A nurse is caring for a client who is 24 hr postoperative following a cesarean birth.
Select 1 condition and 1 client finding to fill in each blank in the following sentence.
The client is at risk for developing
The Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"B"}
A. Postpartum hemorrhage is incorrect because the client has scant lochia rubra and a firm fundus at the umbilicus, which indicate normal uterine involution and bleeding.
B. Seizures is correct because the client has signs of severe preeclampsia, such as headache, blurred vision, nausea, hyperreflexia, and clonus. These are indications of increased intracranial pressure and cerebral edema, which can lead to seizures or eclampsia.
C. Hyperglycemia is incorrect because there is no evidence of diabetes mellitus or gestational diabetes in the client's history or findings.
D. Hypoxemia is incorrect because there is no evidence of respiratory distress or impaired gas exchange in the client's history or findings.
E. Infection is incorrect because the client has no signs of infection, such as fever, malaise, foul-smelling lochia, or elevated WBC count.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Incorrect. The nurse should educate the parent on the importance of nebulizer treatments to deliver medications that thin and loosen mucus in the airways.
B. Incorrect. The nurse should advise the parent to contact the provider if the child has a fever, which could indicate an infection or inflammation in the lungs.
C. Correct. The nurse should initiate a request for a high-frequency chest compression vest, which is a device that vibrates the chest wall and helps mobilize mucus from the lungs.
D. Incorrect. The nurse should encourage the parent to support the child's participation in team sports, which can improve lung function and social skills.
Correct Answer is B
Explanation
A. Adjust the crutches for comfort as needed. This is incorrect because the crutches should be adjusted to fit the client's height and arm length, and should not be changed without proper guidance.
B. Use a three-point gait. This is correct because this gait allows the client to avoid putting weight on the affected leg and maintain balance and stability.
C. Wear leather-soled shoes. This is incorrect because leather-soled shoes can be slippery and increase the risk of falls and injuries.
D. Advance the affected leg first when walking upstairs. This is incorrect because the client should advance the unaffected leg first when walking upstairs, and the affected leg first when walking downstairs.
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