During a significant postpartum hemorrhage, the physician orders the nurse to administer 1000 mcg Misoprostol per rectum STAT. The nurse has on hand Misoprostol 200 mcg tablets. How many tablets should the nurse administer?

Choice A rationale

A soft fundus indicates uterine atony, an abnormal finding requiring immediate intervention. This teaching would lead to improper patient monitoring of complications such as hemorrhage.

Choice B rationale

Clots as large as a golf ball are not considered normal and may signal uterine atony or retained placental fragments, which necessitate medical intervention for hemorrhage risk.

Choice C rationale

Decreased brownish-red lochia may reflect normal postpartum changes as it progresses to serosa and alba but is not typically an indicator of complications.

Choice D rationale

Increased lochia or a return to bright red bleeding signals potential complications like subinvolution or late postpartum hemorrhage, which demand prompt medical attention.

Choice A rationale

Surgical intervention is a secondary measure for obstetric hemorrhage and is considered only after initial non-invasive interventions fail to control bleeding, such as fundal massage and uterotonic medications.

Choice B rationale

Fundal massage is the first-line intervention for uterine atony as it stimulates uterine contractions, reducing blood loss by compressing blood vessels at the placental site and promoting hemostasis.

Choice C rationale

Establishing venous access is essential for fluid resuscitation and medication administration but is not the immediate priority compared to fundal massage for controlling active bleeding.

Choice D rationale

Catheterizing the bladder may help assess urinary output and prevent bladder distension, which can impede uterine contraction, but it is not the initial intervention for hemorrhage.