A 20-year-old woman, gravida 2 para 2, is evaluated in the postpartum unit 8 hours after a vaginal delivery She is experiencing
fatigue, perinea! discomfort, and bloody vaginal discharge The patient has voided twice since delivery but finds it difficult to initiate
urination. She presented with rupture of membranes at 40 weeks gestation and, after a prolonged induction, had an uncomplicated
vaginal delivery under epidural anesthesia with a third-degree laceration that was quickly repaired The placenta delivered
spontaneously after which the patient had an episode of rigors and chills for 30 minutes that has not recurred. Estimated deliveryrelated
blood loss was 500 ml; the patient received an oxytocin infusion for 4 hours after delivery Temperature is 37.9 C (100.2 F),
blood pressure is 120/80 mm Hg, and pulse is 76/min. Pelvic examination shows an intact perinea! repair but bloody discharge and
small blood clots on her perinea! pad Her uterus is firm, and the uterine fundus is at the umbilicus. Which of the following is the most
appropriate next step in management of this patient?
- QA Administer antibiotics
- 0 B. Administer oxytocin
- 0 C. Obtain urinalysis
- 0 D. Perform pelvic ultrasound
- 0 E. Provide routine postpartum care
0 voters