A nurse is assisting with the care of a client who gave birth 3 days ago.
Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, 2 actions the nurse should take to address that condition, and 2 parameters the nurse should monitor to assess the client's progress.
The Correct Answer is []
- Potential Condition: Endometritis. The symptoms of malaise, chills, decreased appetite, elevated temperature, tachycardia, a boggy and tender uterus, and foul-smelling lochia are indicative of a postpartum infection, such as endometritis.
- Actions to Take:
- Monitor the lochia amount and odor: This will help assess the presence of infection and the effectiveness of treatment.
- Assist with the administration of prescribed antibiotics: Antibiotics are the primary treatment for endometritis.
- Parameters to Monitor:
- Temperature: Monitoring for fever can help assess the response to treatment and indicate if the infection is resolving or worsening.
- Heart rate: Tachycardia may be a sign of infection or other complications, so it's important to monitor changes in heart rate.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Terbutaline is typically used to manage preterm labor, not a contraindication for dinoprostone, which is used for labor induction.
B. FHR (Fetal Heart Rate) of 140/min with moderate variability is within normal limits and would not be a reason to withhold dinoprostone.
C. WBC count is within normal limits, indicating no infection, thus not a contraindication for dinoprostone.
D. Lesions noted on vaginal introitus and labia majora could indicate an active Herpes simplex virus infection, which is a contraindication for vaginal delivery due to the risk of neonatal infection.
E. Breech presentation is a concern for delivery method but does not contraindicate the use of dinoprostone for labor induction.
Correct Answer is D
Explanation
A. Wearing an underwire bra is not recommended for breastfeeding mothers, especially those with inverted nipples, as it can cause pressure and discomfort, potentially leading to blocked milk ducts and mastitis.
B. Applying breast cream regularly is not specifically beneficial for inverted nipples. It can help with nipple soreness or dryness, but it does not aid in drawing out inverted nipples.
C. Plastic-lined breast pads can help with leakage but do not address the issue of inverted nipples. They do not assist in reshaping or encouraging the protrusion of the nipples.
D. Placing breast shells in the bra can help draw out inverted nipples by applying gentle, consistent pressure around the areola, which encourages the nipples to protrude, making breastfeeding easier for the newborn.
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