A nurse is caring for a client who is postpartum and has a prescription for Rho (D) Immunoglobulin. The nurse should verify which of the following prior to administration?

C) Massage the client's fundus to promote contractions:

Given the client's symptoms of excessive bleeding (soaked perineal pad in 10 minutes) and signs of hypovolemia (pale skin color, feeling weak, and light-headedness), massaging the client's fundus to promote contractions is the priority action. This intervention helps stimulate uterine contractions, which can aid in controlling postpartum hemorrhage by reducing uterine atony, a common cause of excessive bleeding after childbirth.

A) Administer oxytocin by continuous IV infusion:

While administering oxytocin by continuous IV infusion is a crucial intervention to promote uterine contractions and control bleeding in postpartum hemorrhage, massaging the fundus is the initial action to stimulate contractions directly. Oxytocin administration can follow fundal massage if the bleeding persists or worsens.

B) Tilt the client onto her right side with her legs elevated to at least 30°:

Positioning the client on her right side with legs elevated can improve venous return and cardiac output, but it is not the priority action in this scenario. Immediate treatment to address the potential cause of postpartum hemorrhage takes precedence over positioning adjustments.

D) Insert an indwelling urinary catheter:

Inserting a urinary catheter may be necessary to monitor urinary output and assess for bladder distention, especially if the client's fluid status needs close monitoring. However, it is not the priority action in this scenario, where addressing postpartum hemorrhage is the immediate concern

A) Stop breastfeeding:

Stopping breastfeeding is not recommended as it can lead to engorgement, mastitis, and a decrease in milk supply. Instead, the nurse should encourage the client to continue breastfeeding and offer strategies to reduce nipple soreness.

B) Start breastfeeding with the nipple that is less sore:

Starting breastfeeding with the nipple that is less sore can help reduce discomfort during feeding. This allows the baby to feed more gently on the sore nipple after satisfying initial hunger on the less sore side.

C) Massage the breasts and nipples prior to feeding:

Massaging the breasts and nipples prior to feeding can help stimulate milk flow, soften the breasts, and reduce nipple soreness. It also helps the baby latch on more effectively, reducing discomfort for both the mother and the baby.

D) Apply breast milk to the nipples:

Applying breast milk to the nipples after feeding can help soothe and heal sore nipples. Breast milk has antibacterial properties and can promote healing, making it a natural and safe remedy for nipple soreness.

E) Change the infant's position on the nipples:

Changing the infant's position on the nipples can help prevent further irritation and soreness. Experimenting with different breastfeeding positions, such as the football hold or side-lying position, can distribute pressure more evenly on the nipples and promote better latch and feeding efficiency.