A nurse is caring for a client.
Complete the following sentence by using the lists of options.
The client is at risk of developing
The Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"C"}
The client has dark red vaginal bleeding and low hemoglobin (8.1 g/dL) and hematocrit (24%), which indicate significant blood loss.
The low blood pressure (95/62 mm Hg) and tachycardia (104 bpm) are signs of the body's response to blood loss, which can lead to hypovolemic shock.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Apply a transparent dressing to the wound: Incorrect. Transparent dressings are not appropriate for controlling active bleeding.
B. Tie a tourniquet around the leg distal to the wound: Incorrect. A tourniquet should only be used as a last resort if direct pressure fails to control the bleeding.
C. Apply direct pressure to the wound with thick dressing material: Direct pressure is the first-line intervention to control bleeding and promote hemostasis.
D. Irrigate the wound with sterile water: Incorrect. Irrigation is not the priority in an actively bleeding wound; controlling the bleeding is more critical.
Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"A"}
Explanation
Bowel perforation is a serious complication that can occur as a result of necrotizing enterocolitis (NEC), which is a condition often seen in preterm infants. In NEC, the intestines become inflamed and can eventually rupture, leading to bowel perforation. The neonate's symptoms, including abdominal distention, firm abdomen, decreased bowel sounds, and a small amount of blood in the stool, are consistent with NEC. The abdominal x-ray showing marked distention of the intestine further supports this diagnosis.
Necrotizing enterocolitis (NEC) is a common and life-threatening condition in preterm infants (like this neonate born at 34 weeks gestation), particularly those receiving enteral feedings. It can lead to bowel perforation, sepsis, and other serious complications.
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