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Urine dipstick:
pH 6.0 mg/dl. (4.6 to 8 mg/dL)

Specific Gravity 1.022 (1.010 to 1.025)

Leukocyte esterase negative (Negative)

Nitrite negative (Negative)

Protein trace negative (Negative)

Glucose negative (Negative)

Ketones none (None)

Bilirubin none (None)

Blood none (None)

Which of the following statements should the nurse include in the client's teaching?

Select all that apply.

“Try using an abdominal support belt."

"Take hot showers to help relieve itching

"Wear loose-fitting clothing

“Wear fat or low-heeled shoes"

"You can douche bwice weekly."

“Eat two large meals a day”

"You should avoid fried foods

Answer and Explanation

Correct Answer : C,D,G

Based on the provided information, the nurse should include the following statements in the client's teaching:

C. "Wear loose-fitting clothing": This is because the specific gravity of the urine is slightly elevated (1.022), which may indicate mild dehydration. Loose-fitting clothing can help promote comfort and ventilation, especially in cases of dehydration.

D. "Wear flat or low-heeled shoes": There is no specific indication related to the urine dipstick results, but it is generally good advice for maintaining proper foot health and preventing strain on the feet and ankles.

G. "You should avoid fried foods": There are no specific indications related to the urine dipstick results, but a healthy diet is always beneficial for overall well-being. Avoiding fried foods can be a part of a balanced diet and promote better health.

The following statements should not be included in the client's teaching based on the provided urine dipstick results:

A. "Try using an abdominal support belt": There is no indication related to the urine dipstick results that suggests the need for an abdominal support belt.

B. "Take hot showers to help relieve itching": Itching is not mentioned in the urine dipstick results, so there is no specific indication to recommend hot showers for this purpose.

E. "You can douche twice weekly": Douche is not related to urine dipstick results, and douching is generally not recommended as it can disrupt the natural balance of vaginal flora and may cause more harm than good.

F. "Eat two large meals a day": There is no indication related to the urine dipstick results that suggests a specific meal plan, and eating two large meals a day may not be suitable for everyone's dietary needs.

It's important for the nurse to provide teaching based on the client's specific needs and health conditions. In this case, the nurse can focus on maintaining hydration (based on the specific gravity result) and promoting a balanced diet and healthy lifestyle. Always individualize teaching based on the client's health status and any specific concerns they may have.

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Correct Answer is A

Explanation

A. Correct. At 12 weeks of gestation, the nurse should position the ultrasound stethoscope above the symphysis pubis to assess the fetal heart rate.
B. Fundal height measurement is used to assess uterine growth and is not applicable for assessing fetal heart rate.
C. Placing the client in a side-lying position is not necessary for assessing fetal heart rate at 12 weeks of gestation.
D. Leopold maneuvers are used to determine fetal position and lie and are not directly related to auscultating the fetal heart rate.

A. A client who is scheduled for a procedure in 1 hr B. A client who received a pain medication 30 min ago for postoperative pain C. A client who has 100 mL of fluid remaining in his IV bag D. A client who was just given a glass of orange juice for a low blood glucose level

Correct Answer is D

Explanation

A. A client who is scheduled for a procedure in 1 hr is not in immediate danger and can be assessed later.

A client who received a pain medication 30 min ago for postoperative pain may not need immediate assessment, unless there are signs of increased pain or other complications. The nurse can document the medication administration and observe the client’s response.
A client who has 100 mL of fluid remaining in his IV bag may not need immediate assessment, unless there are signs of fluid overload or electrolyte imbalance. The nurse can monitor the client’s fluid intake and output, weight, blood pressure, pulse, temperature, and laboratory values.
A client who was just given a glass of orange juice for a low blood glucose level need immediate assessment to reassess for persistent hypoglycemia

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