

Infusion rate (mL/hr) = 325 mL / 3 hours ≈ 108.33 mL/hr

Step 2: Round to a whole number

108 mL/hr

A. Uterus firm and midline B. Moderate amount of lochia rubra C. Uterus boggy and midline D. Moderate amount of lochia rubra E. foul odor present F. Temperature 37.5° C (99.5° F) G. Heart rate 88/min H. Temperature 38.3° C (100.9° F) I. Heart rate 105/min

Correct Answer is ["C","E","H","I"]

Explanation

Findings that require follow-up:

Uterus boggy at 24 hr postpartum:

A boggy uterus indicates poor uterine contraction, which can lead to postpartum hemorrhage. Effective uterine contraction is crucial to prevent excessive bleeding after delivery, and this finding warrants immediate intervention, such as fundal massage or administering uterotonic medications.

Lochia rubra with foul odor:

Foul-smelling lochia is a sign of potential infection, often indicative of endometritis, which is an infection of the uterine lining. The presence of this odor requires prompt follow-up and possibly antibiotic treatment to prevent further complications.

Elevated temperature (38.3°C/100.9°F) at 24 hr postpartum:

A postpartum fever may indicate infection, such as endometritis or a urinary tract infection (UTI). This fever should be investigated further to determine the cause and appropriate treatment, as untreated infections can lead to serious complications.

Increased heart rate (105/min) at 24 hr postpartum:

Tachycardia in the postpartum period can be a sign of infection or early signs of hemodynamic instability, possibly due to blood loss or infection. Close monitoring is necessary, and the healthcare provider should be notified to evaluate the cause and initiate treatment if necessary.

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A nurse is assessing a client who is 8 hour postpartum. Where should the nurse expect to find the fundus?

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Naxlex Comprehensive Predictor Exams

A client is ordered 325mL of packed red blood cells over 3 hours. What is the rate to be set on the infusion pump? Round to a whole number

Correct Answer is ["108"]

Explanation

Correct Answer is ["C","E","H","I"]

Explanation

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