Practice Quiz

CNM Certified Nurse Midwife

Category - Postpartum

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A nurse midwife is assessing the fundal tone and height of a client who gave birth to a healthy baby boy 24 hours ago. After obtaining the vital signs, the nurse midwife notes that the fundus is at the level of the umbilicus. Which of the following is the next action of the nurse midwife?
  1. Document the findings as normal.
  2. Obtain the vital signs every 15 to 30 minutes.
  3. Initiate fundal massage.
  4. Administer oxytocin.
Explanation
Answer: C - An hour after the delivery, the fundus is expected to be one fingerbreadth below the umbilicus. This client is experiencing uterine atony. The first step in managing uterine atony is fundal massage. If the uterus cannot maintain its contractions, oxytocin is administered. The client’s vital signs should be closely monitored, but the first action of the nurse midwife should be to initiate fundal massage.
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