When developing the plan of care for a woman who has had an abdominal hysterectomy, the nurse would identify which action as contraindicated?

encouraging range-of-motion exercises

ambulating the client

applying elasticized stockings

massaging the client's legs

Answer and Explanation

The Correct Answer is C

A. Encouraging range-of-motion exercises: Range-of-motion exercises are generally encouraged post-hysterectomy to prevent complications such as blood clots and promote circulation. This action is appropriate and not contraindicated.

B. Ambulating the client: Ambulation is an essential aspect of postoperative care to prevent complications like atelectasis, pneumonia, and deep vein thrombosis (DVT). This action helps improve circulation and aids in the recovery process. It is appropriate and not contraindicated.

C. Applying elasticized stockings: Elasticized stockings, also known as compression stockings, are commonly used postoperatively to prevent deep vein thrombosis (DVT) by promoting blood flow in the legs. However, in the case of abdominal hysterectomy, if the incision site is below the level of the stockings, they may impede circulation to the surgical site and hinder wound healing. Therefore, this action may be contraindicated depending on the specific circumstances of the surgery and incision site.

D. Massaging the client's legs: Massaging the client's legs is generally not recommended post-hysterectomy, especially in the immediate postoperative period. Manipulating the legs could potentially disrupt healing tissues, increase the risk of bleeding, or cause discomfort to the client. Therefore, this action may be contraindicated.

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Correct Answer is D

Explanation

A. Stability of the woman's emotional and psychological status:

Emotional and psychological well-being are undoubtedly important factors in pregnancy outcomes. However, in the context of gestational diabetes, while stress and psychological factors can influence overall health, including blood sugar levels, they are not the primary focus when discussing reducing complications associated with diabetes during pregnancy. While managing stress and promoting emotional stability are important aspects of prenatal care, they are not directly related to reducing complications specifically associated with gestational diabetes.

B. Reduction in retinopathy risk by frequent ophthalmologic evaluations:

Diabetic retinopathy is a complication of diabetes that affects the eyes and can lead to vision impairment or blindness if left untreated. While regular ophthalmologic evaluations are crucial for individuals with diabetes to monitor for retinopathy and other eye complications, this factor is not the most important in reducing complications associated with pregnancy and diabetes. Gestational diabetes primarily affects pregnancy outcomes, and while retinopathy risk is a concern in the long term for individuals with diabetes, it is not the primary focus during pregnancy.

C. Control of blood urea nitrogen (BUN) levels for optimal kidney function:

Blood urea nitrogen (BUN) levels are markers of kidney function, and kidney complications can be a concern in individuals with diabetes, including gestational diabetes. However, during pregnancy, the focus is primarily on controlling blood glucose levels to reduce complications associated with gestational diabetes. While kidney function is important and should be monitored in pregnant women with gestational diabetes, it is not the most crucial factor in reducing complications specifically related to pregnancy and diabetes.

D. Degree of blood glucose control achieved during the pregnancy:

This is the most important factor in reducing complications associated with pregnancy and gestational diabetes. Controlling blood glucose levels is paramount in managing gestational diabetes to reduce the risk of complications for both the mother and the baby. Tight glycemic control helps to minimize the risk of adverse outcomes such as macrosomia, birth trauma, preterm birth, and other complications associated with uncontrolled blood sugar levels during pregnancy.

A. oligohydramnios B. preeclampsia C. chorioamnionitis D. post-term labor

Correct Answer is B

Explanation

A. Oligohydramnios:

Oligohydramnios refers to a condition where there is too little amniotic fluid surrounding the fetus in the womb. It can be concerning because amniotic fluid plays a crucial role in protecting and cushioning the fetus, aiding in lung development, and preventing compression of the umbilical cord. While oligohydramnios can be a complication in pregnancy, it's not necessarily more common or specific to twin pregnancies compared to singleton pregnancies.

B. Preeclampsia:

Preeclampsia is a serious pregnancy complication characterized by high blood pressure and signs of damage to other organ systems, such as the liver and kidneys. It usually develops after 20 weeks of pregnancy and can lead to serious complications for both the mother and the babies if not managed properly. Multiple pregnancies, including twins, are considered a risk factor for developing preeclampsia. Therefore, pregnant women carrying twins require close monitoring for signs and symptoms of preeclampsia.

C. Chorioamnionitis:

Chorioamnionitis is an infection of the fetal membranes (chorion and amnion) and amniotic fluid. It typically occurs due to bacterial infection ascending from the vagina into the uterus, often during prolonged labor or rupture of membranes. While chorioamnionitis is a concern in pregnancy, it's not necessarily more common in twin pregnancies compared to singleton pregnancies.

D. Post-term labor:

Post-term labor refers to labor that begins after 42 weeks of gestation. Prolonged pregnancy beyond the due date can increase the risks of complications for both the mother and the baby, including fetal distress, macrosomia (large birth weight), and meconium aspiration. Post-term labor can occur in both singleton and multiple pregnancies, but it's not specifically more associated with twin pregnancies.

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When developing the plan of care for a woman who has had an abdominal hysterectomy, the nurse would identify which action as contraindicated?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is B

Explanation

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