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The nurse reviews the client's laboratory results.

Exhibits

SELECT words from the choices below to fill in each blank in the following sentence.

The nurse should anticipate a provider's prescription for

and .
Answer and Explanation

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

Rationale for correct choices

• oxytocin: The client is term, contracting regularly, and already 3 cm dilated, indicating early active labor progression. Oxytocin may be anticipated to augment labor when contractions are present but not yet efficient. The presence of infection risk (fever, malodorous discharge) also increases the need to progress labor toward delivery.

• nalbuphine: The client reports pain that increases to 8 during contractions, indicating a need for pharmacologic analgesia. Nalbuphine is an opioid analgesic used in labor for moderate to severe pain and is appropriate for intrapartum pain management. It can be anticipated when the client requests stronger pain relief before progression to active labor.

Rationale for incorrect choices

• magnesium sulphate: This medication is used for seizure prophylaxis in preeclampsia or for neuroprotection in preterm labor. The client’s blood pressure is within normal range, and gestation is 38 weeks, so there is no indication for magnesium sulfate.

• misoprostol: Cervical ripening is not required because the cervix is already 3 cm dilated with active contractions. Misoprostol would not be indicated when labor is already progressing, especially in the presence of suspected infection, where accelerating delivery is preferred.

• hydralazine: Hydralazine is an antihypertensive used for severe hypertension in pregnancy. The client’s blood pressure is 128/82 mm Hg, which does not indicate hypertensive management.


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Related Questions

Correct Answer is C

Explanation

A. Arterial blood gases: ABGs assess acid-base balance and respiratory status, which are not directly affected by lithium therapy. They are not required prior to initiating lithium.

B. Total cholesterol: Lithium does not significantly impact lipid metabolism, so baseline cholesterol is not necessary before starting therapy.

C. Thyroid hormones: Lithium can affect thyroid function and may cause hypothyroidism over time. Evaluating baseline thyroid hormone levels prior to therapy helps monitor for potential adverse effects and guides ongoing management.

D. Hemoglobin: Lithium does not directly affect hemoglobin levels, so baseline hemoglobin measurement is not required for safe initiation of therapy.

Correct Answer is B

Explanation

A. Schedule routine oral suctioning: Suctioning can increase intracranial pressure and should be performed only when necessary, using short, gentle passes. Routine suctioning is not recommended for a child with increased ICP, as it can exacerbate neurological injury.

B. Pad the side rails of the bed: An unresponsive child is at high risk for injury from involuntary movements or seizures. Padding the side rails helps prevent trauma and is a key safety intervention in children with increased intracranial pressure, making it the priority action in this scenario.

C. Obtain isolation supplies: Isolation precautions are only needed if the child has a contagious condition. Increased intracranial pressure does not automatically indicate a risk of infection transmission, so isolation supplies are not immediately necessary.

D. Place the child in Trendelenburg position: Trendelenburg positioning (head-down) can further increase intracranial pressure and is contraindicated. Children with elevated ICP should be positioned with the head of the bed elevated to promote venous drainage and reduce pressure.

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