A nurse is collecting data from a client who received oxytocin 10 units IM 30 min ago for excessive vaginal bleeding. Which of the following findings should the nurse expect?
Explanation & Rationale
A. Client report of uterine cramping: Oxytocin stimulates uterine contractions to control postpartum bleeding. Mild to moderate cramping is an expected and therapeutic effect of the medication, indicating the uterus is responding appropriately. B. Boggy fundus 3 fingerbreadths above the umbilicus: A boggy, elevated fundus suggests ongoing uterine atony and uncontrolled bleeding, which is not an expected finding after oxytocin administration. This would require immediate reassessment and intervention. C. Client report of burning with urination: Oxytocin does not affect the urinary tract directly. Dysuria is unrelated to oxytocin administration and is not an expected outcome. D. Saturation of perineal pad in 15 min: Excessive bleeding despite oxytocin indicates insufficient uterine contraction or another complication. Effective oxytocin therapy should reduce vaginal bleeding, so rapid saturation of pads is an abnormal finding.