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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 C

Explanation

Rationale:

A. Increasing the rate of infusion of IV oxytocin could exacerbate the uterine hyperstimulation and fetal decelerations, potentially leading to fetal distress. It is not appropriate in this situation.

B. Slowing the client's rate of breathing would not address the issue of fetal decelerations caused by uterine hyperstimulation. This action is not relevant to the situation described.

C. Discontinuing the infusion of the IV oxytocin is the correct action in this scenario. The presence of uniform decelerations beginning at the peak of contractions suggests uterine hyperstimulation, likely caused by oxytocin. Discontinuing the oxytocin infusion allows the uterus to rest, reducing the risk of further fetal distress.

D. Decreasing the rate of infusion of the maintenance IV solution is not the priority in this

situation. The issue is uterine hyperstimulation caused by oxytocin, so discontinuing the oxytocin infusion is the appropriate action to take.

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

Explanation

  • 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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