A postpartum client becomes concerned when a gush of blood occurs during the fundal assessment. What should the nurse explain about this occurrence?
1. "Do not worry. I will make sure everything is fine."
2. "We see this from time to time. It's not a big deal."
3. "Blood has pooled in the vagina while you were in bed."
4. "The gush is an indication that your fundus is not contracting."
3
Explanation:
1. This response is not therapeutic because it focuses on the nurse and has a "do not worry" aspect that is demeaning.
2. Although a gush of blood during fundus assessment is fairly common, this response is not therapeutic because it does not address the client's concern.
3. Because of the angle of the vagina, lochia pools in the vagina while a woman is lying or semisitting in bed, which leads to a gush when fundal massage is performed.
4. The fundus might be contracting well. The gush is from pooled lochia in the vagina.
You might also like to view...
When people have needs that go beyond their ability to care for themselves, they are said to be experiencing which of the following?
a. Self-care deficit b. Self-care ability c. Self-care abundance d. Self-care disability
When administering IV bolus phenytoin to an infant, the nurse must use:
a. a scalp vein IV access. c. a central venous access device. b. an antecubital IV access. d. a brachial artery catheter.
You are the nurse caring for a client who is psychotic and has been diagnosed with a mood disorder
Which of the following is a drug that is not an antipsychotic but is often ordered by the provider to aid in managing psychosis in clients with mood disorders? a. Ritalin b. Reserpine c. lithium d. phenobarbital
A healthcare professional wants to work on community projects that would include strategies to reduce the risk of developing cancer. Which projects should the professional volunteer for?
a. Offering free smoking cessation classes to college students b. Establishing a support group for patients receiving chemotherapy c. Providing a breast cancer screening at a senior center twice a year d. Supplying low sugar, low-fat snacks at an after-school tutoring program e. Funding a support service that offers transportation to cancer treatment centers