A nurse is caring for a client who is at 15 weeks of gestation during a routine prenatal visit.

Exhibits

Which of the following findings should the nurse identify as an indication of a potential complication of pregnancy? Select all that apply.

Choice A rationale:
Yellow exudate will form at the surgical site in 24 hours, which is a normal part of the healing process.
Choice B rationale:
A dark red appearance of the penis could indicate a complication such as infection or necrosis, which would require medical attention.
Choice C rationale:
The Plastibell is not removed manually; it falls off naturally within 5 to 8 days.
Choice D rationale:
A snug diaper could cause pressure and discomfort on the surgical site; it’s recommended to fasten the diaper loosely.

The Plastibell circumcision technique is one of the most common methods of newborn circumcision. It involves placing a plastic ring under the foreskin and tying a suture around it to cut off blood flow. The foreskin then falls off naturally with the ring in seven to 10 days.

The correct answer is A. The nurse should include that “yellow exudate will form at the surgical site in 24 hours” as part of the teaching to the parents. This is because the yellow exudate is a normal sign of healing and should not be confused with infection.

The other options are incorrect because:

b. The parents should notify the provider if the end of the baby’s penis appears black, not dark red. This could indicate that the ring is too tight and is cutting off blood supply to the glans.
c. The Plastibell will not be removed 4 hours after the procedure. It will stay on the penis until the foreskin falls off naturally in seven to 10 days.
d. The newborn’s diaper should be loose, not snug. This is to prevent the ring from being dislodged or rubbing against the diaper.

Choice A rationale:
Administering ephedrine IV is not the appropriate action for a client experiencing an amniotic fluid embolism during labor. Ephedrine is typically used to treat hypotension during spinal anesthesia, not amniotic fluid embolism.
Choice B rationale:
Assisting the client to empty their bladder is not the appropriate action for a client experiencing an amniotic fluid embolism during labor. While bladder care is important, it is not the priority in this situation.
Choice C rationale:
Assessing for the presence of clonus is not the appropriate action for a client experiencing an amniotic fluid embolism during labor. Clonus is typically assessed in clients with preeclampsia or eclampsia, not amniotic fluid embolism.
Choice D rationale:
Preparing to initiate cardiopulmonary resuscitation is the appropriate action for a client experiencing an amniotic fluid embolism during labor. Amniotic fluid embolism can lead to cardiovascular collapse, therefore, immediate resuscitation measures should be prepared15.