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A nurse is caring for a client who is at 36 weeks of gestation.

Exhibits

For each day 2 finding, click to specify whether the finding indicates that the client's condition has improved, has not changed, or has declined.

A.

Liver function tests

B.

Edema

C.

Fetal heart rate and variability

D.

Headache

E.

Epigastric discomfort

F.

Urine dipstick

Answer and Explanation

The Correct Answer is {"A":{"answers":"A"},"B":{"answers":"B"},"C":{"answers":"C"},"D":{"answers":"A"},"E":{"answers":"A"},"F":{"answers":"B"}}

  • Liver Function Tests: Improved
    The significant decrease in AST, ALT, ALP, and bilirubin levels indicates improved liver function.

  • Edema: Improved
    The reduction from +3 to +2 edema in the lower extremities shows a decrease in swelling, indicating improvement.

  • Fetal Heart Rate and Variability: Declined
    The decrease in FHR with minimal variability and no accelerations suggests a decline in fetal status.

  • Headache: Improved
    The reduction in headache pain from a score of 8 to 2 indicates improvement.

  • Epigastric Discomfort: Improved
    The absence of epigastric pain on Day 2 suggests improvement.

  • Urine Dipstick: Not Changed
    The protein levels in the urine remained at 2+ on both days, indicating no change in kidney function.


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Related Questions

Correct Answer is ["A","B","C","D"]

Explanation

A. "I'll make sure his diaper is loose in the front." This is correct because a loose diaper can prevent pressure on the circumcision site, reducing discomfort and the risk of disrupting the healing process.
B. "I'll expect the plastic ring to fall off by itself within a week." This statement is accurate as the Plastibell ring is designed to fall off on its own as the circumcision heals.
C. "I'll call the doctor if I see any bleeding." This is an appropriate action as bleeding can be a sign of a complication and should be assessed by a healthcare provider.
D. "I'll apply petroleum jelly to his penis with diaper changes." This is correct; applying petroleum jelly can help prevent the diaper from sticking to the circumcision site and aid in healing.
E. "I'll wash his penis with warm water and mild soap each day." This statement is not recommended with the Plastibell technique as it can disrupt the healing process. The site should be kept as dry as possible to allow the ring to fall off naturally.

Correct Answer is ["D","E"]

Explanation

A. Abundant lanugo is incorrect because postmature newborns typically lose their lanugo before birth.

B. Vernix in the folds and creases is incorrect as vernix caseosa, the white, cheese-like substance covering the skin of the fetus, is often absent in postmature newborns due to it being absorbed as the gestation period extends beyond the normal term.

C. Short, soft fingernails are not expected in postmature newborns; instead, they may have long, overgrown nails.

D. Cracked, peeling skin is a common finding in postmature newborns due to prolonged exposure to amniotic fluid and a decrease in the protective vernix caseos

A.

E. A positive Moro reflex is a normal finding in newborns, including those who are postmature, indicating a healthy neurological response.

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