A nurse is caring for a client.

Exhibits

The nurse is caring for a client on the postpartum unit.

The nurse is caring for the client following an emergency cesarean birth. Which of the following findings indicate an improvement in the client's condition?

Select all that apply.

Hemoglobin

Heart rate

Pain level

Temperature

Vaginal bleeding

Blood pressure

Answer and Explanation

Correct Answer : B,C,E,F

A. Hemoglobin: Although an improvement in hemoglobin would be ideal, it may take more time to see a significant change after blood loss or transfusion. A rise in hemoglobin indicates that the body is recovering from blood loss, but it is not as immediate an indicator of improvement as other factors, such as heart rate or blood pressure stabilization.

B. Heart rate: A decrease in the heart rate toward the normal range (60-100 beats/min) indicates improvement in the client's condition. The initial heart rate of 120-128 beats/min (tachycardia) suggests the client may have been compensating for blood loss or pain. A more stable heart rate would suggest a response to treatment and improvement in their cardiovascular status.

C. Pain level: A reduction in pain score is an important indicator of recovery post-surgery. After an emergency cesarean birth, pain management is a critical aspect of recovery, and a reduction in pain intensity would suggest that the client is improving and responding well to pain management interventions.

D. Temperature: A normal temperature would suggest no infection or complications. However, temperature changes in the immediate postpartum period can be influenced by various factors (e.g., infection, hormonal changes, or recovery from surgery). It is not as immediate an indicator of recovery as heart rate or blood pressure.

E. Vaginal bleeding: A decrease in vaginal bleeding, especially after a cesarean, would indicate that bleeding is being effectively controlled and the uterus is contracting appropriately, reducing the risk of hemorrhage or complications like uterine atony.

F. Blood pressure: A return to normal blood pressure levels (e.g., closer to the pre-pregnancy baseline) would indicate that the client's circulatory status is stabilizing. The dropping blood pressure seen earlier (from 95/62 mm Hg to 85/48 mm Hg) indicated hypovolemic shock or a response to blood loss, so stabilization and an increase in blood pressure would be a positive sign.

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Correct Answer is D

Explanation

A. Monitor vital signs every hour for the first 4 hr: Incorrect. Vital signs should be monitored more frequently, typically every 15 minutes during the first hour after administration, due to the risk of bleeding.

B. Administer medications intramuscularly: Incorrect. Intramuscular injections should be avoided while the client is on alteplase due to the increased risk of bleeding.

C. Provide a diet low in protein: Incorrect. There is no need for a low-protein diet with alteplase therapy. The focus should be on managing bleeding risks and monitoring for complications.

D. Observe for bruising of the skin: Alteplase is a thrombolytic medication, and one of its major side effects is bleeding. The nurse should monitor the client for signs of bruising, bleeding, or hemorrhage.

A. Use droplet precautions when caring for the child. B. Administer aspirin to the child for fever. C. Assign the child to a negative air pressure room. D. Assess the child for Koplik spots.

Correct Answer is C

Explanation

A. Varicella (chickenpox) requires airborne, not droplet, precautions.

B. Aspirin is contraindicated in children with viral illnesses due to the risk of Reye's syndrome.

C. A negative air pressure room is necessary to prevent the airborne spread of varicella.

D. Koplik spots are associated with measles, not varicella.

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A nurse is caring for a client. Exhibits The nurse is caring for a client on the postpartum unit. The nurse is caring for the client following an emergency cesarean birth. Which of the following findings indicate an improvement in the client's condition? Select all that apply.

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A nurse is caring for a client.

Exhibits

The nurse is caring for a client on the postpartum unit.

The nurse is caring for the client following an emergency cesarean birth. Which of the following findings indicate an improvement in the client's condition?

Select all that apply.