A nurse is caring for a client who experienced a vaginal delivery 12 hours ago. When palpating the client's abdomen, at which of the following positions should the nurse expect to find the uterine fundus?

2 cm above the umbilicus

At the level of the umbilicus

One fingerbreadth above the symphysis pubis

To the right of the umbilicus

Answer and Explanation

The Correct Answer is B

The correct answer is choice B. At the level of the umbilicus.

Choice A rationale:

The fundus is typically not found 2 cm above the umbilicus 12 hours postpartum. This position is more common immediately after delivery or in cases of uterine atony or retained placental fragments.

Choice B rationale:

At 12 hours postpartum, the uterine fundus is expected to be at the level of the umbilicus. This indicates normal involution of the uterus, where it contracts and shrinks back to its pre-pregnancy size.

Choice C rationale:

One fingerbreadth above the symphysis pubis is not a typical position for the fundus 12 hours after delivery. This position is more likely several days postpartum as the uterus continues to involute.

Choice D rationale:

The fundus being to the right of the umbilicus may indicate a full bladder, which can push the uterus to one side. This is not a normal finding 12 hours postpartum and would require intervention to empty the bladder.

: https://bchsfoutreach.ucsf.edu/sites/bchsfoutreach.ucsf.edu/files/handouts/Washington%20Hospital%20Postpartum%204-2018.pdf : https://nursekey.com/fundal-palpation-postpartum/

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Correct Answer is D

Explanation

Choice a reason:
An irregular fetal heart rate is not typically associated with a hydatidiform mole because, in many cases of complete molar pregnancy, there is no fetus, and thus no fetal heart rate to assess. In partial molar pregnancies, there may be a fetus with an irregular heart rate, but this is not a definitive sign of a hydatidiform mole.

Choice b reason:
Profuse, clear vaginal discharge is not a common finding in hydatidiform mole. The typical vaginal discharge associated with a molar pregnancy is often described as "grape-like" or "prune juice-like" due to the presence of molar tissue being passed.

Choice c reason:
A rapid decline in hCG levels is not expected in hydatidiform mole; in fact, unusually high levels of hCG are more characteristic of this condition. The abnormal placental tissue in a molar pregnancy tends to produce higher than normal amounts of hCG.

Choice d reason:
Excessive uterine enlargement is a key finding in hydatidiform mole. The uterus often becomes larger than expected for the gestational age because the abnormal placental tissue grows rapidly and takes up more space within the uterus. This can happen within 10 to 16 weeks of gestation and is one of the primary clinical signs that lead to the suspicion of a molar pregnancy.

A. Pelvic pain B. Hematuria C. A localized area of breast tenderness D. A moderate amount of dark red lochia with a foul odor

Correct Answer is A

Explanation

Choice a) reason: Pelvic pain is a common symptom of endometritis. The pain is typically located in the lower abdomen and may be associated with uterine tenderness upon physical examination. This symptom, especially when combined with other signs such as fever and foul-smelling lochia, strongly suggests the need for further evaluation for endometritis.

Choice b) reason: Hematuria, or blood in the urine, is not a typical symptom of endometritis. While it could be a sign of other postpartum complications, such as urinary tract infections or bladder injury during childbirth, it does not directly indicate endometritis.

Choice c) reason: A localized area of breast tenderness is more indicative of a breast infection, such as mastitis, especially if associated with breastfeeding. It is not a symptom of endometritis, which affects the uterus and not the breasts.

Choice d) reason: While foul-smelling lochia can be a sign of endometritis, the key is the presence of a foul odor. A moderate amount of dark red lochia alone, without a foul odor, is a normal finding in the immediate postpartum period. It's the transition from rubra (red) to serosa (pink/brown) to alba (yellow/white) that is expected as the uterus heals.

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A nurse is caring for a client who experienced a vaginal delivery 12 hours ago. When palpating the client's abdomen, at which of the following positions should the nurse expect to find the uterine fundus?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse in a prenatal clinic is caring for a client who is suspected of having a hydatidiform mole. Which of the following findings should the nurse expect to observe in this client?

Correct Answer is D

Explanation

A nurse is assessing a client for postpartum infection. Which of the following findings should indicate to the nurse that the client requires further evaluation for endometritis?

Correct Answer is A

Explanation

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