A nurse is caring for a client who is 2 days postpartum. Which of the following findings should the nurse report to the provider?

4+ deep-tendon reflexes

Urine output 2.500 mL/day

Scant lochia rubra with a few small clots

Bilateral ankle edema

Answer and Explanation

The Correct Answer is A

A. 4+ deep-tendon reflexes: Deep-tendon reflexes are typically assessed using a scale ranging from 0 to 4+, with 4+ indicating hyperactive reflexes. In a postpartum client, hyperactive deep-tendon reflexes could indicate a potential complication such as preeclampsia or eclampsia, which require immediate medical attention. Therefore, the nurse should report this finding to the provider promptly.
B. Urine output 2,500 mL/day: A urine output of 2,500 mL/day is within the expected range for a postpartum client and does not require immediate intervention. Adequate urine output is important for assessing renal function and hydration status, but this finding does not indicate an urgent concern.
C. Scant lochia rubra with a few small clots: Scant lochia rubra with small clots is a normal finding in the early postpartum period. Lochia typically progresses from rubra (red) to serosa (pink) to alba (white) over time. As long as the lochia is not excessive or accompanied by large clots, this finding is not concerning and does not require immediate reporting to the provider.
D. Bilateral ankle edema: Mild bilateral ankle edema is common in the postpartum period and is often attributed to hormonal changes and shifts in fluid balance. While the nurse should continue to monitor for signs of worsening edema or other symptoms of preeclampsia, mild edema alone is not typically considered a critical finding requiring immediate reporting to the provider.

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Correct Answer is B

Explanation

A. Take antacids that contain mint for heartburn. - This statement is incorrect. While antacids can help neutralize stomach acid and relieve heartburn symptoms, antacids containing mint can relax the lower esophageal sphincter (LES), leading to increased reflux symptoms. Therefore, clients with GERD should avoid antacids containing mint.
B. Avoid consuming foods containing chocolate. - This statement is correct. Chocolate is a common trigger for GERD symptoms due to its high fat content, which can relax the LES and delay stomach emptying, leading to increased acid reflux. Advising the client to avoid foods containing chocolate can help minimize GERD symptoms.
C. Increase dietary intake of citrus fruits. - This statement is incorrect. Citrus fruits are acidic and can exacerbate GERD symptoms by increasing stomach acid production and irritating the esophagus. Therefore, clients with GERD should limit or avoid citrus fruits to reduce acid reflux.
D. Lie down for 30 min after eating a meal. - This statement is incorrect. Lying down after eating can worsen GERD symptoms by allowing stomach acid to flow back into the esophagus more easily. Instead, clients with GERD should remain upright for at least 2-3 hours after eating to help prevent acid reflux.

A. Suggest that the client attend adult day care three times per week. B. Review assisted living accommodations with the client. C. Discuss a long-term care referral for the client with the provider. D. Instruct the client about the use of telehealth services.

Correct Answer is D

Explanation

A. Suggest that the client attend adult day care three times per week: While adult day care can provide socialization opportunities and supervision for older adults, it may not be suitable for all clients, especially those who are still independent and prefer to live in their own homes. Additionally, attending adult day care may not directly address the client's diabetes management needs.
B. Review assisted living accommodations with the client: Assisted living accommodations are typically considered for individuals who require assistance with activities of daily living (ADLs) or who can no longer live independently. Since the client in this scenario lives independently, reviewing assisted living accommodations may not be appropriate at this time.
C. Discuss a long-term care referral for the client with the provider: Long-term care referrals are generally reserved for individuals who require ongoing assistance with ADLs and medical care that cannot be adequately provided in a home setting. Since the client is currently living independently and managing their diabetes, a long-term care referral may not be necessary.
D. Instruct the client about the use of telehealth services: This is the most appropriate intervention for the client in a rural area who may have limited access to healthcare resources. Telehealth services can provide remote monitoring, education, and support for managing diabetes while allowing the client to remain in their home environment. This intervention promotes independence and supports the client's ability to manage their condition effectively while living in a rural area.

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A nurse is caring for a client who is 2 days postpartum. Which of the following findings should the nurse report to the provider?

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