CNM Certified Nurse Midwife

Answer: D - Clients who give birth to twins are at risk for postpartum hemorrhage. Multiple pregnancies can distend the uterus, which may result in uterine atony. A uterus with ineffective contractions is most likely to develop hemorrhage. To evaluate the client’s risk, the nurse midwife should closely monitor for the fundal height and tone. Administration of pain medication and encouraging the client to void are appropriate interventions, but they are not the priority actions of the nurse midwife. A cold compress is applied to the perineum to relieve or control pain. Warm compresses may increase the client’s risk for bleeding and may aggravate the inflammation process.