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Zorluk: OrtaAnte/Intra/Postpartum and Newborn Care

A nurse is receiving shift report for a group of clients on the postpartum unit. Which client should the nurse assess first?

  1. A client who is 4 hours postpartum with a uterine fundus that is palpable above the umbilicus and displaced to the right.Cevap
  2. B
    A client who is 24 hours postpartum and reports intense uterine cramping while breastfeeding.
  3. C
    A client who is 2 days postpartum and has an oral temperature of 37.8∘C37.8^\circ\text{C} (100.0∘F100.0^\circ\text{F}).
  4. D
    A client who is 12 hours postpartum and is experiencing profuse diaphoresis and frequent urination.

Cevap

The client who is 4 hours postpartum with a uterine fundus that is palpable above the umbilicus and displaced to the right.
A uterine fundus that is displaced (usually to the right) and palpable above the umbilicus indicates bladder distention. A full bladder displaces the uterus and prevents it from contracting effectively. This leads to uterine atony, placing the client at immediate risk for postpartum hemorrhage. This client requires priority assessment and intervention to empty the bladder (via voiding or catheterization) and immediate reassessment of fundal tone.

Adım Adım Çözüm

1
Analyze the clinical findings for each postpartum client to differentiate between normal physiological adaptations and potential complications.
Three clients exhibit normal postpartum findings, while one client exhibits a sign of a developing complication.
Identifying the client at greatest risk of instability is necessary to establish the correct priority of care.
2
Evaluate the finding of a displaced uterine fundus in a 4-hour postpartum client.
A fundus located above the umbilicus and deviated to the right strongly indicates bladder distention.
A distended bladder prevents the uterus from contracting properly (uterine atony), which is the leading cause of postpartum hemorrhage.
3
Apply prioritization principles (Airway, Breathing, Circulation) to the client group.
The client with the displaced fundus is at immediate risk for hemorrhage (Circulation) and requires prompt intervention to empty the bladder and reassess uterine tone.
Clients at risk for life-threatening complications, such as hemorrhage, must be assessed and managed before clients experiencing normal postpartum discomforts.

Anahtar Kavram

Postpartum Complications and Prioritization (Bladder Distention)
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Konular

Ante/Intra/Postpartum and Newborn Care

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