The nurse continues to care for the client.
Which of the following actions should the nurse take? Select all that apply.
Vaginal culture
Obtain provider prescription for antibiotics
Ibuprofen 600 mg every 6 hr for mild to moderate pain
Obtain provider prescription for phenazopyridine
Urine culture
Correct Answer : B,D,E
A. The client’s symptoms (burning with urination, pain) and urinalysis findings are indicative of a urinary tract infection (UTI), which is typically caused by bacteria in the urinary tract. There are no clear indications of a vaginal infection (e.g., discharge, odor, or other symptoms specific to vaginal infections), so a vaginal culture is not needed for this clinical scenario.
B. The client’s symptoms and laboratory results (positive leukocyte esterase, WBC casts, cloudy urine) strongly suggest a UTI, and the elevated WBC count further confirms infection. Antibiotics are the primary treatment for a urinary tract infection. For pregnant clients, it is crucial to select antibiotics that are safe in pregnancy, as untreated UTIs can lead to preterm labor, kidney infections (pyelonephritis), and fetal complications.
C. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that is generally contraindicated during pregnancy, especially in the third trimester, due to its potential for causing premature closure of the ductus arteriosus, renal complications, and increased bleeding risk. Alternative pain management strategies should be used in pregnancy.
D. Phenazopyridine is a urinary analgesic that can be used to relieve the pain, burning, and discomfort associated with UTIs. However, it is generally not recommended during pregnancy, especially in the first trimester, and should only be used in pregnancy if prescribed by a healthcare provider. There are potential concerns with the safety of phenazopyridine in pregnancy, and it should not be administered without a provider's approval.
E. A urine culture is a diagnostic test that can confirm the presence of a urinary tract infection and
identify the specific bacteria responsible for the infection. Given the client’s symptoms and positive findings on urinalysis, a urine culture should be obtained to help guide the choice of appropriate antibiotics. This will help ensure the effective treatment of the infection and prevent complications.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is {"dropdown-group-1":"C","dropdown-group-2":"D"}
Explanation
The client is at risk for developing transient tachypnea of the newborn andhypoglycemia.
Rationale
Target 1: Transient Tachypnea of the Newborn (TTN)
- Transient tachypnea of the newborn (TTN) is a condition characterized by rapid breathing (tachypnea) in the first few hours after birth, typically caused by delayed clearance of fetal lung fluid. It often resolves within 24-48 hours.
- The newborn in the exhibit has a respiratory rate that is increasing: at 64 minutes, the rate is 68/min, and it increases to 76/min by 0700. This is significantly higher than the normal respiratory rate for a newborn (30-60/min) and is a key sign of tachypnea.
- Given the increased respiratory rate and the newborn’s age, transient tachypnea of the newborn is a likely concern. This condition is particularly common in late preterm and full-term infants who experience some delay in clearing fetal lung fluid after birth.
Target 2: Hypoglycemia
- Hypoglycemia in newborns can occur due to several factors, such as increased metabolic demand (which could be indicated by the tachycardia and respiratory rate), poor feeding, or stress during delivery.
- Tachycardia is one of the early signs of hypoglycemia in newborns, as the body responds to low blood sugar by increasing the heart rate to compensate for the lack of energy.
- The heart rate is consistently high, with values of 154/min and 156/min during the assessment. This tachycardia could be indicative of hypoglycemia, as the body works harder to compensate for low glucose levels.
Rationale for other conditions;
Bronchopulmonary Syndrome:
This condition refers to lung diseases like bronchopulmonary dysplasia (BPD), which typically occurs in premature infants who have had prolonged mechanical ventilation. There are no signs of this condition in the current assessment, such as the need for respiratory support or signs of chronic lung disease.
The newborn's respiratory rate and tachycardia are more consistent with transient tachypnea rather than a chronic condition like bronchopulmonary syndrome.
Tachycardia:
Tachycardia itself is a symptom, not a diagnosis. The infant's tachycardia could be a response to hypoxia or hypoglycemia, so the condition causing the tachycardia needs to be addressed (which is hypoglycemia and transient tachypnea of the newborn).
Correct Answer is C
Explanation
A. Fidelity refers to being loyal, faithful, and keeping promises, which does not directly apply to this situation.
B. Autonomy refers to respecting a person's right to make their own decisions, which is not the focus here.
C. Beneficence refers to promoting the well-being of others, and in this situation, the nurse is demonstrating care by providing comfort to the grieving client.
D. Veracity refers to telling the truth, which is not the focus of the nurse's actions in this case.
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