ATI RN
ATI Pediatrics Final Exam Questions
Extract:
A client who is 2 hr postpartum. The nurse notes that the client soaked a perineal pad in 10 min, the client's skin color is ashen, and she states she feels weak and light headed
Question 1 of 5
A nurse is caring for a client who is 2 hr postpartum. The nurse notes that the client soaked a perineal pad in 10 min, the client's skin color is ashen, and she states she feels weak and light headed. After applying oxygen via nonrebreather face mask at 10 L/min which of the following actions should the nurse take next?
Correct Answer: D
Rationale: The correct answer is D: Massage the client's fundus to promote contractions. This action helps prevent postpartum hemorrhage by ensuring the uterus contracts effectively. The signs of excessive bleeding, such as soaking a perineal pad in 10 minutes, ashen skin color, weakness, and lightheadedness, indicate potential hemorrhage. Massaging the fundus stimulates uterine contractions, which helps control bleeding. Positioning the client on her right side with legs elevated (choice
A) is incorrect because it does not directly address the underlying issue of uterine atony leading to hemorrhage. Administering oxytocin (choice
B) is important but not the immediate next step, as massage is a more direct intervention. Inserting a urinary catheter (choice
C) is not necessary in this urgent situation.
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