Question

A new mother received epidural anesthesia during labor and had a forceps delivery after pushing for 2 hours. At 6 hours postpartum her systolic blood pressure has dropped 20 points, her diastolic blood pressure has dropped 10 points, and her pulse is 120 beats/min. The client is anxious and restless. On further assessment, a vulvar hematoma is verified. After notifying the health care provider, what is the nurse's next action?

1. Reassure the client.
2. Monitor fundal height.
3. Apply perineal pressure.
4. Prepare the client for surgery.

Answer 1

The nurse should monitor the fundal height after discovering a vulvar hematoma in a new mother postpartum, as this can be a sign of internal bleeding and possible postpartum hemorrhage.

Step-by-step explanation:

After notifying the health care provider that a new mother has a vulvar hematoma postpartum, the nurse's next action should be to monitor the fundal height. This is vital as changes in the fundal height can indicate whether there is increased bleeding inside the uterus. This could be a sign of internal bleeding which, given the new mother's symptoms of a drop in blood pressure and an elevated pulse, could suggest a postpartum hemorrhage complicating her recovery.