Question

A client arrives at the postpartum unit after delivery of her infant. On performing an assessment, the nurse notes that the client is shaking uncontrollably. Which nursing action is appropriate?

A. Provide a warm blanket
B. Administer pain medication
C. Encourage the client to rest
D. Check for signs of infection

Answer 1

The appropriate nursing action is to provide a warm blanket to the postpartum client who is shaking uncontrollably, as it is a comforting measure that can address the common post-delivery shivering. Further assessment can be done thereafter for signs of infection, pain, or other issues.

Step-by-step explanation:

When a nurse observes that a postpartum client is shaking uncontrollably, the appropriate nursing action is to first provide comfort measures such as warm blankets because shaking can often be due to the body’s reaction to the physical stress of labor and changes in body fluids and hormones. It can also be a reaction to the epidural or anesthesia used during labor. While checking for signs of infection is important, providing warmth is a more immediate action to comfort the client. If shaking continues or other symptoms are present, evaluating for signs of infection or other complications would be the next step. Administering pain medication might be appropriate if the shaking is related to pain; however, this requires a specific assessment by the nurse to justify this intervention. Encouraging the client to rest is always beneficial but does not directly address the acute symptom of shaking.