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NCLEX-RN

Category - Physiological

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Following the fourth stage of labor, a client is bleeding excessively. On assessment, the fundus is firm. Which of the following is the initial nursing action?

Document the physical assessment findings
Notify the physician
Massage the fundus
Administer oxytocin (Pitocin)

Explanation

Answer: B - If the client is bleeding excessively and the fundus is firm, a laceration in the cervix or vagina is likely. Massaging a firm fundus will not stop the bleeding. Oxytocin is administered only if it is prescribed by the physician. The best initial nursing action is to notify the physician.

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