A nurse is caring for a client who is 1 hr postpartum and has uterine atony. The client is exhibiting a large amount of vaginal bleeding. Which of the following actions should the nurse take?
Avoid performing sterile vaginal examinations.
Anticipate a prescription for misoprostol.
Obtain a specimen for a Kleihauer-Betke test.
Administer betamethasone IM.
The Correct Answer is B
Rationale:
A. Avoiding sterile vaginal examinations is not the appropriate action for managing uterine atony and postpartum hemorrhage. Vaginal examinations may be necessary to assess the degree of cervical dilation and to identify potential causes of bleeding.
B. Anticipating a prescription for misoprostol is appropriate for managing uterine atony and postpartum hemorrhage. Misoprostol is a prostaglandin analog that helps to promote uterine contractions and control bleeding.
C. Obtaining a specimen for a Kleihauer-Betke test is not the priority action in this situation. The Kleihauer-Betke test is used to estimate the amount of fetal-maternal hemorrhage in Rh-negative mothers.
D. Administering betamethasone IM is not indicated for the management of uterine atony and postpartum hemorrhage. Betamethasone is a corticosteroid used to promote fetal lung maturity when preterm birth is anticipated.
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Related Questions
Correct Answer is C
Explanation
A. While an autopsy can be an option for determining the cause of stillbirth, it is not a requirement, and the decision should be made by the parents. This statement may add undue pressure on the client.
B. There is no legal requirement for parents to name a stillborn fetus. This can be a sensitive topic, and it is essential to respect the parents' wishes and feelings in this regard.
C. Providing the client with photos of the fetus can help the parents in their grieving process, allowing them to create memories and acknowledge their loss. This action can offer emotional support and validation of their experience.
D. Limiting the time the fetus is in the client's room may not consider the parents' need for closure and the opportunity to say goodbye. Encouraging the family to spend time with their stillborn child can be an important aspect of the grieving process.
Correct Answer is D
Explanation
Rationale:
A. Thick, white vaginal discharge is not characteristic of trichomoniasis. Trichomoniasis typically presents with a frothy, yellow-green, or grayish vaginal discharge.
B. Vulva lesions are not commonly associated with trichomoniasis. The primary symptom is vaginal discharge.
C. While urinary frequency can occur in some cases of trichomoniasis due to irritation of the urinary tract, it is not as specific a finding as the characteristic malodorous discharge.
D. Malodorous discharge is a hallmark symptom of trichomoniasis. The discharge is often described as having a foul or fishy odor and may be accompanied by itching and irritation of the genital area.
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