The patient gave birth to a 7 pound, 14 ounce female 30 minutes ago. The placenta has not yet delivered. Manual removal of the placenta is planned. The nurse should prepare to:
1. Start an IV of lactated Ringer's.
2. Apply anti-embolism stockings.
3. Bottle-feed the infant.
4. Send the placenta to pathology.
Correct Answer: 1
Rationale 1: The patient undergoing manual removal of the placenta will need either IV sedation or general anesthesia. An IV is necessary.
Rationale 2: Anti-embolism stockings are used after major surgery that leads to immobility, thus increasing the risk of embolism. However, anti-embolism stockings are not needed for this patient because manual removal of the placenta is not major surgery and does not lead to post-procedure immobility.
Rationale 3: The patient's partner or family member, or a nursery nurse, can feed the infant. The patient is at risk for excessive blood loss due to retained placenta, and preparation for manual removal of the placenta is a higher priority at this time.
Rationale 4: The placenta might be sent to pathology after it is removed, but preparing the patient for manual removal of the placenta now is a higher priority.
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