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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?

A.

Vaginal intercourse can be resumed after 2 weeks.

B.

Increased intake of zinc-rich foods is recommended.

C.

Aspirin may be taken for cramps.

D.

Products of conception will be present in vaginal bleeding.

Answer and Explanation

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. .


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Related Questions

Correct Answer is C

Explanation

Choice A rationale

Hyperemesis gravidarum is severe nausea and vomiting during pregnancy, typically occurring in the first trimester. Amniocentesis is a procedure performed later in pregnancy, so hyperemesis is not a direct complication of the procedure.

Choice B rationale

Proteinuria is the presence of protein in the urine, which can be a sign of preeclampsia during pregnancy. While amniocentesis carries a small risk of complications, proteinuria is not a direct expected complication of the procedure itself.

Choice C rationale

Hemorrhage, or excessive bleeding, is a potential complication of amniocentesis because the procedure involves inserting a needle through the abdominal wall and uterus to withdraw amniotic fluid. This can potentially damage blood vessels, leading to bleeding at the insertion site or internally.

Choice D rationale

Hypoxia is a condition in which the body or a region of the body is deprived of adequate oxygen supply at the tissue level. While fetal well-being is monitored during and after amniocentesis, hypoxia is not a direct complication for the mother.

Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A"},"C":{"answers":"B"},"D":{"answers":"A"}}

Explanation

Rationales for Each Condition

Hyperemesis Gravidarum

  1. Weight loss: Excessive vomiting leads to poor nutritional intake and dehydration, causing unintended weight loss. The normal weight gain expected in the first trimester of pregnancy is around 0.5–2 kg. A weight loss of 0.9 kg in two weeks is concerning.
  2. Hypotension: Dehydration due to persistent vomiting causes reduced intravascular volume, leading to low blood pressure. Normal blood pressure ranges from 90/60 mm Hg to 120/80 mm Hg. The client's 96/52 mm Hg value indicates potential volume depletion.
  3. Tachycardia: Fluid loss and electrolyte imbalances increase heart rate as a compensatory mechanism to maintain perfusion. The normal heart rate ranges from 60–100 bpm, and the client's 116 bpm suggests dehydration-related tachycardia.

Cystitis

  1. Dysuria: Inflammation of the bladder due to infection causes pain or burning during urination, a classic symptom of cystitis. The absence of other urinary symptoms, such as urgency or hematuria, helps differentiate cystitis from other conditions.

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