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The nurse is continuing to care for the client.

Exhibits

Complete the following sentence by using the list of options

The provider has admitted the client to the inpatient obstetric unit and written prescriptions based on the client's condition.

The action the nurse should take first is

followed by .
Answer and Explanation

The Correct Answer is {"dropdown-group-1":"C","dropdown-group-2":"B"}

Rationale for Correct Choices:

  • Evaluating the fetal heart rate tracing: The client’s report of decreased fetal movement and severe hypertension raises concern for fetal compromise. Immediate fetal assessment ensures the fetus is tolerating the intrauterine environment, especially before administering medications like magnesium sulfate.
  • Administering magnesium sulfate IV: This is prescribed to prevent eclampsia, given the client’s severely elevated BP, hyperreflexia, and proteinuria. After confirming fetal status, seizure prophylaxis should be initiated without delay.

Rationale for Incorrect Choices:

  • Administering acetaminophen PO: Although ordered for headache, the symptom is a manifestation of severe preeclampsia. Treating it symptomatically without addressing its cause could delay necessary critical interventions.
  • Obtaining a 24-hour urine collection: Useful for confirming the extent of proteinuria, but not immediately necessary for clinical decision-making given existing positive findings.
  • Inserting an indwelling urinary catheter: This supports fluid monitoring during magnesium therapy, but fetal assessment and seizure prevention take precedence.
  • Administering betamethasone IM: Important for fetal lung development in preterm pregnancies, but it is not the immediate priority when there is a high risk for seizure or fetal distress.


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Related Questions

Correct Answer is {"A":{"answers":"A"},"B":{"answers":"B"},"C":{"answers":"A"},"D":{"answers":"B"},"E":{"answers":"A"}}

Explanation

Rationale:

  • Encourage the client to discuss their feelings: Encouraging emotional expression is a key therapeutic approach in managing bulimia nervosa. It allows the client to explore underlying psychological issues, such as anxiety and fear of weight gain, which often contribute to disordered eating behaviors.
  • Provide a reduced sodium diet: Sodium restriction is not indicated in this client. In fact, the client has a slightly low sodium level (134 mEq/L), and further restriction could worsen electrolyte imbalances, which are already contributing to cardiac instability.
  • Request a prescription for fluoxetine: Fluoxetine, an SSRI, is approved for the treatment of bulimia nervosa and can reduce the frequency of binge-purge episodes. It is also effective in treating coexisting anxiety or depressive symptoms, which are common in this population.
  • Request a prescription for bupropion: Bupropion is contraindicated in clients with eating disorders due to its seizure risk. In clients with bulimia, frequent vomiting and low electrolytes increase this risk significantly, making bupropion an inappropriate choice.
  • Monitor daily intake and output: Monitoring intake and output helps evaluate hydration status and kidney function, both of which may be compromised due to chronic purging. It also helps track nutritional rehabilitation and prevent complications from electrolyte shifts.

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.

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