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The nurse assesses a postpartum patient as having moderate lochia rubra with clots on her second postpartum day. Which of the following interventions would be appropriate?

Explanation

•There is no complications or any signs of postpartal hemorrhage. To assess involution process, the nurse should palpate the fundus to see if it is firm and well contracted. During birth, the fetal head exerts pressure on the bladder and urethra as it passes on the bladder’s underside. This pressure may leave the bladder with a transient loss of tone. To prevent permanent damage to the bladder from over distention, assess the woman’s abdomen frequently.

• Lochia rubra is a postpartum vaginal discharge consisting almost entirely of blood. There are often small particles of deciduas and mucus during the the first 3 postpartum days.

•The other intervention choices are inappropriate because the woman is not suffering from blood loss.

•Methergine should not be given because the woman is in her second postpartal day and has a normal lochia as expected.

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