Newbie! Part 2 Interview tomorrow

[KLeigh123]

Hi guys! I'm new to this board. I recently graduated from nursing school and passed my boards in September. I interviewed on a maternity unit last week. Tomorrow I am going in for part 2 which is a simulation. (I'm hoping the patients will only be postpartum as I will be working on a postpartum unit)

I'm trying to go over all potential postpartum complications. I'm assuming hemorrhage could be a big possibility. I'm also looking over cystitis, hematoma, mastitis, pulmonary embolism or thrombophlebitis. Any other ideas?

My question: As I'm looking over my nclex list of interventions for hemorrhage, the book is stating to 1- massage fundus, 2-take blood pressure (shock) 3- call doctor 4- start fluids. When i was speaking to a couple of nurses at work today, they advised me to always call the doctor first b/c of shock. So i guess my question is-- if my patient is hemorrhaging, wouldn't my first concert be to STOP the bleeding by massaging the fundus and then taking the BP to report to the doctor?

All other advice is welcome. Thank you for your feedback!

[firstinfamily, RN]

I haven't done post partum nursing for a long time, but I would have at least taken a set of vital signs before calling the MD. The unit may have a policy that the nurse should massage the fundus before calling the MD if suspecting hemorraging. We did this automatically before calling the MD as it was expected to be normal nursing action and did not need an MD order. However, times have changed, so perhaps the policy of the facility would state what would be appropriate. I would not think a nurse would need a MD order to massage the fundus if hemorrhage is suspected. We routinely massaged the fundus every 2 hours after childbirth, as this was a standing order at that time.

[KLeigh123]

Thank you for your input. Are there any other major assessments that you feel I'm missing here besides LOC?