A nurse is caring for a school-age child who is 2 hr postoperative following cardiac catheterization.

The nurse observes blood on the child’s dressing.

Which of the following actions should the nurse take?

The correct answer is Choice D, "We can provide a copy of your records, but the therapist's notes are not included."

Rationale for Choice A:

• Puts the client on the defensive:Asking "Why are you interested in seeing your therapist's notes?" can make the client feel like they need to justify their request,potentially leading to defensiveness or withdrawal.
• May not uncover true motivation:The client may not feel comfortable revealing their true reasons for wanting to see the notes,and this approach could hinder open communication.
• Undermines client autonomy:It's important to respect the client's right to access their own information,even if it's not always beneficial.Questioning their motives could make them feel less empowered in their treatment.

Rationale for Choice B:

• Paternalistic and dismissive:Saying "I don't think you will benefit from reviewing your therapist's notes right now" assumes that the nurse knows what's best for the client without exploring their perspective.
• Discourages open communication:It shuts down conversation and may prevent the client from expressing their concerns or needs.
• Could damage therapeutic relationship:By dismissing the client's request,the nurse risks eroding trust and rapport,which are essential for effective therapy.

Rationale for Choice C:

• Assumes dissatisfaction with treatment:Asking "Are you not happy with your treatment?" immediately focuses on potential problems rather than understanding the client's motivations.
• May not be accurate:The client's request may not stem from dissatisfaction with treatment but rather from curiosity,a desire for control,or other reasons.
• Could create unnecessary anxiety:Raising concerns about treatment satisfaction without proper exploration could create anxiety or doubts in the client's mind.

Rationale for Choice D:

• Clear and informative:It directly addresses the client's request while providing accurate information about the availability of records.
• Protects therapist's notes:It upholds the therapist's right to maintain confidentiality of their thought processes and clinical impressions.
• Offers alternative solutions:It suggests that the client can access other parts of their record,potentially addressing their underlying need for information.
• Professional and respectful:It maintains professional boundaries and respects the client's right to information without disclosing protected notes.

Placenta previa is a condition where the placenta implants in the lower part of the uterus, partly or completely covering the cervical opening.

This can cause painless, bright red vaginal bleeding, usually in the third trimester. Spotting is a sign of placenta previa and should be reported to the provider immediately. Choice A is wrong because nausea is not a specific finding of placenta previa.

Nausea can occur in normal pregnancy or in other conditions such as hyperemesis gravidarum or preeclampsia.

Choice B is wrong because polyhydramnios is not a finding of placenta previa.

Polyhydramnios is a condition where there is too much amniotic fluid in the uterus, which can cause complications such as preterm labor, cord prolapse, or fetal malformations.

Choice C is wrong because uterine tenderness is not a finding of placenta previa.

Uterine tenderness is a sign of abruptio placentae, which is a condition where the placenta separates from the uterine wall before delivery.

This can cause severe abdominal pain, dark red vaginal bleeding, and fetal distress.