A nurse on a postpartum unit is caring for a client who is experiencing hypovolemic shock. After notifying the provider, which of the following actions should the nurse take next?

Massage the client's fundus.

Insert an indwelling urinary catheter.

Administer oxygen at 10 L/min

Elevate the client's right hip

Answer and Explanation

The Correct Answer is A

A. After notifying the provider, the nurse should massage the client’s fundus. This action helps to contract the uterus and reduce bleeding, which is crucial in managing hypovolemic shock due to postpartum hemorrhage.

B. Insert an indwelling urinary catheter: This action is important for monitoring urine output, which is a key indicator of renal perfusion and overall fluid status. However, it is not the immediate priority when managing hypovolemic shock due to postpartum hemorrhage.

C. Administer oxygen at 10 L/min: Providing oxygen is crucial to ensure adequate tissue oxygenation, especially in a shock state. While important, it comes after addressing the source of bleeding, which is the primary cause of the hypovolemic shock.

D. Elevate the client’s right hip: This action helps to prevent uterine displacement and improve venous return, which can be beneficial. However, it is not the first step in managing hypovolemic shock due to postpartum hemorrhage.

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Correct Answer is B

Explanation

The correct answer is B. A distended bladder reduces pelvic space needed for birth.

A. A distended bladder itself is not typically traumatized by pelvic exams. However, a full bladder can impede the progress of labor and may affect the accuracy of pelvic exams.

B. This statement is accurate. A distended bladder can reduce the available pelvic space needed for the descent of the baby during labor. An empty bladder allows the fetal head to engage more easily in the pelvis.

C. A full bladder is not directly associated with an increased risk for fetal trauma. The primary concern is the impact on pelvic space and the progress of labor.

D. While a full bladder can contribute to urinary tract infections, it is not the primary reason for encouraging the client to avoid a distended bladder during labor.

A. "It's too soon for you to be worrying about this now." B. "A repeat cesarean birth is safer for both you and your baby." C. The primary consideration is what type of incision was performed this time D. There are so many variables that you'll have to ask your obstetrician

Correct Answer is D

Explanation

The correct answer is D. "There are so many variables that you'll have to ask your obstetrician."

A. "It's too soon for you to be worrying about this now" dismisses the client's concerns and does not provide useful information. It's important to address the client's question and offer guidance.

B. "A repeat cesarean birth is safer for both you and your baby" may not be accurate for all situations. The decision on the mode of delivery (vaginal birth after cesarean - VBAC or repeat cesarean) depends on various factors, and a blanket statement may not apply.

C. "The primary consideration is what type of incision was performed this time" is partially correct.

The type of uterine incision in the current cesarean birth is one factor to consider, but it is not the only consideration. Other factors, such as the reason for the previous cesarean, maternal health, and the obstetrician's assessment, also play a role.

D. "There are so many variables that you'll have to ask your obstetrician" is the most appropriate response.

The decision regarding the mode of delivery in subsequent pregnancies after a cesarean is individualized and depends on various factors. The obstetrician will consider the woman's health, the reason for the previous cesarean, the type of uterine incision, and other relevant factors to provide personalized guidance.

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A nurse on a postpartum unit is caring for a client who is experiencing hypovolemic shock. After notifying the provider, which of the following actions should the nurse take next?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who was in the first stage of labor and is encouraging the client to void every two hours. Which of the following statements should the nurse make?

Correct Answer is B

Explanation

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Correct Answer is D

Explanation

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