On admission to the postpartal unit, the nurse's assessment identifies the client's fundus to be soft, 2 fingerbreadths above the umbilicus, and deviated to the right. This is most likely an…

The correct answer is B. A full bladder. (A) Immediately after expulsion of the placenta, the fundus should be in the midline and remain (B) A boggy displaced uterus in the immediate postpartum period is a sign of urinary distention. Because uterine ligaments are stretched, a full bladder can displace the uterus. (C)…

Physiological Integrity: Reduction of Risk Potential

Question

On admission to the postpartal unit, the nurse's assessment identifies the client's fundus to be soft, 2 fingerbreadths above the umbilicus, and deviated to the right. This is most likely an indication of:

Options

ANormal involution
BA full bladder
CAn infection pain
DA hemorrhage

How the community answered

(20 responses)

A
5% (1)
B
75% (15)
C
15% (3)
D
5% (1)

Explanation

(A) Immediately after expulsion of the placenta, the fundus should be in the midline and remain (B) A boggy displaced uterus in the immediate postpartum period is a sign of urinary distention. Because uterine ligaments are stretched, a full bladder can displace the uterus. (C) Symptoms of infection may include unusual uterine discomfort, temperature elevation, and foul-smelling lochia. The stem of this question does not address any of these factors. (D) While excessive bleeding is associated with a soft, boggy uterus, the stem of this question includes displacement of the uterus, which is more commonly associated with bladder distention.

Topics

#postpartum assessment#uterine fundus#bladder distension#involution

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