The nurse is assisting a multiparous woman to the bathroom for the first time since her delivery 3 hours ago. When the client stands up, blood runs down her legs and pools on the floor. The client turns pale and feels weak. What would be the first action of the nurse?

A. Assist the client to empty her bladder
B. Help the client back to bed to check the fundus
C. Assess her blood pressure and pulse
D. Begin an IV of lactated Ringer's solution

The first action of the nurse should be to help the client back to bed to check the fundus, as heavy bleeding and weakness could indicate postpartum hemorrhage, and the uterine fundus' condition is critical to determining next steps, option b is correct.

Explanation:

When a multiparous woman experiences heavy bleeding and feelings of weakness upon standing for the first time after delivery, the initial action should be b) Help the client back to bed to check the fundus. The bleeding could be a sign of postpartum hemorrhage, which is an emergency situation.

Immediate assessment of the uterine fundus is crucial to determine if atony (lack of muscle tone) is present, which can lead to excessive bleeding. Checking the consistency of the fundus can help to identify if additional interventions, such as massage, medications to contract the uterus, or further medical treatment, are required.

After ensuring immediate safety and the condition of the fundus, the nurse may need to assess her blood pressure and pulse to evaluate for potential signs of shock resulting from blood loss. Depending on the findings, initiation of an IV infusion, such as lactated Ringer's solution, may be necessary to restore circulating volume and prevent hypovolemic shock.