A nurse is measuring the fundal height of a client who is at 36 weeks of gestation. The client suddenly reports nausea. Which of the following actions should the nurse take?

Administer propranolol IV to the client

Position the client on her side.

Ask the client to increase her daily calcium intake.

Use Leopold maneuvers to determine the fetal position.

Answer and Explanation

The Correct Answer is B

A. Administer propranolol IV to the client: Propranolol is a beta-blocker used to treat hypertension and certain cardiac conditions. It is not indicated for sudden nausea during pregnancy and could be harmful if administered without cause.
B. Position the client on her side: At 36 weeks, the gravid uterus can compress the inferior vena cava when the client lies flat, reducing venous return and causing supine hypotensive syndrome, which often presents as nausea. Turning the client to her side relieves pressure and restores circulation.
C. Ask the client to increase her daily calcium intake: Calcium is important during pregnancy, especially for bone health, but increasing intake is not an acute intervention for nausea caused by positional blood flow issues.
D. Use Leopold maneuvers to determine the fetal position: Leopold maneuvers assess fetal position but do not address the client’s immediate symptom of nausea, which may indicate compromised circulation from lying supine. Position change is the priority action.

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Correct Answer is A

Explanation

A. Beneficence: Sitting with the client to provide comfort demonstrates beneficence, which involves actions that promote the well-being and best interests of the client, including offering emotional support during difficult times.
B. Fidelity: Fidelity refers to the nurse’s obligation to be faithful and keep promises made to the client, which involves trustworthiness but does not specifically address providing comfort through presence.
C. Veracity: Veracity is the ethical principle of truth-telling and honesty. Providing comfort by sitting with the client is supportive but not directly related to truthfulness.
D. Autonomy: Autonomy concerns respecting the client’s right to make independent decisions about their care. Offering comfort by presence supports emotional needs but does not directly involve respecting autonomy.

A. Deflate the cuff quickly. B. Place the arm above the level of the client’s heart. C. Use the palpatory method to determine blood pressure. D. Apply the largest cuff available.

Correct Answer is C

Explanation

A. Deflate the cuff quickly: Rapid deflation can result in missing the systolic and diastolic readings entirely, making the measurement inaccurate.
B. Place the arm above the level of the client’s heart: Elevating the arm above heart level can lead to falsely low blood pressure readings due to decreased perfusion.
C. Use the palpatory method to determine blood pressure: When auscultation is difficult, the palpatory method helps estimate the systolic pressure by palpating the radial pulse, guiding appropriate inflation for subsequent attempts.
D. Apply the largest cuff available: Using an improperly sized cuff, especially one that is too large, can yield inaccurate readings; the cuff size should be appropriate to the client’s arm circumference.

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