A nurse is working in a shelter following a disaster. Which of the following is the priority action for the nurse to take?

Choice A reason: Assessing the bladder for distention is an important action, but not the first one. The nurse should first check the uterine tone and position, as a boggy or displaced uterus can indicate uterine atony, the most common cause of postpartum hemorrhage.

Choice B reason: Massaging the client's fundus is the first action to take. The nurse should apply firm, circular pressure to the fundus to stimulate uterine contractions and reduce bleeding. The nurse should also monitor the amount and character of lochia.

Choice C reason: Preparing to administer a prescribed oxytocic preparation is a necessary action, but not the first one. The nurse should first attempt to control the bleeding by massaging the fundus and assessing the bladder. If the bleeding persists, the nurse should administer medications such as oxytocin, methylergonovine, or carboprost to enhance uterine contractions.

Choice D reason: Assessing the client's blood pressure is an important action, but not the first one. The nurse should first manage the bleeding by massaging the fundus and preparing to administer medications. The nurse should also monitor the client's vital signs, including blood pressure, pulse, and temperature, for signs of shock or infection

Choice A reason: Wearing gloves when discarding the syringes is not necessary, as long as the syringes are placed in a sharps disposal container immediately after use. Gloves do not prevent needle-stick injuries or infections¹.

Choice B reason: Storing used syringes in a biohazard bag before discarding is not recommended, as biohazard bags are not puncture-resistant and may leak or spill. Biohazard bags are also not accepted by most disposal programs².

Choice C reason: Taking containers of used syringes to the local recycling center is not appropriate, as recycling centers do not accept medical waste. Recycling centers may also expose workers and the environment to potential hazards from the syringes³.

Choice D reason: Discarding the syringes in a metal container is a correct way to dispose of insulin needles, as long as the container is labeled as "Sharps" and has a tight-fitting lid. Metal containers, such as coffee cans or detergent bottles, are strong and durable and can prevent needle-stick injuries. Metal containers can be dropped off at designated collection sites or mailed back to disposal programs.