A nurse is planning care prior to an amniocentesis for a client who is at 22 weeks of gestation. Which of the following actions should the nurse include in the plan of care?

Instruct the client to be NPO for six hours prior to the procedure

Instruct the client to maintain a full bladder for the procedure

Monitor the fetal heart rate prior to the procedure.

Place the client in Trendelenburg position during the procedure

Answer and Explanation

The Correct Answer is C

Rationale:

A. Instruct the client to be NPO for six hours prior to the procedure: Amniocentesis is typically done under local anesthesia and does not require sedation or general anesthesia, so there is no need for the client to be NPO beforehand.

B. Instruct the client to maintain a full bladder for the procedure: A full bladder is required during early pregnancy to help lift the uterus for better visualization. However, at 22 weeks gestation, the uterus is already an abdominal organ, and a full bladder is not necessary.

C. Monitor the fetal heart rate prior to the procedure: Monitoring the fetal heart rate before an amniocentesis is essential to establish a baseline and ensure fetal well-being. It also aids in identifying any immediate changes following the procedure.

D. Place the client in Trendelenburg position during the procedure: The Trendelenburg position is not appropriate for amniocentesis. The client is typically placed in a supine or slightly tilted position to allow proper access to the uterus and avoid vena cava compression.

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Correct Answer is ["A","B","D"]

Explanation

Rationale:

A. The client slept 5 hr the previous night: Restorative sleep reflects stabilization in manic episodes, where insomnia is a key symptom. Sleeping for five hours is a significant improvement, indicating reduced hyperactivity and improved mood regulation.

B. The client consumes 8 oz of high-calorie fluids each hour: Adequate nutritional intake and hydration are often compromised in mania due to distractibility and hyperactivity. Regular consumption of fluids shows enhanced attention, cooperation, and reduced psychomotor agitation.

C. The client takes short naps during the day: Napping during the day may actually signal persistent hyperactivity or fragmented sleep cycles. Restful, consolidated nighttime sleep is a better indicator of clinical improvement than sporadic daytime naps.

D. The client engages in quiet activities in their room: Participation in low-stimulation activities reflects improved impulse control, attention span, and reduced need for excessive stimulation positive signs of response to lithium and therapeutic interventions.

E. The client appears to listen to unseen others: Persistent auditory hallucinations suggest ongoing psychotic features. Although lithium can reduce mood-related psychosis, hallucinations at this stage indicate incomplete resolution of manic or psychotic symptoms.

A. "You should avoid salting your food prior to eating” B. "You should aim to consume fish at least twice a week” C. "You should wear a medical identification Bracelet or necklace” D. “You should take Ibuprofen if you experience mild pain” E. “You should keep your nitroglycerin with you at all times”

Correct Answer is ["A","B","C","E"]

Explanation

Rationale:

A. "You should avoid salting your food prior to eating": Avoiding added salt helps control blood pressure and reduce fluid retention, both of which are crucial for preventing cardiac stress. This is especially important after an MI and in clients with COPD who are already at risk of pulmonary congestion.

B. "You should aim to consume fish at least twice a week": Fish high in omega-3 fatty acids, such as salmon or sardines, support cardiovascular health by lowering triglyceride levels and reducing inflammation. This dietary habit is recommended in secondary prevention following myocardial infarction.

C. "You should wear a medical identification bracelet or necklace": Medical alert jewelry informs first responders about chronic illnesses such as COPD, history of MI, anxiety disorders, and current medications like nitroglycerin or alprazolam. This can prevent dangerous delays or errors in emergency care.

D. "You should take ibuprofen if you experience mild pain": Ibuprofen can increase cardiovascular risk by raising blood pressure, promoting sodium retention, and interfering with the antiplatelet effect of aspirin. Acetaminophen is a safer alternative for clients with heart disease or those on antiplatelet therapy.

E. "You should keep your nitroglycerin with you at all times": Nitroglycerin must be readily available in case of angina. Immediate access ensures quick symptom relief and reduces the risk of cardiac complications. Clients should also be educated to protect it from heat, light, and moisture.

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A nurse is planning care prior to an amniocentesis for a client who is at 22 weeks of gestation. Which of the following actions should the nurse include in the plan of care?

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Explanation

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Explanation

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