A nurse is caring for a client who has preeclampsia.
Which of the following actions is the nurse’s priority when implementing seizure precautions?

Ensure the call button is within the client’s reach

Place suction equipment at the client’s bedside

Dim the lights in the client’s room

Pad the side rails of the client’s bed

Answer and Explanation

The Correct Answer is B

Choice A rationale: Ensuring the call button is within the client's reach is important for general patient safety and communication, but it is not the highest priority for seizure precautions.

Choice B rationale: Placing suction equipment at the client's bedside is crucial for managing airway secretions during a seizure. Having suction equipment readily available ensures that the client's airway can be cleared promptly, which is vital for maintaining breathing and preventing aspiration.

Choice C rationale: Dimming the lights in the client's room can help reduce stimuli that may trigger seizures, but it is not the most urgent action to take when implementing seizure precautions.

Choice D rationale: Padding the side rails of the client's bed is important to prevent injury during a seizure, but ensuring that suction equipment is available takes priority to maintain airway patency and prevent complications.

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Correct Answer is A

Explanation

Choice A rationale
Hypotension is a known adverse effect of epidural analgesia. The epidural can block sympathetic nerve fibers, which can lead to vasodilation and a drop in blood pressure.
Choice B rationale
A maternal temperature of 37.4 C (99.4 F) is within the normal range and is not typically a cause for concern. While epidural analgesia can potentially cause a slight increase in body temperature, a significant fever is not a common side effect.
Choice C rationale

Polyuria, or excessive urination, is not a typical side effect of epidural analgesia. While the epidural can affect nerve signals to the bladder, it does not typically cause the kidneys to produce more urine.
Choice D rationale
A fetal heart rate of 152/min is within the normal range for a fetus (110-160 beats per minute). While epidural analgesia can potentially affect the baby’s heart rate if it causes significant maternal hypotension, a heart rate of 152/min is not indicative of a problem. CytomegalovirusCytomegalovirus Explore

A. Prepare the patient for a pudendal nerve block B. Apply hydrogel pads to the perineum every 4 hours C. Encourage the patient to apply a warm pack to the perineum for discomfort D. Place a witch hazel pad on the patient’s perineal pad after each voiding

Correct Answer is D

Explanation

Choice A rationale
A pudendal nerve block is not typically used for postpartum perineal pain management. It is more commonly used during labor to relieve pain in the perineum and vagina.
Choice B rationale
While hydrogel pads can provide cooling relief, they are not typically used for third-degree perineal lacerations. These types of lacerations often require more intensive interventions.
Choice C rationale

Applying a warm pack to the perineum can help with discomfort, but it is not the primary intervention for a third-degree perineal laceration.
Choice D rationale
Witch hazel pads are often recommended for postpartum perineal care. They can provide relief from soreness, reduce inflammation, and promote healing.

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A nurse is caring for a client who has preeclampsia. Which of the following actions is the nurse’s priority when implementing seizure precautions?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

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Correct Answer is D

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A nurse is caring for a client who has preeclampsia.
Which of the following actions is the nurse’s priority when implementing seizure precautions?