A nurse is planning care immediately following birth for a newborn who has a myelomeningocele that is leaking cerebrospinal fluid. Which of the following actions should the nurse include in the plan of care?

Administer broad-spectrum antibiotics.

Cleanse the site with povidone-iodine.

Monitor the rectal temperature every 4 hr.

Prepare for surgical closure after 72 hr.

Answer and Explanation

The Correct Answer is B

Rationale:

A. Administering broad-spectrum antibiotics is not indicated as the first-line intervention for a myelomeningocele that is leaking cerebrospinal fluid. Antibiotics may be initiated later if signs of infection develop.

B. Cleansing the site with povidone-iodine is essential to reduce the risk of infection and prevent contamination of the exposed neural tissue.

C. Monitoring the rectal temperature every 4 hours is important for assessing the newborn's overall health but is not specific to managing a myelomeningocele.

D. Surgical closure of the myelomeningocele may be necessary, but immediate care focuses on protecting the exposed neural tissue and preventing infection before surgical intervention.

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Correct Answer is D

Explanation

A: Administering an IV bolus of lactated Ringer's is typically used to correct electrolyte imbalances or as a volume expander in the case of blood loss. In peripartum cardiomyopathy, fluid overload should be avoided as it can exacerbate heart failure symptoms.
B: Misoprostol is used to prevent or treat postpartum hemorrhage, but it is not directly related to the management of peripartum cardiomyopathy.

C. Assess blood pressure twice daily:
While monitoring blood pressure is important for overall cardiovascular management, assessing it only twice daily is insufficient for a client with peripartum cardiomyopathy. This condition requires frequent and comprehensive monitoring of vital signs, fluid balance, and cardiac function to prevent complications.

D. Restrict daily oral fluid intake:
Restricting fluid intake is a key intervention in managing peripartum cardiomyopathy because it helps to prevent fluid overload, which could exacerbate heart failure. Clients with this condition often experience reduced cardiac output, and limiting fluids can reduce the strain on the heart and improve overall management of symptoms

A. "Your provider will schedule a chorionic villus sampling to determine the sex of your baby." B. "This procedure determines if your baby has genetic or congenital disorders." C. "We can schedule the procedure for later today if you'd like." D. "You cannot have an amniocentesis until you are at least 35 years of age."

Correct Answer is B

Explanation

Rationale:

A. "Your provider will schedule a chorionic villus sampling to determine the sex of your baby." Chorionic villus sampling (CVS) is a different prenatal test that involves taking a sample of chorionic villi for genetic testing, not determining the sex of the fetus.

B. "This procedure determines if your baby has genetic or congenital disorders."

Correct answer.

Amniocentesis is a prenatal test used to diagnose genetic disorders or chromosomal abnormalities, not to determine the sex of the fetus.

C. "We can schedule the procedure for later today if you'd like." Amniocentesis is not typically scheduled on the same day as requested. It requires prior preparation and scheduling.

D. "You cannot have an amniocentesis until you are at least 35 years of age." There's no age restriction for amniocentesis based solely on maternal age. It's typically recommended for women at higher risk for genetic conditions, regardless of age.

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A nurse is planning care immediately following birth for a newborn who has a myelomeningocele that is leaking cerebrospinal fluid. Which of the following actions should the nurse include in the plan of care?

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Naxlex Comprehensive Predictor Exams

A nurse is planning care for a client who is 1 hr postpartum and has peripartum cardiomyopathy. Which of the following actions should the nurse plan to take?

Correct Answer is D

Explanation

A nurse in a provider's office is caring for a 20-year-old client who is at 12 weeks of gestation and requests an amniocentesis to determine the sex of the fetus. Which of the following responses should the nurse make?

Correct Answer is B

Explanation

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