A nurse is caring for a client who is 4 hr postpartum. The nurse notes four saturated perineal pads in the past hour. Which of the following actions should the nurse take first?

Administer misoprostol.

Increase maintenance IV fluid.

Perform perineal hygiene.

Perform fundal assessment and massage.

Answer and Explanation

The Correct Answer is D

A.   administering misoprostol, may be indicated in postpartum care, but it is not the first priority in this situation. The immediate concern is excessive bleeding, which should be addressed first.
B.   increasing maintenance IV fluid, is not the first action to take. While fluid management is important, it is not the priority when the client is experiencing excessive postpartum bleeding.
C.   performing perineal hygiene, is important for overall hygiene, but it is not the first action to take when the client is experiencing excessive bleeding. Controlling bleeding takes precedence.
D.   performing fundal assessment and massage, is the first priority. This helps assess for uterine atony (failure of the uterus to contract), a common cause of postpartum hemorrhage. Massage can stimulate uterine contractions and help control bleeding.

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Correct Answer is B

Explanation

A. applying petroleum jelly to the suppository, is not necessary and may interfere with the medication's absorption.
B. Inserting the suppository along the posterior vaginal wall as far up as one can go.
C. inserting the suppository 5 cm (2 in), is the incorrect technique for administering a vaginal suppository. It should be administered as high up as one comfortably can
D. assisting the client into a prone position, is unnecessary and not related to the administration of the suppository.

A. “This infection can cause your baby to experience hearing loss at birth." B. “If you test positive for GBS, the provider will need to perform a cesarean birth." C. "You will be tested again for GBS at about 36 weeks of gestation." D. "You will take an antibiotic during the last 2 weeks of pregnancy to avoid transferring GBS to your baby."

Correct Answer is C

Explanation

A: This infection does not directly cause hearing loss at birth. Hearing loss in newborns can be associated with genetic factors, birth complications, and certain infections, but GBS is not known to be a direct cause of hearing impairment.

B: A positive GBS test result does not necessitate a cesarean birth. The standard management for GBS-positive mothers is the administration of intrapartum antibiotic prophylaxis, not cesarean delivery, unless there are other obstetric indications.

C: Testing for GBS is typically done between 36 and 37 weeks of gestation because this timing is close to delivery, when the test results are most predictive of the baby's risk of exposure during birth.

D: Antibiotics are not given during the last 2 weeks of pregnancy to prevent GBS transmission. Instead, they are administered during labor to ensure effective levels of the drug during delivery, which is the critical period for preventing transmission to the baby.

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A nurse is caring for a client who is 4 hr postpartum. The nurse notes four saturated perineal pads in the past hour. Which of the following actions should the nurse take first?

Nursing Test Bank

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