The child is a 2-year-old who fell into a pool. He was retrieved from the pool by a family member but was not breathing. The family member started CPR, and the ambulance brought him to the hospital.

What factors are important in determining the level of hypoxemia that the child may have experienced during the submersion?

Select all that apply.

The correct answer and explanation is:

d) Massage the fundus and avoid direct pressure on the cesarean incision.

This is the best action to take for a client who experiences a sudden gush of vaginal blood and clots after a

cesarean section. Massaging the fundus helps to stimulate uterine contractions and reduce bleeding.

Avoiding direct pressure on the incision prevents pain and wound dehiscence.

a) Insert an indwelling catheter to empty the bladder and contract the fundus.

This is not the first action to take for a client who experiences a sudden gush of vaginal blood and clots after a cesarean section. Inserting an indwelling catheter requires a physician's order and may cause discomfort and infection. The client may already have a catheter in place after the surgery.

b) Check fundal consistency and continue to monitor the lochial flow amount.

This is not enough to do for a client who experiences a sudden gush of vaginal blood and clots after a cesarean section. Checking fundal consistency and monitoring lochial flow are important, but they do not address the cause of bleeding or prevent further blood loss.

c) Return the client to bed and maintain bedrest until the lochial flow slows.

This is not appropriate for a client who experiences a sudden gush of vaginal blood and clots after a cesarean section. Returning the client to bed and maintaining bedrest may delay ambulation and increase the risk of thromboembolism. It also does not stop the bleeding or treat the underlying cause.

Choice A rationale:

The combination of trimethoprim and sulfamethoxazole has a synergistic effect, which means that the two drugs work together to inhibit bacterial growth more effectively than either drug alone. This combination is commonly used to treat urinary tract infections (UTIs) caused by susceptible bacteria.

Choice B rationale:

The combination of trimethoprim and sulfamethoxazole does not have an additive effect that reduces the dosage and frequency of administration of each drug. Instead, it is prescribed as a fixed combination with specific dosages of each drug.

Choice C rationale:

The combination of trimethoprim and sulfamethoxazole does not have an antagonistic effect that prevents the development of resistance to either drug. In fact, the combination is chosen because it covers a broader spectrum of bacteria and reduces the likelihood of resistance development.

Choice D rationale:

The combination of trimethoprim and sulfamethoxazole does not have a selective effect that targets only the bacteria causing the UTI and spares the normal flora. It affects a wide range of bacteria, including both pathogenic and normal flora.