If a postpartum client has saturated a peripad with rubra drainage two hours after vaginal delivery, what is the nurse’s priority action?

In the context of postpartum care, a saturated peripad with rubra drainage two hours after vaginal delivery raises concerns regarding potential postpartum hemorrhage. In this situation, the priority action for the nurse is to assess the client’s fundus. This assessment is crucial because the firmness and position of the fundus can provide immediate insight into whether uterine atony, which is a leading cause of early postpartum hemorrhage, is present.

By palpating the fundus, the nurse can determine if it is firm and at the expected level in the abdomen. A boggy fundus (one that is soft or not well contracted) is indicative of uterine atony, which may require prompt intervention, such as uterine massage and possibly medication to promote uterine contraction and control bleeding. This action directly addresses the potential life-threatening condition of significant blood loss.

Further actions, such as obtaining laboratory values or increasing IV fluids, may be necessary if the initial assessment and potential interventions do not stabilize the client, but assessing the fundus remains the immediate priority to guide further management. Changing the peripad would also not address the underlying issue that may be causing the excessive bleeding.