A nurse in an ambulatory surgery center is providing discharge teaching to a client who had a dilation and curettage (D&C) following a spontaneous miscarriage.
Which of the following should be included in the teaching?
Vaginal intercourse can be resumed after 2 weeks.
Increased intake of zinc-rich foods is recommended.
Aspirin may be taken for cramps.
Products of conception will be present in vaginal bleeding.
The Correct Answer is A
Choice A rationale
Following a dilation and curettage (D&C) for a spontaneous miscarriage, the uterus needs time to heal. Resuming vaginal intercourse after approximately 2 weeks allows for some initial healing of the uterine lining and helps reduce the risk of infection. Healthcare providers typically advise waiting until bleeding has significantly decreased and discomfort has subsided.
Choice B rationale
While adequate nutrition is important for overall recovery after a miscarriage, there is no specific recommendation to increase the intake of zinc-rich foods in particular. A balanced diet supporting tissue repair is generally advised.
Choice C rationale
Aspirin is a salicylate and has antiplatelet properties. It is generally not recommended for managing cramps after a D&C due to the increased risk of bleeding. Acetaminophen or ibuprofen are typically preferred for pain relief.
Choice D rationale
Following a D&C for a spontaneous miscarriage, the products of conception have been removed from the uterus. While some vaginal bleeding is expected as the uterus heals, it should not contain identifiable fetal or placental tissue. Persistent passage of such tissue could indicate an incomplete evacuation or other complications requiring medical attention. .
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","C","E","F"]
Explanation
Choice A rationale
Hourly monitoring of deep tendon reflexes is crucial in clients receiving magnesium sulfate for severe preeclampsia. Magnesium sulfate acts as a central nervous system depressant, and diminished or absent deep tendon reflexes (normal range: 2+ to 4+) can indicate magnesium toxicity, necessitating immediate intervention to prevent serious complications like respiratory depression.
Choice B rationale
A urinary output of less than 30 mL per hour signals potential renal hypoperfusion, which can be exacerbated by severe preeclampsia and magnesium sulfate administration. Reduced kidney function can lead to the accumulation of magnesium, increasing the risk of toxicity. Prompt notification of the physician allows for timely adjustments in the treatment plan.
Choice C rationale
Calcium gluconate is the antidote for magnesium sulfate overdose. Having it readily available is essential in case the client exhibits signs of magnesium toxicity, such as respiratory depression, severe hypotension, or loss of reflexes. Prompt administration of calcium gluconate can reverse the effects of magnesium and prevent life-threatening complications.
Choice E rationale
Hourly monitoring of intake and output is vital to assess fluid balance and renal function in pregnant clients with severe preeclampsia receiving magnesium sulfate. Accurate measurement helps in detecting oliguria, a sign of worsening preeclampsia or magnesium toxicity, allowing for timely interventions to maintain adequate hydration and prevent complications.
Choice F rationale
Severe preeclampsia significantly impacts both renal and cardiac function due to widespread vasoconstriction and endothelial dysfunction. Close monitoring of these systems through laboratory tests (e.g., serum creatinine, BUN, electrolytes, ECG) and clinical assessments is essential to detect and manage potential complications such as acute kidney injury, heart failure, and arrhythmias.
Correct Answer is ["B","D"]
Explanation
Choice A rationale
Proteinuria, the presence of protein in the urine, is not a typical immediate complication following an amniocentesis. It is more commonly associated with preeclampsia, a condition of pregnancy. While the nurse would monitor the patient's overall condition, proteinuria is not a direct risk related to the amniocentesis procedure itself.
Choice B rationale
Hemorrhage is a potential complication following an amniocentesis. The procedure involves inserting a needle through the abdominal wall and uterus to withdraw amniotic fluid, which carries a risk of bleeding at the insertion site, within the uterus, or even fetomaternal hemorrhage (bleeding from the fetal circulation into the maternal circulation). The nurse must monitor for signs of bleeding, such as increased pain, decreased blood pressure, or vaginal bleeding.
Choice C rationale
Hypoxia, a deficiency in the amount of oxygen reaching the tissues, is not a direct immediate complication of amniocentesis for the mother. While fetal well-being is monitored during and after the procedure, maternal hypoxia is not a typical risk associated with the amniocentesis itself.
Choice D rationale
Infection is a significant potential complication following an amniocentesis. The invasive nature of the procedure creates a risk of introducing bacteria into the amniotic cavity or the maternal tissues. The nurse should observe for signs of infection such as fever, chills, abdominal tenderness, or leakage of fluid from the insertion site.
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