A nurse is planning care for a client who is 1 hour postpartum and has peripartum cardiomyopathy.

Which of the following actions should the nurse plan to take?

The correct answer is choice a. Check the client’s serum medication level.

Choice A rationale:

Checking the client’s serum medication level is the most direct and objective method to evaluate medication adherence. It provides a quantifiable measure of the digoxin level in the blood, indicating whether the client is taking the medication as prescribed.

Choice B rationale:

Determining the client’s apical pulse rate is important for monitoring the effects of digoxin, as it can affect heart rate. However, it does not directly measure medication adherence.

Choice C rationale:

Asking the client if they are taking the medication as prescribed relies on self-reporting, which can be inaccurate due to forgetfulness or intentional non-disclosure.

Choice D rationale:

Assessing the client’s kidney function is important for dosing and monitoring potential side effects of digoxin, but it does not directly evaluate medication adherence.

Choice A rationale
Turning a baby’s car seat forward when they are 1 year old is not recommended. According to the American Academy of Pediatrics, children should ride in a rear-facing car seat as long as possible, until they reach the highest weight or height allowed by their seat. This is because rear-facing car seats provide the best protection for the baby’s head, neck, and spine in a crash.
Choice B rationale
While it’s important to keep a baby warm in the car seat, using a sleep sack is not the safest option. Bulky outerwear and blankets can interfere with the tightness of the harness, which can compromise the safety of the baby. Instead, it’s recommended to dress the baby in lighter layers and place a warm blanket over them and the harness.
Choice C rationale
A car seat challenge test, also known as a car seat trial, is usually performed on babies who were born preterm, not at full term. This test checks whether the baby can sit in a car seat safely without any breathing problems or other complications. Since the newborn in question was delivered at 38 weeks of gestation, which is considered full term, a car seat challenge test is not typically required.
Choice D rationale
The car seat should indeed be positioned at a 45-degree angle. This angle is especially important for newborns and infants who are rear-facing, as it helps to support their head and prevent it from falling forward.