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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","E"]

Explanation


A. Administering oral morphine is anticipated because it is used to manage withdrawal symptoms in newborns with Neonatal Abstinence Syndrome (NAS..
B. Swaddling is a non-pharmacological intervention that can provide comfort and reduce overstimulation.
C. Administering naloxone is not typically the first line of treatment for NAS and is used in cases of acute opioid overdose, which is not indicated by the information provided.
D. Encouraging the birthing parent to breastfeed may not be appropriate due to the presence of heroin in the system, which can be transmitted to the newborn through breast milk.
E. Continuing NAS scoring is essential to monitor the newborn's condition and response to treatment.

Correct Answer is C

Explanation

Rationale:

A. While covering the cord with a sterile, moist saline dressing is important, it is not the first priority when the umbilical cord is prolapsed.

B. While preparing for an immediate birth may become necessary, the first action should be to relieve pressure on the cord to prevent cord compression and compromise to fetal circulation.

C. This is the priority action to prevent cord compression and maintain fetal oxygenation.

D. Placing the client in the knee-chest position can help relieve pressure on the cord, but the nurse's immediate action should be to manually support the cord while awaiting further

instructions from the healthcare provider.

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