A child experiencing an allergic reaction receives a prescription for epinephrine 0.01 mg/kg SUBQ.

The child weighs 66 pounds, and the medication is labeled "Epinephrine 1mg/mL.”. How many mL should the practical nurse (PN) administer to this child? (Enter the numerical value only. If rounding is required, round to the nearest tenth.)

Choice A rationale

While postpartum depression is a serious concern, immediately jumping to a question about suicidal thoughts can be alarming and may shut down communication unless other specific warning signs are present. A more gentle and open-ended approach is generally preferred initially to build rapport and gather information.

Choice B rationale

While it is true that many new mothers experience challenges with bonding, simply stating this without further exploration can minimize the client's feelings and prevent her from elaborating. It does not provide an opportunity for the client to express the depth or specifics of her emotional experience.

Choice C rationale

Focusing on the husband's bonding shifts the attention away from the client's expressed feelings and needs. While partner involvement is important, the immediate priority is to address the client's own emotional state and her perceived lack of bonding with her baby.

Choice D rationale

Encouraging the client to talk about her feelings provides an open-ended opportunity for her to express her concerns, explore the contributing factors, and feel heard. This therapeutic communication technique allows the nurse to gather more specific data and assess for potential postpartum mood disorders or other issues, promoting a client-centered approach.

Choice A rationale

Performing deep tendon reflexes every 4 hours is primarily indicated for clients at risk of magnesium sulfate toxicity, not directly for fetal heart rate decelerations after the peak of contractions. These decelerations suggest uteroplacental insufficiency, where oxygen supply to the fetus is compromised, and magnesium sulfate is used for pre-eclampsia.

Choice B rationale

A left side-lying position alleviates compression of the inferior vena cava and aorta by the gravid uterus, thereby improving uteroplacental blood flow and oxygen delivery to the fetus. This physiological change can often resolve late decelerations, which are indicative of uteroplacental insufficiency due to reduced maternal blood flow.

Choice C rationale

Inserting an indwelling urinary catheter to monitor hourly output is essential for assessing fluid balance and renal perfusion, especially in high-risk pregnancies or those receiving intravenous fluids. However, it does not directly address or correct fetal heart rate decelerations caused by uteroplacental insufficiency.

Choice D rationale

Collecting a urine specimen for electrolytes and protein is a diagnostic measure for conditions like pre-eclampsia, which involves proteinuria and electrolyte imbalances. While important for overall maternal assessment, it does not provide an immediate intervention for late fetal heart rate decelerations.