A practical nurse (PN) is assigned to care for a client who gave birth 12 hours ago. The PN is preparing to gather data regarding the client's uterine tone and postpartum bleeding. In what order should the PN perform the following actions? Arrange the steps from first to last.
- 1Instruct the client to use the restroom to completely empty her bladder.
- 2Position the client flat on her back with her knees slightly bent.
- 3Place one hand securely just above the client's symphysis pubis.
- 4Gently palpate the top of the uterine fundus with the dominant hand.
- 5Observe the perineal pad to evaluate the amount and character of discharge.
Answer
The correct sequence is: Instruct the client to empty her bladder, Position the client with knees bent, Place one hand above the symphysis pubis, Palpate the uterine fundus, and finally Observe the perineal pad for discharge.
The proper protocol for postpartum uterine data collection must follow a strict sequence to ensure accuracy and client safety. First, physiological barriers must be removed by having the client void, as a full bladder displaces the uterus. Next, the client is positioned to relax the abdomen. Crucially, the lower uterine segment must be manually supported before the actual fundus is palpated to prevent uterine inversion. Finally, with the uterus supported and contracted, the resulting lochia flow is observed to determine the extent of postpartum bleeding.
Step-by-Step Solution
Key Concept
Accurate and safe postpartum fundal data collection requires preliminary preparation (empty bladder, relaxed position) followed by a specialized two-handed palpation technique to prevent uterine inversion while assessing for bleeding.