A client whose first child was delivered by cesarean section is 20 weeks pregnant with her second child and wishes to have a vaginal birth after cesarean (VBAC). What information is most important for the practical nurse (PN) to obtain?
Client's intent regarding breastfeeding of the newborn.
The type of uterine incision used for previous birth.
History of contracting Herpes simplex virus.
Religious preference of the client's family.
The Correct Answer is B
Knowing the type of uterine incision from the previous cesarean section is crucial when considering the option of vaginal birth after cesarean (VBAC). The type of incision can provide important insights into the potential risks and complications associated with a trial of labor.
Specifically, a low transverse uterine incision is considered the most favorable for VBAC, as it has a lower risk of uterine rupture compared to other types of incisions, such as a classical or vertical incision.
A. While information about the client's intent regarding breastfeeding of the newborn is important for providing appropriate support and education, it does not have a direct impact on the decision-making process for VBAC.
C. A history of contracting Herpes simplex virus is relevant to the client's overall health and may have implications for the management of the pregnancy, but it is not directly related to the decision regarding VBAC.
D. The religious preference of the client's family, while important for respecting cultural and spiritual beliefs, does not have a direct impact on the decision-making process for VBAC.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
The client's question about whether the surgical opening will be visible suggests that they have concerns or misconceptions about the upcoming fecal diversion surgery. By reviewing the client's expectations of elimination after surgery, the PN can provide accurate information and address any anxieties or concerns the client may have.
The other options are not directly related to the client's question and are not the most appropriate actions to take in this situation:
A. Determining if this is the client's first indwelling catheter is unrelated to the client's question about the visibility of the surgical opening. It may be important to assess the client's history of urinary catheter use for other purposes, but it does not address the client's immediate concern.
B. Asking the client if they finished the bowel sterilization prescription is also unrelated to the visibility of the surgical opening. While bowel sterilization may be a part of the preoperative preparation for fecal diversion surgery, it does not address the client's questions and concerns.
D. Verifying that the client had nothing by mouth (NPO) for the past 24 hours is important for general preoperative care but does not address the client's specific question about the visibility of the surgical opening.
Correct Answer is D
Explanation
A. C-reactive protein level:
C-reactive protein (CRP) is a marker of inflammation but does not specifically identify the causative organism of an infection. While elevated CRP can suggest infection or inflammation, it doesn't provide the necessary information for treatment.
B. Serum blood glucose (BG) level:
Serum blood glucose levels are important to monitor in diabetic patients because high glucose levels can impair healing and increase the risk of infection. However, it does not directly help identify the causative organism in this situation.
C. Serum albumin:
Serum albumin reflects nutritional status and can indicate malnutrition or poor wound healing. While it may be relevant for healing, it is not the most immediate test to evaluate for infection.
D. Culture for sensitive organisms:
Given the red, swollen wound with drainage and foul odor, a wound culture is the most appropriate first step to identify the specific infectious organism. This will guide the healthcare provider in selecting the most appropriate antibiotic treatment.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today