The nurse is caring for a client who is two days post-aortic-iliac bypass surgery. Which assessment finding should be reported to the surgeon immediately?

Choice a reason:
Risperidone is an antipsychotic medication that can help manage both positive symptoms (such as delusions and hallucinations) and negative symptoms (such as apathy and social isolation) of schizophrenia. Monitoring both types of symptoms is essential to evaluate the overall effectiveness of the treatment. Positive symptoms are often more responsive to medication, while negative symptoms can be more challenging to treat and may require a comprehensive approach including psychosocial interventions.

Choice b reason:
Disorganized symptoms, which include disorganized speech and behavior, are another aspect of schizophrenia that can be impacted by risperidone. While these symptoms are not mentioned in the client's current presentation, they are still important to monitor as part of a comprehensive assessment of the client's condition.

Choice c reason:
Negative symptoms like apathy and social isolation can significantly impact a client's quality of life and functional abilities. Risperidone can help improve these symptoms, but they often require longer treatment duration and additional supportive therapies for significant improvement.

Choice d reason:
Positive symptoms such as delusions and hallucinations are critical targets for risperidone treatment. These symptoms can be distressing and disruptive, and their improvement is a key indicator of the medication's effectiveness. Monitoring the reduction or resolution of these symptoms is crucial for assessing the client's response to risperidone.

Choice A reason:
Administering oxygen using a non-rebreather mask is a subsequent step if initial measures do not improve fetal heart rate decelerations. It can help increase the amount of oxygen available to the fetus. Oxygen administration is a supportive measure that can be used if there are signs of fetal distress. In the scenario described, where the fetal heart rate slows after the start of a contraction with the lowest rate occurring after the peak, it suggests late decelerations, which are often associated with uteroplacental insufficiency. Administering oxygen can help increase the fetal oxygen reserve and is a common intervention during labor when there are concerns about fetal well-being.

Choice B reason:
Increasing the rate of maintenance IV infusion is typically considered when there is a concern for maternal hypotension or dehydration, which may not be the immediate cause of the observed fetal heart rate pattern. Increasing the rate of an IV infusion can help improve maternal hydration and blood pressure, which in turn can enhance placental perfusion. However, this intervention is more indirect and may not provide the immediate response needed to address fetal heart rate decelerations. It is typically considered after more direct interventions, such as repositioning the mother, have been attempted.

Choice C reason:
Elevating the client's legs can help improve venous return to the heart, potentially increasing maternal cardiac output and blood flow to the placenta. While this can be beneficial, it is not the primary intervention for late decelerations. Repositioning the mother to improve uteroplacental circulation is generally the first step.
Choice D reason:
Placing the client in the lateral position is often the first action taken when late decelerations are observed. This position helps improve uteroplacental blood flow and can quickly address potential issues related to fetal oxygenation. This position helps to relieve pressure on the inferior vena cava and aorta, which can be compressed by the gravid uterus, especially in the supine position. Relieving this pressure helps to improve uteroplacental circulation and can quickly address the cause of late decelerations, which is often related to compromised blood flow to the placenta.