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A nurse is caring for a client who is at 36 weeks of gestation.

Exhibits

For each day 2 finding, click to specify whether the finding indicates that the client's condition has improved, has not changed, or has declined.

A.

Liver function tests

B.

Edema

C.

Fetal heart rate and variability

D.

Headache

E.

Epigastric discomfort

F.

Urine dipstick

Answer and Explanation

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

  • Liver Function Tests: Improved
    The significant decrease in AST, ALT, ALP, and bilirubin levels indicates improved liver function.

  • Edema: Improved
    The reduction from +3 to +2 edema in the lower extremities shows a decrease in swelling, indicating improvement.

  • Fetal Heart Rate and Variability: Declined
    The decrease in FHR with minimal variability and no accelerations suggests a decline in fetal status.

  • Headache: Improved
    The reduction in headache pain from a score of 8 to 2 indicates improvement.

  • Epigastric Discomfort: Improved
    The absence of epigastric pain on Day 2 suggests improvement.

  • Urine Dipstick: Not Changed
    The protein levels in the urine remained at 2+ on both days, indicating no change in kidney function.


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Related Questions

Correct Answer is ["6"]

Explanation

The Apgar score is 6.

It is based on 5 signs evaluated at 1 and 5 minutes after delivery that indicate the physiologic state of the neonate: heart rate over 100 = 2; slow, weak cry = 1; some flexion of extremities = 1; grimace in response to suctioning of the nares = 1; body pink in color with blue extremities = 1.

Total score= 6

Correct Answer is B

Explanation

Rationale:

A. Obtain a type and crossmatch: While obtaining a type and crossmatch may be necessary in the event of significant hemorrhage, the first action should be to address the potential cause of hypotension, which could be uterine atony.

B. Evaluate the firmness of the uterus: Postpartum hypotension is often caused by uterine atony, so the first action should be to assess the firmness of the uterus and massage it to stimulate contraction if necessary.

C. Administer oxytocin infusion: Oxytocin infusion may be necessary to help contract the uterus and control bleeding, but it should be implemented after assessing uterine firmness.

D. Initiate oxygen therapy by nonrebreather mask: While oxygen therapy may be needed if the client is hypotensive due to hemorrhage, assessing uterine firmness is the priority action to address the potential cause of hypotension.

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