A nurse is assessing a client 6 hours after a vaginal delivery. The client voided 100 mL approximately 2 hours ago but now reports increasing lower abdominal discomfort. Assessment reveals a uterus that is firm but displaced to the right and palpated 2 cm above the umbilicus. Lochia rubra is moderate without clots. Which nursing action should the nurse implement first?

A nurse is reviewing the medical records of four postpartum clients. Which client is at the greatest risk for developing a postpartum infection?

A 67-year-old client is admitted to the intensive care unit with septic shock secondary to pneumonia. Twelve hours after admission, the nurse notes new petechiae over the client’s chest, oozing of blood from the central venous catheter insertion site, and blood-tinged urine in the urinary catheter tubing. Which laboratory finding would most strongly support the nurse’s suspicion that the client is developing disseminated intravascular coagulation (DIC)?

A nurse is assessing a client 3 weeks after a vaginal delivery. The client states, “I dread waking up every morning. I cry several times a day, I don’t enjoy being with my baby, and I feel like everyone would be better off without me.” Which nursing response is the priority?

A nurse is reassessing a client 2 hours after an uncomplicated vaginal birth. The client has moderate vaginal bleeding. The uterus is firm, midline, and remains well contracted after fundal massage. Which additional assessment finding is the highest priority for the nurse to report to the healthcare provider?

A 14-year-old adolescent is brought to an urgent care clinic after experiencing two episodes of dizziness over the past month while participating in soccer practice. The client reports feeling increasingly fatigued, has difficulty concentrating in school, and states that her menstrual periods have become heavier over the past six months, often lasting 7 to 8 days. Vital signs are temperature 98.4°F (36.9°C), heart rate 108/min, blood pressure 98/60 mm Hg, and respiratory rate 18/min. Which condition should the nurse suspect is the most likely cause of this client’s symptoms?

A nurse is caring for a client 2 hours after a vacuum-assisted vaginal delivery of a 4,180-g (9 lb 3 oz) infant. The client reports escalating rectal pressure and severe perineal pain that she rates as 10/10 despite receiving prescribed analgesics 20 minutes earlier. Assessment reveals a firm, midline uterus at the level of the umbilicus with scant lochia rubra. The nurse notes unilateral swelling of the right labia that is tense, ecchymotic, and exquisitely tender to palpation. Which nursing action is the priority?

A 58-year-old client underwent a bone marrow aspiration and biopsy from the posterior iliac crest 45 minutes ago to evaluate unexplained pancytopenia. Which assessment finding should prompt the nurse to contact the provider immediately?

A 38-year-old client is discharged with a new prescription for ferrous sulfate after being diagnosed with iron deficiency anemia related to chronic gastrointestinal blood loss. During a follow-up phone call one week later, which client statement indicates that additional teaching is needed?

A 42-year-old client is admitted with progressive fatigue, jaundice, and dark-colored urine. Laboratory studies reveal a decreased hemoglobin level, elevated indirect bilirubin, increased lactate dehydrogenase (LDH), a positive direct Coombs test, and an elevated reticulocyte count. The provider diagnoses warm autoimmune hemolytic anemia (AIHA). When reviewing the client’s history, which additional finding would the nurse most strongly associate with the development of this disorder?