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A nurse on a postpartum unit is caring for a client.

Exhibits

The nurse should anticipate a provider's prescription for a(n)

and .
Answer and Explanation

The Correct Answer is {"dropdown-group-1":"E","dropdown-group-2":"D"}

Rationale for Correct Choices

  • Intravenous antibiotics: The client presents with uterine tenderness, dark foul-smelling lochia, a mildly elevated temperature, and an elevated WBC count, all of which point to endometritis, a common postpartum infection. The first-line treatment for endometritis is broad-spectrum IV antibiotics to prevent complications like sepsis.
  • Increase in daily fluid intake: Infection and fever can increase fluid loss through insensible means, and fluids support circulation, renal function, and antibiotic delivery. Encouraging increased fluid intake also helps address dehydration from fever and supports healing and lactation.

Rationale for Incorrect Choices

  • Kleihauer-Betke test: This test detects fetal-to-maternal hemorrhage and is used in trauma or suspected placental abruption in Rh-negative mothers. There is no indication of bleeding or Rh incompatibility in this case, so it is not appropriate here.
  • Tocolytic medication: Tocolytics are used to suppress uterine contractions in preterm labor. This client is postpartum and has no signs of preterm labor or uterine hyperstimulation, so this medication is not warranted.
  • Intrauterine tamponade balloon: This device is used for severe postpartum hemorrhage due to uterine atony that doesn’t respond to medical treatment. The client has moderate lochia but no signs of active hemorrhage or hemodynamic instability, so it is not indicated.


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Related Questions

Correct Answer is D

Explanation

Rationale:

A. Misoprostol: Misoprostol is a prostaglandin used to stimulate uterine contractions and control postpartum hemorrhage. It is generally safe for clients with hypertension, as it does not cause significant vasoconstriction or elevate blood pressure.

B. Oxytocin: Oxytocin is commonly used to manage postpartum hemorrhage by inducing uterine contractions. It does not have hypertensive effects and is safe for use in clients with a history of high blood pressure.

C. Terbutaline: Terbutaline is a beta-agonist used for tocolysis, not for treating postpartum hemorrhage. Although it may cause tachycardia and hypotension, it is not a uterotonic and is not relevant in this context.

D. Methylergonovine: Methylergonovine is contraindicated in clients with hypertension because it causes intense vasoconstriction, which can significantly elevate blood pressure and increase the risk of stroke or cardiac events in hypertensive clients.

Correct Answer is A

Explanation

Rationale:

A. Assist the adolescent in applying for Medicaid: Medicaid can provide essential prenatal care, delivery services, and pediatric coverage for low-income individuals. Helping the adolescent apply addresses both her financial and health concerns, supporting positive outcomes.

B. Refer the adolescent to local mental health clinic: While emotional support is important, this action doesn’t directly address her stated concern about affording and caring for the baby. It may be appropriate later but is not the immediate priority.

C. Contact the adolescent parent for assistance: Contacting family may be helpful if the adolescent consents, but it must respect her autonomy and confidentiality. It is not the nurse’s first step without permission or expressed need for family involvement.

D. Advise the adolescent to place the newborn for adoption: Suggesting adoption without the adolescent initiating that discussion may be inappropriate and coercive. Nurses should provide options neutrally and supportively, not direct decisions about parenting or adoption.

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