The practical nurse (PN) is caring for a postpartum client who delivered 5 hours ago and has saturated a perineal pad with a few clots within 15 minutes.
Which action is most important for the PN to implement?
Increase the intravenous infusion rate.
Massage the fundus.
Notify the healthcare provider.
Assess the vital signs.
The Correct Answer is D
The most important action for the PN to implement is to **assess the vital signs**. Saturation of a peripad within 15 minutes to 1 hour after delivery must be promptly reported. Data such as the amount of bleeding, the condition of the uterus, checking the maternal vital signs, and observing for signs of shock would play a vital role in the care of the patient with hemorrhage¹. Early recognition and treatment of PPH are critical to care management.
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Related Questions
Correct Answer is A
Explanation
This can offer a safe place for her and her unborn child. The shelter can also provide resources for counseling and legal assistance if needed.
The safety plan and restraining order are important measures, but the priority should be to ensure the client's immediate safety.
The visit summary documenting the report of abuse is also important, but it should not be the only information provided to the client.
Correct Answer is C
Explanation
Passage of meconium stool is a normal and expected event in the first 24-48 hours of life. The absence of meconium stool can be indicative of bowel obstruction or other underlying medical conditions, and requires further investigation and evaluation by the healthcare team. The other options are important pieces of information, but they do not carry the same level of urgency as the absence of meconium stool.
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